PREGNANCY 101: PAIN MANAGEMENT DURING LABOUR
In this pregnancy class, Sonali Shivlani helps you brave through those labour pains, and helps you effectively manage those contractions, to help with a smooth delivery
Methods to follow for a smooth delivery
For most women, especially first-time mothers, it’s the pain they’re going to endure during labour that worries them the most. After all, there’s no doubt that they’ve heard plenty of stories of hours of labour, or watched numerous videos of women screaming in the delivery room, that the pain seems to get the better of them. This is exactly why, this article talks about some of the pain management methods that you can opt for. Naturally, there are some pharmacological methods and some nonpharmacological methods you can choose from.
A pharmacological method is also treated as an intervention, as it interferes with the natural process. However, in some cases, it can be a blessing. Let’s start with the epidural. This is an analgesic which is administered in the lower back, and numbs all sensation in the lower body. The contractions still proceed as normal; the only difference is that, now, the nerves do not carry the pain sensation to the brain. As it is administered in the lower back, most mothers feel that it causes a permanent backache. However, this is not true. Epidurals are used all over the world for most lower body surgeries. If a woman in labour is experiencing a lot of pain and discomfort, and if she is progressing slowly, then an epidural may be the right choice for her as it can help to relax her. On the other hand, if labour is moving well and she is coping with the contractions, taking an
epidural can slow things down. It’s really her decision whether to take the epidural or not. However, she can take this call only during labour. Another popular pain management option is Entonox gas which is popularly known as laughing gas, and is made of 50 per cent nitrous oxide and 50 per cent oxygen. These are natural gases and are considered safe for mother and child. Another plus is that it is self administered which means the mom takes it on an SOS basis. The effects are temporary and wears off very easily. It can also make you feel sick or nauseated. Many women find that taking it for long durations, can leave the mouth feeling very dry. There are some other drugs available for pain relief during labour but these are injectables and directly get into the bloodstream. This affects the foetus as well, and unless absolutely necessary, are not prescribed for women in labour.
No pain, more gain
While medical intervention can definitely present some form of relief, for a truly natural and wonderful experience, let’s get to the main, and possibly most interesting, part of the discussion —the non-pharmacological methods of pain relief. First and foremost, the most important thing to do is go in with a positive frame of mind. The more relaxed you are, the faster labour progresses. Naturally, the opposite would mean prolonged labour. But, being relaxed is easier said than done. But, this small fact should not deter one from trying to achieve a state of calm and relaxation, despite the labour. After all, birth is natural, and as women, our bodies are designed to birth, so trust your instincts and the fact that your body knows what it has to do. It is also important to plan who will be your birth companion. This person is someone whom you trust completely, as well as someone whom you can be completely natural with. Remember, birth is physical. You may also not realise what you are saying or doing. You don’t really want to dwell on formalities and niceties at that time. For most women, the best birth companion is their spouse. This is the person with whom you are physically and emotionally most comfortable. You may also want to consider hiring a professional birth companion —a labour doula. These are qualified women who have been trained to support and guide women during labour and birth. Now, here’s the tricky bit when it comes to giving birth—don’t scream and shout. This just means you’ll use up all your energy and tire quicker. Also, when you are screaming, you’re not really breathing, adding to your exhaustion. If that’s not all, your screaming might make your support person and the medical staff a little nervous. Instead of using your energy to scream, direct it to helping you focus on your breathing. Labour breathing is a little different—short breaths using only your chest and not your abdomen. We also encourage inhaling through the nose and exhaling through the mouth. This can actually help to relax you. However, this may be difficult in the beginning so don’t just start to use it during labour. It works best when it has been practiced regularly. Moms who attend regular pregnancy classes, and who have practicing this type of breathing a few times a week, for at least 12 weeks
prior to their due dates, report better pain management success than moms who learn breathing techniques during workshops. This is exactly why practice makes perfect. Remember, if possible, do move around in labour. This can actually help the baby get into position faster. You can also practice various labour positions like half squats, using the exercise ball, straddling a chair, lunging, etc. You never really know which position will make you more comfortable, and at what time, so trying a few different positions might just prove useful.
Over the years, many women have let me in on some of their favourite labour painmanagement techniques, and even though they may sound bizarre, they can actually work. For example, one mum binge watched Friends during her labour while another mom practiced chanting. One mom enjoyed her partner giving her a lower back rub while another preferred not to be touched at all. From pacing the hallways to belly dancing, doing breathing exercises to practicing different positions to make yourself comfortable, you can try it all. But remember, something that might help in the moment, may not help an hour later. You definitely need a big bag of tricks to help with the pain management. Pack a few massage tools in your labour bag, carry your favourite music along; you could also consider some relaxing essential oils, like lavender, which can soothe the senses. You can also eat and drink during labour. Just small tiny tit bits like sweets, glucose biscuits or just sip on cooled water. This will help you stay hydrated as well as maintain your sugar levels. Naturally, discuss this with your doctor when you check in to the hospital as eating and drinking during labour is allowed, only if everything is progressing normally. Labour can be long, labour can be painful, but one this is for certain, most women do not remember the pain once they hold their baby in their arms. This is why focus on powering through. The rest, as they say, is history!
M&B’s panellist Sonali Shivlani is an Internationally Certified Pregnancy Consultant and a child nutrition counsellor. She is the executive director of CAPPA India, and also trains aspiring birth professionals to achieve certification in pregnancy, birth and lactation counselling. If you have any concerns related to pregnancy, birth and the postdelivery period, Sonali Shivlani will answer all your questions through her column. Do send in your queries to firstname.lastname@example.org.