Don’t feel failure for using pain relief in labour, mothers told

WOMEN are under such pressure to give birth naturally that many feel they have ‘failed’ if they opt for pain relief, doctors say. Some experts have become too ‘evangelical’ about natural childbirth without taking into account the effect that pain has on women, they argue.

It has fuelled a boom in trendy relaxation techniques aimed at easing pain without drugs.

But a Royal Society of Medicine debate next month will be told women should not feel ashamed for asking for pain relief during labour because medical aids such as epidurals have few adverse effects.

Dr Felicity Plaat, president-elect of the Obstetric Anaesthetists’ Association, who will give her personal view at the event, said: ‘I know of many women who have asked for an epidural in labour, or asked to be told about it beforehand, who definitely have a feeling that they have failed, which shocks me.

‘Childbirth can be a savage process. Only the person experiencing the pain can know how bad that pain is.’

She added: ‘Having an epidural does increase the risk of a forceps delivery and slows down the second stage of labour, but evidence shows that has decreased and we are able to minimise this now.

‘Some people are just evangelical about natural childbirth, but I want to give them the facts.’

One trendy technique that has taken off in the past five years – and said to have been considered by the Duchess of Cambridge – is hypno-birthing. It is a form of selfhypnosis combined with breathing and relaxation techniques aimed at making natural childbirth easier without drugs.

Supporters of such techniques suggest that pain is part of childmore birth and should not be ‘medicalised’ like illness. With an epidural, a baby may need to be delivered with forceps because the pain relief makes it harder for the mother to feel contractions, reducing the urge and, to some degree, the power to push a baby through the birth canal. There may also be pressure to get a baby out if it is taking longer.

But this does not cancel out the reasons for having an epidural, according to Dr David Bogod, a consultant anaesthetist for Nottingham University Hospitals NHS Trust, who will also speak at the debate.

He said: ‘The opinion that you are somehow less of a woman for requiring pharmacological pain relief is, in my experience, one that is more prevalent in the UK than elsewhere.

‘It is my strong view that we should not force pain relief on to women. We should provide them with the information and facilities about pain relief options, and leave the choice to them.’

He added: ‘Some people believe that pain is an integral part of childbirth, but I disagree because pain can be one of the most negative impacts of labour. We see women so frightened of going into labour, or who had a bad labour previously, that they are requesting a caesarean, which can be more dangerous, just to avoid it.’

His comments follow a study presented to the American Society of Anesthesiologists last month that found giving women an epidural during childbirth could cut the risk of post-natal depression.

The research, tracking 201 women through labour, found the greater their pain, the more likely they were to suffer depression in the months after giving birth.

The medical profession has been split on the issue and the RSM has invited anaesthetists taking part in the debate to support or oppose the motion that abolishing pain does not have a negative impact on labour.

‘Childbirth can be a savage process’