Is our own birth influencing our attitude to pain relief in pregnancy?

When I work with mums to be or those trying to conceive I take time to explore their own birth story.  Our own entrance into the world can leave lasting impressions that set a tone or mood around birth. Do we have an inherent belief in our capacity to birth or do we assume interventions will be needed? Perhaps there have been miscarriages or other challenges in the family and it is important for us to differentiate our story from what happened  to others.  

Women need all the encouragement they can get in the birthing arena. Time and time again I hear of mums who assume that they will need the epidural and are surprised when their body takes over.  Looking at the statistics though  it seems as though women do not have the self-belief, support or wish to attempt to have a natural physiological birth. In the US over 73% of mothers choose an epidural and around 68% of first-time mothers in Ireland. Although an epidural may be presented as a more comfortable and pain free way to give birth, it also comes with risks  and a need for continuous monitoring. It also tends to lengthen labour by up to an hour and a half. 

Epidurals were first introduced in the 1980’s for those wishing to avoid a full anesthetic for a c-section delivery. They have since become increasingly popular as the paradigm of "pain relief" has won popularity over the “working with pain" paradigm, writes Rhea Dempsey in her article 'Pain is My Friend'.

The cascade of intervention is a term used to point to how early routine interventions may have unintended and unpredictable consequences.  Seemingly small interventions  will need to be "solved" with further interventions, which may in turn create even more problems.  

The introduction of an Oxytocin drip for example may sound innocent enough as after all Oxytocin is naturally present in our bodies and is  commonly known as ‘the hormone of love.’ What women may not know is that the artificial version inhibits the release of endorphins that can help us tolerate labour pains. Pitocin can also interfere with our own naturally arising Oxytocin which is critical for the post-natal bonding and the production of breast milk.

The implications of interventions, if not deemed medically necessary, need to be thoroughly understood and evaluated. Pains are likely to rapidly escalate when interventions are used in ways that are a lot harder to tolerate than pains that come on gradually:  

• When waters are broken pre or during labour. 
• When Synthetic Oxytocin or (“Pitocin”) is used to strengthen or induce contractions, this can accentuate pain as well as distress for baby. 
• Static monitoring is hard for most to tolerate.
• Sudden drops in blood pressure are possible with interventions
• A longer labour is likely 
• Urination and pushing baby out may be difficult. A catheter may be needed to empty the bladder.
• Electronic fetal monitoring and intravenous fluids may also be required to  monitor, prevent or treat these effects. 
• Vacuum extraction or forceps may be needed to help move the baby out. If these are ineffective, a c-section may be needed.

I hope you are all breathing easily…

It may be hard to read all of this at once and for many thousands of women there are other ways. Exploring the physiological purpose of pain in labour opens joyful possibilities.