Do I Want Pain Medication During Birth?

We should first understand why pain happens during birth.


There is nothing inherently painful about the process of labor. The vagina and cervix are designed to stretch around the largest diameter of the baby’s head. The stretching of these tissues is not painful. I remember my first birth. All I had heard all my life was how painful giving birth was. And it’s certainly portrayed that way on television and in the movies, so that’s what we expect. But that was not the reality of the experience. I was awakened one night by the need to go to the bathroom. I would go sit on the toilet and feel an intense sensation of needing to have a bowel movement, but nothing would come out. I would go back to bed, then 20 minutes later I’d feel the need to go again. I called the hospital and told them I needed to know what was safe for me to take for constipation. They said I needed to come in and be checked. I told them no, I just needed to go to the bathroom really bad. They said they couldn’t prescribe anything for me until I was checked. They had heard this too many times before. When I was checked, I was four centimeters dilated. I was having labor contractions!


I know you have all had this experience. You are driving on the interstate highway, and there are no gas stations in sight. You realize you have to go to the bathroom. A wave of pressure builds up as your body tries to push out the waste, and you grip the steering wheel and concentrate on trying to keep it in until you reach a gas station. Then the pressure subsides for a while. After a few minutes, pressure begins to build up again, and once again you grip the steering wheel, taking deep breaths and trying to make it through to the end of the wave. This is exactly what labor contractions feel like.


There are a couple of situations that could involve pain. The first is maternal exhaustion. Going through labor is the equivalent of running a marathon. You wouldn’t dream of doing that much physical exercise without plenty of fluids, electrolytes, and some food for quick energy. Yet the standard practice is to withhold food from women in labor. This can produce maternal exhaustion. Your muscles can’t contract effectively without good nutrition. Consequently, women should be allowed to eat and drink as they like in labor. Without the proper nutrition, the muscle contracts ineffectively and painfully.


The second situation that can involve pain is when the baby’s head descends through the pelvis. Sometimes the baby’s head will put pressure on a nerve, or blood pooling around the cervix can cause nerve pain. The best cure for this to change positions. Being upright and active tends to decrease discomfort during labor.


The third situation is back pain caused be the back of the baby’s head pressing against the spine. The best cure for this is to stand and do large pelvic circles, or have someone massage the lower back. Getting into the all fours position and tilting the pelvis up and down can also take pressure off the spine. A warm shower or soaking in a hot bath can also help relieve discomfort.


If you are giving birth outside the hospital, pain medication will not be available. If in the hospital, the pain medication used most often are epidurals and spinal blocks. Occasionally an analgesic such as Demerol might be administered. But these drugs are more likely to cause negative effects, such as slowing the progress of labor, Pain medications may be transmitted to the baby, though this varies by medication type. Transmission may cause side effects in the baby, such as difficulty breathing after birth or difficulty breastfeeding.


Having a labor support person during labor and birth has been helpful to some women. Others prefer to be alone so that they have no distractions and can simply let nature take its course without worrying about what others in the room are doing.


During my first birth, I kept asking for pain medication. When I finally got it, I was disappointed to learn that it didn’t take away the strange sensations my body was feeling that I had been interpreting as pain. I was still clearly able to feel the buildup of pressure that felt so overwhelming. The medication is designed to numb pain, but it wasn’t pain I was feeling. It was just a cascade of strange sensations I had no frame of reference for, and the brain was interpreting them as pain.


So to summarize, the best ways to avoid pain are to be well rested, well nourished, remain upright and active, change positions frequently, take a warm shower or bath, get a back massage, avoid the stress of having too many people in the room, and avoid the stress of disempowering situations. Deep breathing, squatting, yoga, relaxation and visualizations, meditation and self-hypnosis can help. The emotional freedom technique (EFT) has also been helpful to some people.


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