Labor Pain Management: What You Should Know
Over the course of pregnancy, women experience different fears and concerns. And, by the end of pregnancy, labor and pain seem to go hand in hand. For this reason, women become afraid of pain and possible complications. Even though our ancestors gave birth to us and, therefore, here we are, labor pain seems to be something inevitable.
It doesn’t mean that we shouldn’t take advantage of the advances in medicine, which have changed the way we give birth. However, you shouldn’t forget that every woman is capable of giving birth.
Pain management techniques were developed to relieve pain, and not to contribute to the medicalization of labor. Remember that women have the ability to give birth here and now, or in the middle of the jungle millions of years ago.
Probably, the most famous technique is the epidural shot, which has changed the history of labor. Even though it reduces pain during labor, dilation and expulsion, it’s important to remember that it doesn’t eliminate it.
In fact, women should be able to feel the contractions in a tolerable way. When this doesn’t happen, doctors tend to use instruments to assist the delivery (forceps, vacuums, etc.).
It’s important to eliminate the belief that because of the epidural, you won’t feel pain. On the other hand, you shouldn’t think that giving birth is the most painful thing in the world. Every woman has a different body. In fact, each woman has a different experience every time they give birth. So, remember: this moment will be only yours.
During dilation and expulsion, you’ll have many choices. These choice can be pharmacological and non-pharmacological.
Labor pain management: non-pharmacological measures
- Relaxation and breathing techniques. You should be in a quiet environment. In addition, it would be very good to always be with the same midwife. This way, you’ll feel confident and in a safe, intimate and comfortable environment. Forget about hospitals’ old habits of people coming and going from the delivery room, when changing shifts. Remember that they should always ask for your permission and introduce themselves.
- Immersion in water. Certain hospitals have birth baths. According to several studies, immersion in water during dilation reduces contraction pain, benefits dilation and reduces tearing. However, not many hospitals have birth baths, and not many professionals know how to assist water births.
- Freedom of movement. It’s important that you’ll be able to move freely, in order to find the position you like the most. You can use the Pilates ball to move your pelvis or any other instrument that will also help the baby. Many times, the need for fetal monitoring or medication interferes with your freedom of movement.
- Massages, aromatherapy, hypnosis, music therapy, TENS (transcutaneous electrical nerve stimulation), heat and cold. You should do anything you think is helpful.
Pharmacological measures
- Neuraxial block. Epidural and spinal block (or combined). The epidural shot was created in 1921. It consists of introducing local anesthesia in the epidural area, which blocks the terminal nerves from the bone marrow. Then, they perform a lumbar puncture to place a catheter, which maintains the perfusion until the end of the delivery. Thus, remember that the epidural lasts until the end. It takes around 20 minutes to cause an effect. The walking epidural is a good choice because it reduces pain, but you can still move and walk freely. Notwithstanding, the epidural shot may have some side effects, such as hypotension, backache, itching, headache and, exceptionally, nerve damage, breathing problems and death. This is why you have to sign an informed consent form before getting it.
- Peripheral nerves block. Paracervical and pudendal. Paracervical block is only used during the first stages of dilation. It has a quick effect, but it has more chances of causing side effects. On the other hand, doctors use the pudendal block during expulsion, when they use instruments to assist the delivery, when they perform an episiotomy, or as a contribution to the epidural.
More pharmacological measures
- Nitrous oxide. The gas is inhaled and has a quick effect (50 seconds). It can be used at any stage of labor and it doesn’t affect the baby. Furthermore, its effectiveness depends on each person. It can cause nausea and sickness. However, these symptoms disappear once you stop using it.
In conclusion, the most important thing is to be aware of all the options available wherever you choose to give birth. Besides, you should be open to every possibility. Sometimes, you can change your mind during the process, and it can be frustrating. Therefore, you should know all the options and decide along the way.
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- Ortiz-Gómez JR, Palacio-Abizanda FJ, Fornet-Ruiz I. (2014). Técnicas analgésicas para el parto: alternativas en caso de fallo de la epidural. SCIELO. 2014 Dic; 37(3).