Birth anxiety is mostly about pain and how to deal with it, possible complications and often too about the effects of birth on one’s body. Questions about options generally have to with these factors too, although some women simply want to be informed and proactive in making a choice. It is always very sad for me that women seem to think that a typical ‘normal’ hospital delivery with all the usual procedures is the same as a ‘natural’ birth. In fact, there are three ways to give birth: normal vaginal delivery, Caesarean section and natural birth (as Mother Nature intended, not as we humans have tried to impose our methods on an event which can be so beautiful and empowering). Giving birth is hard work (not called labour for no reason!) but show me the woman who does not know how to work hard! Anxiety always makes birth more difficult as this raises adrenaline and cortisol levels in the bloodstream and these suppress the hormones that make labour easier and reduce pain naturally.

Your natural pain relief for labour options are the following:

• Labour and birth positions: walking, standing and bending forward to rest the upper body on a table, kneeling and rotating the hips and occasionally squatting. This helps stretch the pelvis so that baby can fit through more easily. Gravity helps to move baby downwards and movement releases endorphins, the body¹s natural painkillers.
• Relaxation techniques: concentrating on the rhythm of your breath, playing music you love and low lighting.
• Warm water: wind towels or sheets soaked in warm water around your abdomen or relax in a deep warm bath (not too hot or you might feel faint). For some moms this slows labour, at which point they get out. For others, it speeds the process up.
• Encouragement from a woman’s partner, doula or midwife helps lower pain levels.
• Homoeopathic remedies like Caulophyllum, Acteae Racemosa and Rescue Remedy help make labour more efficient and improve pain-coping skills.
• Special techniques like visualisation and medical hypnosis help some women pace themselves through labour.
• Touch therapies like massage, reflexology and acupuncture provide comfort and support the body’s natural painkillers.

Medical pain relief options include:

• Muscle relaxants like Aterax injections take the edge off pain by lowering some of the tension of the womb and surrounding muscles, making dilation faster and enabling baby to pass through the birth canal more easily. There are also less effects on baby than with analgesics.
• Analgesic injections like Pethidine may help reduce the pain of contractions. Some women find this effective, others comment that it makes them feel as if they are ‘on a trip¹ rather than reducing the pain. It passes through the placenta to baby and may cause respiratory problems in the newborn, although there are other drugs to counter this.
• Entonox (nitrous oxide and oxygen to increase the pain threshold, breathed in through a handheld mask) is not available in all hospitals, but when available it provides safe and effective pain relief and can be used as needed, rather than in a one-off dose.
• Spinal anaesthesia (epidural) can provide either total pain relief by temporarily paralysing the lower body, or just the abdominal and pelvic region with some movement of the legs still possible ­ this is called ‘mobile epidural’. Epidurals are not always totally successful, but they do provide the most effective pain relief with few direct negative effects. Secondary effects due to falling blood pressure, for instance, must be carefully monitored. It raises the likelihood of consequent medical intervention, like episiotomy and Caesar. It should be administered at about 5cm to 6cm dilation in first labours and at about 4cm in subsequent ones. The procedure is not painful, apart from an initial injection to numb the site on the spinal column where the epidural will be administered. A drip and a catheter in the bladder are necessary. Ideally the effects should begin to wear off just as first stage labour ends so that the mom can cooperate with the pushing contractions.
• The TENS machine is used by some private hospitals and midwives to block pain with electrical impulses and increase the body¹s natural painkiller or endorphin production. You¹ll need to practice using it ahead of time. Electrodes are attached to the lower back or the abdomen and a gauge is used to select the strength of the impulse needed. Women who are not that keen on gadgets may feel less comfortable with this, but others report great results.

 
© Sister Lilian 2011