Seems crazy right, choosing not to take pain relief during the (supposedly) most painful thing anyone can endure. Why would any woman willingly choose to feel every contraction and the stretching of their body whilst their substantially sized child is born.
I personally have heard comments such as “Don’t be the hero, take the epidural”, or “you’ll cave in” or even “you don’t get a medal for a drug free birth”. Some people may even roll their eyes at you when you tell them you birthed naturally, without so much as gas.
First let’s look at the options for pharmacological pain relief
Epidural: the most popular choice for women. It involves the injection of local anaesthetic into the epidural space (space around the spinal cord). If done correctly, it will block pain and movement from the waist down. Great for pain relief, but also renders the mother unable to move her lower body (1).
Morphine/pethidine: a narcotic pain relief administered as an injection or in an IV. Usually administered with anti-nausea medication, due to the tendency to cause nausea. It also passes through the placenta to the baby, and has been known to cause respiratory depression and reduce the suckling reflex in newborns (2).
Gas (Nitrous oxide): aka laughing gas. It’s administered via a hand held tube. Not entirely effective at reducing pain but may “take the edge off”. It may also make you feel off this planet, which isn’t always the best thing. Probably the best aspect of gas is that it encourages deep breathing and concentration on the breath, which is an effective distraction technique alone. The benefit is that the effect of the gas wears off in minutes (2)
Risk and concerns of medication
Unfortunately, whilst the idea of having a pain free birth sounds ideal, there are many risks and complications that come with taking pharmacological pain relief during labour.
Concerns about pharmacological pain relief include:
Let’s discuss epidurals.
Firstly, the benefits are obvious, no pain (or less pain) and you may even be able to sleep during labour. Epidurals are also helpful in case of maternal high blood pressure during labour and pre-eclampsia.
Epidurals have a direct impact on the natural hormonal processes during labour. They reduce oxytocin, prostaglandins and beta-endorphins, all which have important roles for progressing labour.
Labour is likely to take longer, an extra 26 minutes during the second stage and extra 15 minutes pushing. There’s a doubled risk of requiring forceps or vacuum. On top of that, there is an increased need for synthetic oxytocin (syntocinin/Pitocin). The combination of epidural and syntocinin cause fetal heart rate abnormalities (Aka fetal distress), which ultimately increases the need for forceps/vacuum or caesarean.
Risks to Mum
Now that you can see the potential risks, an epidural doesn’t seem so enticing. It’s not just a simple option for pain relief.
How women cope without pain relief
Is the only other option to suffer through labour? Nope. Thankfully, nature helps women overcome the pain with an amazing cocktail of hormones that flow freely when birth is left to happen on its own.
Oxytocin, the love hormone, is produced in copious amounts during labour and birth, increasing as labour progresses. Other amazing hormones include endorphins, which produce a dream-like-state and are a natural pain relief.
Pain can be viewed as something helpful, instead of something to be feared. Labour pain, unlike the pain of breaking a bone, isn’t a “bad” pain. It’s a useful pain. A pain that can be seen as a guide for your body to move in a certain way. For example, my labour pain was all in my lower back, and to relieve this pain I instinctually leant forward, swayed my hips and used counter pressure. My body was telling me that I needed to move in this way to allow my baby to move into position (he was posterior, causing the pain in my lower back).
There are some very effective natural/drug free pain relief options. My favourites being:
Benefits of Un medicated birth
There are so many benefits to having an unmedicated birth. The first and I personally believe the most important is that is the safest option. You don’t have any of the associated risks that come with an epidural. It’s your best chance of delivering a baby vaginally, without augmentation.
Without intervening in the natural hormonal release, your body will labour and birth how it is designed to.
Another huge benefit is the amazing peak of oxytocin you feel when your baby is born. It is absolute bliss, there is no other feeling that compares. As mentioned before, epidurals stop this huge release of oxytocin.
Some women choose to birth without pain relief because they want to experience labour, for everything it is. They want to remember every little detail. They understand how much of a huge personal transformation that labour and birth can be. It can be such a beautiful, live changing, strength giving experience.
Of course, epidurals are absolutely essential in some circumstances, and can be such a blessing when there is a long labour and the labouring mother desperately needs a rest.
Ultimately, maybe we aren't so crazy for choosing to birth without medication and minimal intervention.
Here are what other mums have to say about their choice of unmedicated birth:
“I choose natural birth because I am convinced that it is best for both mum and bub when there are no medical reasons to alter what is a normal and natural process.” – Bethany
“Un medicated helped me achieve an uninterrupted labour for my hba4c.” – Gerri
“I chose it because I knew my body was fully capable of doing it. I wanted me and my baby to be fully present for the experience.” – Michelle
“Because I believe our bodies know best. I didn’t want to interrupt the natural flow of hormones that takes place.” – Jodie
“For me; having read the literature, I wanted to avoid the cascade of interventions that would increase my risk of an instrumented birth or surgical birth.
For my baby; I wanted to optimise their healthy entry into the world without drugs that affect their respiration or instruments that could injure them (e.g. Ventouse or forceps)
Additionally, women are made to birth. It's a natural process; unmedicated is how it is intended to be done. The more pertinent question is "why do people chose a medicated birth?" Fear of pain? Poor information/preparation? Induction more painful? So why were you induced? There are some valid reasons for a medicated birth but I feel many people chose one because it has become an unfortunate cultural norm and they equate birth with a pathological process that *should* be medicated (when this is most often not the case...)” - Emily