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The Paradox of Pain Free Childbirth

There is a general consensus that childbirth is painful. For centuries women have been enduring the pain of childbirth. And searching for a pain free way to have babies.

In the mid 1800's ether and chloroform were discovered to be effective anesthetics for surgery. It wasn't long before women were demanding their use in childbirth. However, as with any drug, there were side effects: it often stopped contractions, increased the need for forceps (which can cause vaginal trauma and injuries to the baby), and drugged babies.

Enter the early 1900s when a mixture of scopolomine and morphine were used to induce “Twilight Sleep” for labor. Women would supposedly go to sleep and wake up after the baby was born. Seems like a good plan. Except that it wasn't. Sam McCulloch over at BellyBelly calls it the “Brutal Way Some Women Gave Birth”. Besides the amnesia that it caused, it often caused uncontrollable delirium which required hands tied to bed, legs tied in stirrups and heads wrapped so they wouldn't hurt themselves. They were left for hours or days to labor in twilight-sleep on their own, left in their own excrement. Morphine slowed contractions which obviously makes labor longer, causes headaches and respiratory distress in the newborn. Thankfully this brutality was stopped.

While epidurals had been around for several decades, they didn't become common place in obstetrics until the 1970s and 80s. Currently, over 60% of women have an epidural, with some hospitals reporting rates as high as 80% or more. This would indicate that we have finally discovered a safe, effective way to give birth painlessly. However safe epidurals have become though, there are still potential side effects that one should be aware of prior to choosing this form of pain relief. There is an increased risk of having a surgical birth (cesarean section) related to having an epidural which creates its own set of painful symptoms afterwards. Still more likely to need vacuum or forceps assisted delivery which can cause trauma both to Mom and Babe. Long term backache in 20% of women as a result of epidural. Severe headache, fever and itching are very real possibilities. You will need a urinary catheter which is likely to be uncomfortable or cause a urinary tract infection which are usually rather painful. As well you will have an IV in your arm which may be uncomfortable to down right painful. Besides all that, you won't be given an epidural until you are in active labor which is about 6 cm cervical dilation. That means you will still be feeling the pangs of early labor.

When avoidance of pain becomes the major emphasis of childbirth care, the paradoxical effect is that more women have to deal with pain after their babies are born.” ~ Ina May Gaskin

There is no shame in choosing an epidural. There are benefits to having one for sure. I have seen women give birth vaginally because they had an epidural when without it they most likely would have had a cesarean birth. Epidurals can give someone who is exhausted from a long labor a break so that when it comes time for pushing, they have the energy to do so. They can bring down the blood pressure of someone who has pre-eclampsia, again saving them from an emergency cesarean. However, people should not arbitrarily choose an epidural without considering the risks along with the benefits and possible alternatives that have fewer or no adverse effects. So its not really a matter of choosing no pain but rather a choosing of the type and time of the pain. Before or after birth.

Other comfort measures involving movement, laboring in water, massage, acupressure and relaxation techniques can be very effective in diminishing pain when used in the presence of caring, knowledgable support people.

Finally, taking the fear out of childbirth goes along way to reducing the pain that individuals experience. Women fear the pain of childbirth. Fear increases adrenaline. Fear increases the perception of pain. Educate yourself in the process of pregnancy and childbirth, hire a doula to help keep you and your partner calm. If you still find yourself needing an epidural, you can feel confident that you have made an informed decision. And its a heap better than chloroform or twilight sleep.

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