A QUICK LESSON ON LABOR DRUGS

 

You’ve heard it all before… there are no university medals, just a cute bundle to behold. So, let’s be smart and understand all there is to know, so we can make informed, educated decisions about our bodies and our babies.

This is not a shame-game, moms. We need to get prepped for ALL the resources available – both natural and medicalised. We can then pick and choose what is right for us and our babies, with the support of the professionals we have chosen.

NATURAL PAIN MANAGEMENT

Let’s talk about what you NATURALLY have on your side:

1. Being smart!

Research suggests that if we’re smart about our approach to labour, we can reduce anxiety and cope with labour better. So, get your intel nailed down and you’ll have the game sewn-up.

A couple of thoughts:

  • Attend pre-natal classes at your hospital. These are usually run by either midwives or physiotherapists. They are typically super-informative and fun, and are an opportunity to share the experience with other expectant couples.
  • In addition to the above, look into philosophy-specific birth classes. These are typically run by doulas or childbirth educators, and there are loads to choose from. Explore but be discerning. I’ve attended more than 100 births and there is no ‘silver-bullet’ that will guarantee an easy birth. There’s lots of good to learn, but don’t be fooled.
  • Read books, blogs and articles – Be discerning about who you choose to listen to here. Resist being dragged into other’s birth-horror stories. There’s a monster behind every door. So don’t open it. Keep it positive and read about what’s happening in your body, how you can get the right hormones working for you and what pain management resources are on offer.

2. Being fit and healthy

If you’re fit and healthy, you’re already a step ahead. Gentle exercise and a healthy, balanced diet, will serve you well.

3. Knowing that distractions are your friend

Generally, engaging your senses toward something pleasurable works well.

  • Massage – by strong circular motions (usually at the sacrum) or light-touch. Massage is a very individual thing so make sure whoever is supporting you in this birth knows your preferences for touch and can read your signals well.
  • Heat packs and the use of the shower and bath are super helpful. Pain is reduced by up to a staggering 40% when using heat, so use that heat-bank, wherever you can find it.
  • Try some essential oils and instrumental music. You’ll feel like you’re at a spa retreat.
  • Acupressure – Although there is little-proven research, the pressure applied to certain parts of the body may be helpful during labour. Some women swear by it.

4. Understanding how to breathe…

  • Sounds ridiculous, right? but, believe it or not, by maintaining a simple breathing rhythm, you will keep those contractions in-check.
  • The technique (no rocket science): Breathe in through your nose, and breathe out through your mouth. Make the breath out longer than the breath in. Try to relax all of your muscles with the breath out. Sounds easy! 

5. Being supported

Whether this is your partner, mom, doula or bestie, you MUST have a support person. Two is preferable, so you’re support is continuous and you’re never alone. Make sure you talk with this person/people before labour and identify what your labour preferences might be.

NB. Remember birth is a ‘fluid’ process and to be adaptable. Be ready to embrace how your own birth will unfold.

Once you’ve understood how you can naturally work with your body, it’s important to then explore your medical options too – even if you don’t plan on using drugs in labour. You don’t want to exhaust all natural avenues, panic and leave with negative feelings about your birth. Get your head around all resources available to you.

MEDICALISED PAIN MANAGEMENT

Let’s talk through your options.

1. Using Nitrous oxide (‘laughing gas’)

Mixed with oxygen, nitrous oxide is administered by a tube and or face mask to the mom’s mouth. Mom inhales this gas with each contraction. It’s important for you to start suckin’ on that gas as soon as you feel a contraction coming, as the gas takes a bit to kick-in. You’ll sound like Darth Vader and although it’s called ‘laughing gas’.. some cry!

Possible advantages:

  • Makes pain more manageable by taking the ‘edge’/‘peak’ off each contraction
  • Doesn’t interfere with your contractions
  • Doesn’t linger in your body
  • Doesn’t linger in baby’s body

Possible disadvantages:

  • Can cause disorientation in you
  • Nausea and vomiting may be experienced
  • You might experience feelings of claustrophobia – if using a face mask
  • Not enough pain relief gained (the case for 1/3 of women)

2. Having pethidine

Pethidine comes from the same ‘family’ of drugs as morphine and heroin. Pethidine is injected intra-muscularly or intravenously and lasts approximately 2-4 hours.

Possible advantages:

  • Good strong pain relief for you

Possible disadvantages (for mother):

  • Nausea (although anti-nausea drugs are typically administered at the same time).
  • Giddiness
  • Disorientation
  • Respiratory depression
  • It’s irreversible, so if you feel like a stoner, you will continue to be one for the next 2-4 hours.

Possible disadvantages (for baby):

  • The unborn baby is exposed to this drug via the umbilical cord.
  • May cause respiratory distress at birth (a reversal drug is given, in this instance).
  • Baby’s reflexes, including sucking reflex, can be compromised.

NB. Debate persists over the effects of pethidine on newborns.

3. Receiving an epidural anaesthesia

Epidurals are the king of the pain relief world. They allow you to stay awake during baby’s birth. The epidural is injected in the back, into the lining of the spinal cord. This results in numbing the mother from the waist down. Baby’s heart rate is monitored continuously.

Possible disadvantages:

  • Some moms experience only a partial-block of pain.
  • You may feel faint or nauseous – sometimes blood pressure drops. (IV fluids are required).
  • You will be confined to bed (which is not necessarily a bad thing in my mind!)
  • A urinary catheter will be inserted.
  • Typically, the second stage of labour is longer, because of the blocked sensation to push.
  • Instrumental delivery requirement rises due to reduced muscle strength.
  • Reduces the likelihood of vaginal delivery.
  • Approx 1% of women experience headache post procedure.
  • Some experience itchiness (usually treated with antihistamines).
  • Tenderness at epidural site.
  • 1/550 experience on-going patches of numbness near the injection site.
  • VERY RARE COMPLICATIONS: infection, blood clots and difficulty breathing.

So moms, with your homework sorted and your list of need-to-knows down-pat, you’re ready for your biggest exam yet. Good luck from me to you. And remember: Before you know it that bundle will be snuggled safely in your arms and your prep will have paid off.


LUCY HERCUS
Mom of six fabulous kids and foster-mom to numerous others. Event manager, doula, childbirth educator, lactation counsellor, owner of Sydney Birth Support, Mamaway Advocate and an encourager of all moms out there giving it their best crack!

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