Drug-free pain relief in labour

HYPNOTHERAPY

How hypnotherapy works as pain relief

Hypnotherapy is a form of self-hypnosis that enables you to ‘tune out’ other distractions and focus on positive supporting drives within you. This enables you to get rid of fear, tension and pain and replace them with relaxed concentration.

It’s based on the accepted notion that if you go into birth feeling frightened, your system will respond accordingly. The fear will lead to increased levels of adrenaline in your body, which causes increased tension in your muscles and your cervix. Fewer ‘contraction’ hormones are then produced, so your uterus has to work much harder to flex and tighten. This subsequently makes contractions far more painful.

Hypnotherapy doesn’t rely on forces imposed from outside, like stage hypnotism, but on your own resources. This is why women usually have classes beforehand, where you learn visualisation and breathing techniques. These are sometimes done with the birthing partner.

How effective is hypnotherapy?

Hypnotherapy can work very well, simply by enabling you to feel relaxed. It doesn’t promise you a pain-free labour or perfect birth, but it can make the experience a very positive one by enabling you to remain in control and free from fear.

HypnoBirthing is based on the work of Dr Grantly Dick-Read who wrote Childbirth Without Fear. He believed that it’s fear and tension that cause pain for 95% of labouring women. If he’s right, then taking these away would drastically reduce, if not eliminate, pain.

Hypnobirthing classes, usually undertaken in mid to late pregnancy, enable you to learn techniques that you can practise at home and implement easily in labour.

The advantages of hypnotherapy

*You’re totally in control, as hypnotherapy techniques cannot override your own natural instincts.
*You can call on it whenever you want, from pre-labour through to the delivery of the placenta.
*Its effects stop as soon as you no longer need it.
*You can use it later in life – when you need to calm down after your toddler has driven you mad, when you have no time for a nap but need to deeply relax, even to overcome bad habits if they develop.

The disadvantages of hypnotherapy

*You’ll probably have to pay for the lessons.

Further info

*www.natalhypnotherapy.co.uk
*www.hypnobirthing.co.uk

WATERBIRTH

How waterbirthing works as pain relief

Tense muscles stop your body from releasing endorphins, the body’s natural painkiller, so the ability to relax the muscles is important in labour. Just as a warm bath can help you to relax on a normal day, so being in water during labour can help you not tense up as the pain hits. This relaxation enables you to ‘pace yourself’ so you can conserve your energy for when you really need it

How effective is a waterbirth?

No one would claim that it overcomes all the pain. But it definitely takes the edge off and for many women that’s enough. Others will still use breathing techniques or even gas and air in the water.

Some women choose to labour in water and then get out for the actual birth, though many end up staying put as they find they’re so comfortable in the water.

The advantages of a waterbirth

*Labour is usually shorter
*The buoyancy of the water enables you to be more flexible so can adopt different positions more easily.
*There’s less, if any, need for other pain relief.
*The environment is often more relaxed and less clinical in a room with a pool and you may find that you have one-to-one care from the midwife
*There’s less trauma to the perineum (the area between the vagina and the back passage).
*The intervention rate is extremely low.
*Your baby’s heart rate can still be monitored intermittently using a hand-held, waterproof Doppler.
*You can still use gas and air in the pool.
*It helps relieve backache, which is good if you’ve suffered from this a lot in pregnancy.
*If you’re having a home birth - and especially if you deliver the placenta in water - it’s a lot less messy, as you just drain the contents of the pool down the toilet!

The disadvantages of a waterbirth

*Some maternity units don’t have birthing pools, or only have one so if someone’s using it you can’t.
*If you want to use one at home, you need to pay to hire it or purchase one.

For more info

*www.activebirthcentre.com
*www.thegoodbirth.co.uk

MASSAGE

How massage works as pain relief

For most people, touching and being touched is comforting and that’s essentially why massage is so soothing when you’re in labour.

Touch makes us feel nurtured and cared for which, in turn, helps us to feel at ease. Tense muscles stop your body from releasing its natural painkillers (endorphins), so the ability to relax the muscles is important in labour. There’s also a suggestion that picturing your birth partner’s hand massaging you as he or she does it helps your body release oxytocin, which keeps the contractions coming.

How effective is massage?

One study showed that women who were massaged during labour were less anxious, experienced less pain, had shorter labours and were less likely to suffer from postnatal depression than those who hadn’t used massage. Research also shows that even touch - such as stroking your brow, patting and handholding - improves your ability to cope.

Relatively little research has been done on the effectiveness of massage in labour, compared with medical pain relief techniques, but many women do find it helps a lot. Still, a lot of women who love the idea of being massaged don’t like to be touched when they’re having a contraction – probably because it’s distracting or too stimulating. But once a contraction has passed, they can enjoy the soothing touch again – your partner needs to understand that!

The advantages of massage in labour

*It’s completely non-intrusive.
*You’re pretty much in control, as you can tell your birth partner what helps or doesn’t.
*If you both go to classes, you can learn baby massage too, which helps to settle and soothe very young babies.
*You can get your partner practising in pregnancy. For instance, ask him to stroke your shoulders and back while you sit leaning over a chair or kneel leaning forward into some pillows. Then in labour, get him to slowly stroke your shoulders, which can help you to breathe slowly and rhythmically, keeping you relaxed.

The disadvantages of massage in labour

*The only possible danger is using oils that your skin is allergic to or that aren’t suitable for labour, as some could have adverse effects on you. But you can check this out in pregnancy with an aromatherapist or maybe you midwife, is they are qualified in massage and aromatherapy.

TENS MACHINE

How does TENS work as pain relief?

TENS stands for Transcutaneous Electrical Nerve Stimulation. It’s a small battery-operated stimulator that transmits gentle electrical impulses through your skin, via four self-adhesive pads positioned on your back. These impulses stimulate your body to release endorphins, its own natural painkillers. By stimulating the nerves, pain signals are blocked before they reach the brain.

How effective is TENS?
Research shows that TENS machines are most effective when they’re introduced in early labour. They enable you to stay mobile, which helps the baby’s head to move lower, and encourages contractions.

The advantages of TENS

*You can play about with it in labour (best to get one around week 37), and work out where to put the pads and how to operate the controls, so you’re confident what you will get out of it in labour.
*There’s a hand-held control box that puts you in control of the intensity of the impulses throughout labour.
*It doesn’t affect your baby in any way.
*You’re mobile throughout labour so it’s less likely your baby will get ‘stuck’.
*It’s a tried and trusted pain relief concept – first recorded by a Roman physician about 2,000 years ago!

The disadvantages of TENS

*Not all NHS facilities have TENS machines, so you might have to hire a machine and if you want it in plenty of time you’ll be paying for it while you’re not using it.
*Having to control it can act as a distraction – you’re less able to focus inwardly, as you need to if you’re also practising hypnotherapy, for example.
*It isn’t suitable for women with epilepsy or heart pacemakers.
*You can’t use a bath or birthing pool as well.

Find out everything you need to know about childbirth in Practical Parenting magazine, out every month.