You’re 37 weeks pregnant and you can no longer ignore the dread that accompanies the excitement of your nearing due date. What is causing this anxiety? Perhaps you have experienced labor and delivery before, and you are nervous about going through it again. Perhaps this is your first time and you aren’t quite sure what to expect, but you know it is supposed to be painful.
Pain is a natural part of delivering a baby into the world. How do we cope with the pain of labor?
Pain management in labor can be medicated or unmedicated. There are several physiological and medical ways to cope with labor pain. You can use as many or as few coping strategies as you like. When using some medicated pain management your mobility may be limited.
A medicated or unmedicated birth is a personal choice. It should be up to the birthing person which pain management strategies they feel comfortable with. Once you are in the experience of labor you may change your mind about your expected approach. Having a birth plan can help you devise your chosen path and options that you feel comfortable with to manage pain.
What is Unmedicated Pain Management?
For millennia humans have had babies without the aid of modern medicine to ease the pain. Here we will explore natural pain remedies that are still used today. The therapies we are looking at in this article are not homeopathic, but physiological.
Some forms of unmedicated pain management in labor are simply distractions from the pain in your body. But others provide natural pain relief by releasing hormones such as endorphins, oxytocin and dopamine. Some of these unmedicated pain relief options can also shorten the length of labor.
Breathing Techniques
Breathing techniques are the most commonly used form of pain management in labor! They can be used along with other forms of pain management, medicated or unmedicated. Use of breathing techniques is a natural form of pain relief. Breathing improves oxygenation, eases nausea, and releases endorphins. The repetitive nature of breathing techniques provides a welcome distraction from labor pains and eases anxiety.
Some commonly used breathing techniques in labor are:
- Focused Breathing – Focused breathing is when you breathe “into” particular groups of muscles in your body in order to relax them. Breathing into your belly, your back, or your pelvis can relieve pain. This is similar to visualization.
- Diaphragmatic Breathing – This is slow and controlled breathing into the abdomen to make it expand and contract. Focuses on a rhythm.
Movement
Movement is a great way to distract or ease the pain of labor. It has the added bonus of helping to open the cervix, shortening labor. Any form of movement can distract from labor pains. It also releases endorphins, which are natural pain relief.
- Walking – Walking is a great distraction from the pain of labor. This movement loosens the pelvis and urges the cervix to dilate, speeding up labor.
- Swaying – Swaying with your birth partner can release oxytocin, a hormonal form of pain relief. It can distract from pain with its rhythmic quality, and shifts the weight in the pelvis.
- Bouncing/Rolling – Bouncing on a birth ball helps you keep in tune with the rhythm of your body. Rolling your hip in circles on the birth ball opens the pelvis and coaxes the baby into the birth canal
Massage
When the body receives a calming touch, such as massage, that can overwhelm the nervous system and decrease receptors for pain. Massage can also release dopamine, endorphins and oxytocin, hormones which naturally provide pain relief. Therapeutic touch and massage decreases anxiety, which reduces pain. It relaxes muscles which have become tense with the work of labor. You can communicate the amount of pressure you prefer, and if that preference changes as labor progresses.
Massage techniques for labor:
- Back – Massage the back using long, even pressured strokes up and down the back from the neck to the top of the bum. Use criss cross stokes with opposing hand movements at the hips.
- Neck and Head – Massaging the neck and head provide stress relief and calm the birth parent. It can also release those pain relieving hormones.
- Hands – Massage the birth parent’s hand using both of your hands. Provide pressure from the inside of the palm pulling outward. This is especially helpful and grounding for those who have had an epidural.
- Feet – Massage the feet as you would the hands, putting pressure in the center and pulling outward (to the sides). Grounding touch can also be provided by pushing the feet gently into the floor or bed.
- Counter pressure – Continuous pressure at the sacrum, on each hip, or on either side of the spine at the lower back can relieve the pain of back labor. Use your fists, elbows, tennis balls or massage balls.
Hydrotherapy
Hydrotherapy is the use of a shower or immersion in water during labor to relieve pain. These therapies reduce blood pressure in the birth parent. Each has a calming effect and can relieve sore muscles. Most hydrotherapy options are not available if the laboring person has had an epidural as their mobility is limited.
Hydrotherapy options are:
- Shower – Showers can reduce the blood pressure of the laboring individual. They provide relaxation and relief for sore muscles. The sensation of the shower stream can stimulate the nipples to accelerate the pace of labor.
- Tub – Immersion in a tub takes pressure off of exhausted muscles and joints. It relieves pain in the pelvis and back, and is especially helpful when experiencing back labor. If you need fetal monitoring, you can ask for intermittent fetal monitoring to accommodate hydrotherapy. Using hydrotherapy to relieve pain does not necessarily mean that you will birth in the tub.
Meditation
At a certain point in labor your attention turns inward to what is happening within your body. This shift usually comes with active labor. You can naturally enter a state of meditation. Tuning into this transition can help you cope with the pain you are experiencing. Focusing on your breath and re-centering your attention on a repetitive action, thought or experience can alter or reduce your perception of pain. It can also release endorphins.
- Guided Meditation – guided meditation can be helpful in early labor
- Hypnosis – hypnobirthing is a labor practice taught by a professional te relieve pain
- Visualization – uses your subconscious to create calm by accessing images
- Body Scan – by gradually focusing on different parts of your body you can call your attention away from the pain or toward the pain as you wish.
What Medical Pain Relief can You Have In Labor?
Epidural Block
An epidural is a very popular form of medicated pain management in labor. If you choose to get an Epidural block, an anesthesiologist will place a catheter in your lower back. This catheter will allow you to administer medication to block the nerve receptors from sending pain signals to the brain. You might still be able to feel and move your legs and feet. However you should not feel the pain of contractions, though the body will still be having them.
Once you have the epidural your movement will be confined to the bed. You still have the option to labor on your side using a peanut ball between your legs to help open the hips. Changing the position of the bed can also allow you to change positions during labor. Because you will not be able to feel your pelvis, a catheter will be used to relieve your bladder. Some may feel detached from their body or the experience of labor and birth. This is why grounding touch and techniques are useful.
Nitrous Oxide
Nitrous oxide, also known as laughing gas, is inhaled by the laboring person. It is a fast acting pain relief that also leaves the system quickly. Nitrous oxide relieves anxiety and brings on a sense of euphoria, making the pain of a contraction easier to cope with. Because it is inhaled it is noninvasive, a good option for anyone who is nervous around needles. Control over your movement will not be limited with nitrous oxide, as it would be if you opted for an epidural.
Nitrous is only administered by the laboring person. They bring the mask to their face with their own hand, and when they feel it has taken effect their hand falls away.
Analgesics
Analgesics are opiates usually administered intravenously with a shot or through an IV port. They provide pain relief and relaxation to the laboring parent. In a long labor if the birth parent decides to opt for analgesic relief they may take a nap after receiving the medication.
There are some risks associated with taking analgesics during labor. Because they are opiates they can make you feel drowsy and nauseated. Analgesics can also cross the placenta and affect your baby. This could make your baby drowsy and possibly slow labor. For these reasons analgesics are best used in a long labor to provide rest and a break for the birth parent.
Conclusion
Just as your pregnancy journey was unique to you, your choices for pain management in labor is a personal choice. You know best how your body reacts to pain, and how it responds to medication.
Perhaps you will go in with the expectation that you will get an epidural right away, and then realize that your body was built to do this and decide to use breathing techniques instead. Maybe on your big day you are experiencing painful back labor and decide to get in a tub to relieve the pain. Some people decide on having an unmedicated birth only to realize that the hours of labor has left them exhausted and in need of an analgesic nap.
Whatever the case may be, it is best to approach your birth with the knowledge that there are many ways you can cope with the pain of labor and birth. You have the power.