Natural Pain Relief Options For Labour
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Informing yourself and opting for natural methods of pain relief makes so much sense, after having spent so much time in your pregnancy agonising over only being allowed a panadol when you are sick. Yet it seems there is a smorgasboard offered to you when you are in labour!
Being exposed to drugs in labour like pethadine (which is a narcotic and crosses the placenta freely) takes a baby much longer to get out of it’s system that it would a fully grown adult. It will wear off on an adult after only three hours, but it has a half-life of around 22 hours in your baby’s little body, and can be detrimental to breastfeeding attachment. This is due to having those same drowsy, spacey effects we get from pethidine (or morphine), only baby suffers from them for much longer.
Perhaps you have seen some scary birth DVD’s in your pre-natal classes – well rest assured, with some good support and tools, labour doesn’t have to be like that.
Below are some known and proven ways to help relieve pain in labour. Having these things tucked away in your labour arsenal may help you during your labour and perhaps get you through without the need for any pharmaceutical pain relief. If you have any suggestions or comments on any of these which worked for you, please email us and let us know!
“I found one of the best forms of pain relief during labour was definitely our doula. Whilst I may have had different techniques to help me through labour pains, my doula was the one who helped me to find the best method of drug free relief for the stage of birth I was at. The support she offered throughout also helped me to stay focused which in itself is pain relief, as stress only leads to pain and she was able to help me keep calm.”
According to studies, women who use Doulas have 60% less requests for epidurals and 50% caesarean sections, amongst many other things. Having a Doula present at your birth is a great way to avoid using pain relief, as she has experience in support methods, positions and tools to help women get more comfortable and feel more supported in labour, so the woman doesn’t feel the need to request pain relief.
It isn’t just homebirth women or those strongly against pain relief who benefit – not only have all my clients been in hospitals, but many have said they weren’t sure how they would go in labour without pain relief as they have a low pain threshold. It’s surprising what you can deal with in labour with some great support. To read more about Doulas, click here.
“I would have to say hot showers running on the lower back was my favourite during labour, I can’t recommend it enough! I had 6 or so showers and didnt want to get out but, I was worried about water usage, because they had a sign up in the shower. Next time, im not getting out!”
Water immersion in labour offers significant benefits for the labouring woman, including pain relief, relaxation and comfort. According to a Cochrane database review:
“Water immersion during the first stage of labour significantly reduces epidural/spinal analgesia requirements and reported maternal pain, without adversely affecting labour duration, operative delivery rates, or neonatal wellbeing. Immersion in water during the second stage of labour increased women’s reported satisfaction with pushing.”
The first stage of labour is the contractions prior to pushing – pushing is second stage. Most midwives and birth attendants will recommend getting into the bath once you are in active labour, as being in a bath creates buoyancy and you want to work with gravity in early labour to make sure the labour isn’t going to stall.
Showers are also great, as you can remain upright and direct the shower head at your lower back if you have back pain. Even if you think you aren’t a shower person, in labour, many women choose to use the shower and some spend a great deal of their labours under the shower.
There are also many benefits for babies born in water. Andrew Davidson is an Obstetrician at John Flynn Hospital in Queensland who says that around 40% of women at the hospital use water immersion for labour. Birth satisfaction amongst those who waterbirth is very high.
He states: “There is a much reduced usage of analgesia in the waterbirth group with no epidurals, very few women using narcotics, while about half use nitrous oxide (gas). Waterborn babies tend to breathe quietly at first rather than cry but in our experience do not have lower Apgars or require more resuscitation.”
For more information on waterbirth, Janet Balaskas has a great book, ‘The Water Birth Book.’ Sadly not many hospitals offer waterbirth so you need to do your research. Mainly birth centres offer this option, or you can waterbirth at home with your own midwife.
“My absolute fave (natural pain relief method) is the bath – instant relief. I won’t ever birth out of one again.”
“For me it was being in the shower, not just because the warm water helps with physical pain but also from a psychological perspective being a hot shower always makes me feel safer and more relaxed. Even when I’m not in labour it’s great stress relief.”
“The bath helped me the most, especially because I had a posterior (backache) labour. I had all the pain in my back as well as my tummy. So having my belly and back submurged in the warm water really helped a lot.”
Learning how to relax is so important in labour, otherwise you end up in the vicious cycle of fear → tension → pain. When you tense up and get tight (which is a natural reaction to any sort of pain) it actually makes that pain worse.
With Calmbirth, you learn:
- To access your natural inner resources to alleviate the fear, anxiety and tension experienced during pregnancy, labour and childbirth
- Practical skills of relaxation, breathing and visualisation which are used during pregnancy, labour, childbirth and beyond
- How the mother’s body is beautifully designed to birth her baby naturally and calmly and with the right preparation, to work with the process rather than resist it
- The importance of a mother’s beliefs and attitudes about birth and how these can be one of the major differences between a positive or negative birth experience
- The importance of bonding with your baby and how this effects your baby's future life
- To be empowered to take control of your own birthing experience
Calmbirthing is an Australian method similar to the American HypnoBirthing method. For more information, visit the Calmbirth website.
“Sitting on the toilet seemed to be quite comfortable which eased my pain… as I felt more relaxed.”
Being comfortable in labour is of course going to make a huge difference in your pain tolerance. The worst position you can be in is flat on your back in bed, and unrestricted from monitoring.
Mobility is important in labour, as is position changes, especially when you are working with gravity and your body. Upright, forward leaning positions are ideal, as when your uterus contracts, it actually contracts forward. Many unrestricted women naturally lean forward with contractions. Therefore working with your body and the surges of contractions is going to be more effective and efficient, resulting in less pain for the labouring woman.
“Given my quick labours and no time for bath showers etc, the number one thing during labour was position – on my knees leaning forward with legs spread. But the very best pain relief of all was holding my baby at the end!”
For more information on active birth, check out Janet Balaskas’ book, ‘New Active Birth.’
Visit a naturopath before birth so they can prepare you some natural pain relief preparations which are safe while pregnant and breastfeeding. You can get some preparations over the counter from your pharmacy like Rescue Remedy.
Massage / Pressure
You don’t need to be a professional to provide massage in labour – loving, nurturing strokes and massage on a woman’s body in labour is all you need to provide.
Some studies have been done on pain relief and massage. One of the studies involved massage conducted by the woman's partner. They found that the woman's anxiety and pain was reduced and her mood improved. Another concluded that massage was a cost-effective option that could be implemented by midwives. Women perceived a reduction in their pain and anxiety levels, and found with partner involvement, they had a more positive birth experience. Yet another concluded that women who were massaged during labour were less anxious, experienced less pain, had shorter labours and experienced less postnatal depression, opposed to the control group of women who did not receive massage.
Massage can be performed by your partner or a doula, but often midwives are too busy to perform massage, so plan for your partner or a support person to do the massage.
Massage stimulates the production of endorphins which are natural pain killers and mood enhancers. In labour, massage can be given on the shoulders, head, back, feet, legs and hands. If you buy oils for massage, make sure you check that the essential oils are safe in labour. Some essential oils need to be avoided. It’s best to buy a base carrier oil, like avocado, grapeseed or almond oil and add safe oils to it if you wish. Some oils safe in labour include lavender (relaxing), geranium (relaxing), orange (uplifiting, refreshing), clary sage (strengthen contractions), but please do check the correct doses with someone who is trained in aromatherapy – even if you go to a store like Jurlique they can help you out.
It’s important to note that some women will not like touch or massage during specific times in their labour or at all, so it’s important to plan other options for natural pain relief as well as massage. Don’t be put off if she doesn’t want to be touched and don’t be afraid of offering again if you think she would like it. Observe her movements – does she have her hand on her back, does her back ache? Is she rubbing her legs? Maybe you could do this for her.
Women with lower back pain often get more relief from pressure (press your palms into her lower back, quite firmly). Even if she doesn’t like massage, she can enjoy this quite a bit.
Another helpful tip with backache is to have the woman sitting back in a chair and her partner or a support person pushing into her knees with their hands. You really need two people to do this as a tag team or with one knee each – women often find it so helpful with lower back pain that they don’t want you to stop, and the person pushing the knees can get very sore wrists – take it from someone who thought their wrists were going to fall off!
The environment in which a woman gives birth can help with relaxation, hence pain relief and comfort.
- Turn the lights off or down. Help her instinctive brain kick in and her thinking brain turn off. Darkness helps with this.
- Bring familiar objects from home if in hospital, like pillows, blankets and other things that have her smell on it – the smells of familiarity, safety and home.
- Music – favourite CD’s for different moods are great, from uplifting to soothing sounds, music can groove some pain away!
- Keep it quiet. Avoid talking unneccesarily when things get serious and asking her lots of questions – her thinking brain is trying to shut down to let the instinctive part of her brain take control, hence why women can appear vague and unable to know what they want in labour. Humour can be great when appropriate, for example early labour, but it’s important not to keep engaging her thinking brain when she’s in strong labour. Encourage others to keep voices down and increase touch and encouraging words when needed.
Another option for sore backs – a wheat pack or another form of heat pack is a great non-pharmaceutical alternative. If you are giving birth in a hospital, be sure to check the policy on heat packs, because some no longer allow you to heat up wheat packs in microwaves due to potential fires (yes it has happened before!). So you may need to choose a non-wheat heat pack, for example the gel ones which heat up in hot water, or you could find out what the hospital suggests.
Heat packs are also great post-natally for after birth pains, while the uterus contracts down to it’s normal size – which happens in only a few days – so it works hard!
Aromatherapy in labour has many great uses. If you are giving birth in hospital, it can provide a nice smell to mask the smell of the hospital, enabling you to relax a little more. While some essential oils are not advised during pregnancy and labour, it is perfectly safe to burn any oil in your burner. You might like to choose some oils suggested in the massage section above.
A point about oil burners – check to see if your hospital has one, as they will not allow you to bring in your own in case of an electrical fault and you blow up the electrical system! Naked flames are also not allowed, so you can’t bring your own oil burners that evaporate with a candle. Your options are usually a battery operated one, which I am yet to find, or a hospital one. You could always ask if it will be okay to use your own if you get your unit electrical tested.
Sterile Water Injections
For some women, back pain in labour is a very difficult problem to manage. Approximately one third of labouring women experience severe lower back pain during labour. Intradermal injections of sterile water provides another non-pharmacological pain relief option.
A small amount of sterile water is injected in four places just under the skin that covers the sacrum, the lower part of the back. Its thought that the sterile water injections stimulate the nerves which quickly send messages to the brain and interrupt the slower messages from inside the body - this has been called the 'gate control' theory of pain management.
Intradermal injections of sterile water have been found to stop backache for over 90% of women. For those women it works for, the relief has been immediate. The catch is that it is quite painful. It has a sharp, wasp like sting, which lasts about 20 seconds, however the vast majority of women who experienced severe backpain reported that it’s worth the sting and likely prevented them for opting for an epidural.
Sterile water injections is still fairly new and midwives need to be specially trained to use it – so you will need to check before the birth if this option is available to you. You might even suggest that they look into it if they don’t have that option.
A TENS machine works by attaching two strips of electrodes on your lower back – one on either side of your spine. These connect to a hand-held battery powered unit, which allows you to control the strength of the electrical impulses. The way it apparently works is that the impulses send a signal to the brain where they compete with pain impulses from the uterus, helping to block the pain.
TENS machines do help some women to cope with early contractions, but it’s effectiveness really does vary greatly from woman to woman. Feedback from both studies and by consensus from women give mixed results. Some women find TENS to be no help at all, and some swear by them. The few clients I have supported who have chosen to use TENS gave it a go until they got into water, then took it off and didn’t bother putting it back. Yet on the other hand some women I have heard from say they couldn’t have coped without it.
It is important to get some instruction on how to use TENS before labour – often places who hire out the machines do have TENS classes so if you choose to use TENS in labour, make sure you book yourself in for some lessons.
- You can use it from the very start of labour
- It can be used anywhere – at home, in the car or in hospital
- You can remain mobile
- Can be used with other forms of pain relief except back massage or water (shower, bath)
- Self administered and controlled
- Some women find it particularly helpful with back labour (posterior babies)
- Can be used post-birth
- It’s not as effective in strong labour as massage or loving care from a doula or privately-hired midwife
- You need to start using it very early in your labour to get the most out of it
- It makes you focus on the early stages of labour when it’s better to play it down and ignore it
- You cannot use it and need to take it off while being monitored, in the shower or in the bath
- You need to press the button to turn it on before each contraction, so you are effectively sitting there waiting for a contraction coming on
- It doesn’t work for all women
- Some women feel that the wires are distracting in labour
- Do not use on broken or irritated skin
Keep Hydrated and Eat If Hungry
BellyBelly’s Support Panel Midwife, Brenda Manning, suggests: “If you don’t think you will remember, ask your partner to remind you to drink at least 300mls of water every couple of hours to avoid dehydration, which can result in fatigue and a poorly functioning uterus. Eating and drinking during labour has been shown to reduce the total length of labour by as much as 90 minutes. Eat light, easily digested food.”
Kelly Winder is a birth attendant (aka doula), the creator of BellyBelly and mum to two beautiful children. Become a fan of BellyBelly on Facebook here or add Kelly as a friend (frequently adding articles and stories) here.
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