Embrace the pain… or the pain relief?

Does pain relief help you enjoy giving birth or is a drug-free labour the ultimate experience? We hear both sides

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The “pain is a natural part of childbirth” approach to labour and birth

Adela Stockton is a doula (a woman who helps a mum-to-be in labour), childbirth homeopath and former midwife who believes in natural, drug-free childbirth. She has a 6-year-old daughter.

“I feel passionately about ‘normal’ birth, because I believe it carries long-term benefits for mum and baby’s physical and mental health. By ‘normal,’ I mean a medication-free labour that begins in its own time, proceeds with no interventional pain relief and ends with a gentle birth of baby and placenta.

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“Labour pain is a normal, integral part of the birthing process. It’s there for a reason, indicating good progress and that the mum is closer to meeting her baby. Why would we treat it with pain relief drugs like a disease? And what of the baby?

“Pain relief, such as pethidine, leaves a woman disoriented, nauseous and sleepy. It also depresses the baby’s respiratory system and sucking reflex, so he can be slow to breathe and establish breastfeeding.

“While removing the sensation of contractions at least partially, if not completely, an epidural slows labour due to numb pelvic floor muscles that would otherwise help the baby to be born. In turn, this increases the risk of a forceps or caesarean birth.

“If a woman in labour needs to shout or moan to help her through contractions, and the noise she’s making causes discomfort to those around her, for whose benefit is interventional pain management offered? Removing or displacing the pain of labour can set off a cascade of intervention: the mum-to-be loses her confidence to embrace the birthing process and, ultimately, her power to give birth normally.

“I believe that many more women could enjoy a gentle birth with no interventional pain relief if they had the right information and support. They need encouragement to build confidence in their innate ability to give birth.

“Non-interventional pain management such as breathing and body awareness, water, change of position, movement or massage all help mums-to-be work with pain.

“Homeopathy and certain essential oils can also be useful, especially when it comes to alleviating fear. Yet all a mum-to-be sometimes needs is a calm, trusted attendant to ‘be’ with her and to keep fear out of the birthing room. If she feels safe and unobserved, she’s more likely to remain conscious of the process and know instinctively how to give birth to her baby safely and gently.

“Her body will naturally produce endorphins (natural pain killers), which increase as labour strengthens and flood her system to create a sense of euphoria in the first moments, even days, following a non-medicated birth. Her baby will be born alert and well, instinctively ready to nuzzle and feed.

“The memory of childbirth stays with us for life. Many who don’t have a gentle birth first time strive for it the second or third time round. Their subsequent sense of empowerment and achievement can go a long way towards healing the emotional pain of a medicalised or traumatic previous birth experience.”

To find out more, see Positive Pain: a guide to emotional wellbeing through pregnancy and birth, by Adela Stockton.

The “pain relief is a step forward” approach to labour and birth

Parenting author Lucy Atkins is mum to three children aged 7, 5 and 2. Having given birth every which way, she sees pain relief as a welcome advancement in modern childbirth.

“What is it with women and pain relief? When I tell other women I gave birth to my second baby in hospital without drugs, they often react as if I’ve done something heroic, if slightly mad.

“When I say I gave birth the first time around using virtually every intervention and form of pain relief known to modern obstetrics, including an emergency caesarean, they look disappointed. Then, when I thrown in that I had my third baby on the living room floor, using gas and air as pain relief, the confusing picture is complete.

“What should I be filed under? Am I a nutty, home-birthing earth mother who smugly eschews drugs and gnaws through her baby’s umbilical cord unaided? Or a selfish, lily-livered poshy who can’t take a bit of pain for the sake of her unborn child?

“Women often ask what to expect in childbirth. There’s only one clear answer to this: the unexpected. No one really knows how a birth will go until it’s over. This is the one reason why I believe that no one has the right to tell any woman how much, or how little pain relief she ‘should’ or ‘shouldn’t’ have in childbirth. Or to judge her for it afterwards.

“And Lordy, do we judge. Take our ‘celebrity’ mums. TV presenter Davina McCall is widely seen as an outstanding earth mother because she’s had three home births. But Victoria Beckham is the self-obsessed control freak, ‘too posh to push’ (three caesareans and counting).

“Of course, these births were, no doubt, partly down to personality and inclination – but also to biological chance. Davina could plan a meds-free home birth till the cows came home, but if her placenta had come away from the womb wall, she’d have ended up full of analgesia with the best of us.

“The ‘pain relief police’ don’t recognise this sort of thing. You’ve probably met them: the evangelical women who hang around mummy gatherings and bang on about the selfish evils of epidurals. They suggest that if you do birth ‘right’ you won’t need drugs; that ‘caving in’ to an epidural is weak. This is claptrap. Yes, the pain of an uncomplicated and healthy birth can be manageable. One of mine was. But one woman’s ‘manageable’ is another’s living nightmare.

“What’s more, these days more than half of all births involve medical intervention such as ventouse (suction to help the baby come out), forceps (tongs) or caesarean. A birthing woman can’t change the system. But she can make choices to help her cope with it. I, for one, would require drugs if someone was sticking tongs up my vagina.

“There are, of course, things you can do to boost your chances of an uncomplicated birth. But ultimately you can’t completely control your baby, your body or the medical system. This is why it’s madness these days to tell a woman in labour she ‘should’ or ‘shouldn’t’ have epidurals, gas and air, pethidine or any other pain relief.

“There are certain downsides to some forms of analgesia in labour. But there are massive downsides to huge, unbearable and traumatising pain (such as postnatal depression and post-traumatic stress disorder for starters). Effective pain relief can be an extraordinarily positive thing in labour. And whether your chosen method involves an intravenous analgesic or a troupe of nuns singing Land Of Hope And Glory as you push, who cares? What matters most is that you cope brilliantly. This way, you’ll be free to get on with the really tough job: motherhood.”

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To find out more, read The First-Time Parent by Lucy Atkins (Collins).

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