Pain relief in labour is obviously a huge topic!
This post is all epidurals…and some nonpharmacological options that you can try before getting an epidural.
Before we get into it, I did want to point out the difference in philosophy between pharmacological and nonpharmacological pain relief.
Pharmacological pain relief is usually about removing the pain.
Nonpharmacological pain relief is about acknowledging the pain, recognising the fact that the pain has a purpose, giving you tools to lessen the pain, and working with the pain…but not completely erase the pain.
Epidurals are a pharmacological option…and a valid one! They do a really good job of eliminating pain.
But if you are trying to avoid an epidural or to manage labour for as long as you can without getting an epidural, here are some things to try.
1. Wait 20 Minutes.
During labour you will experience what is referred to a crisis of confidence. These are the moments when labour really sucks…when you are tired, when it hurts, when you want a break. Basically, it is like hitting a labour wall.
First it is important to recognise that a crisis of confidence is normal! In fact, expect to hit a few walls as labour progresses.
And when you are in that crisis of confidence, it can really feel like an epidural is the only solution.
But often, if you give yourself some time, you can push through that labour wall.
What is happening behind the scenes is that your labour has progressed so your your oxytocin levels have increased, but your endorphins levels haven’t increased to match those higher oxytocin levels.
It takes about five minutes for your body to recalibrate and to produce enough endorphins to cope with this new phase of labour.
And yes, those five minutes are HARD!
But think about other times that you have had to push yourself.
For example, I don’t run often but every once in a while I get it into my head that I need to start running and so I will head off. And, at times, it sucks! My lungs are burning and my legs are burning and I want to quit. But instead of stopping and walking, I tell myself that it is normal for my lungs and legs to burn…my body is just doing exactly what I am asking it to do and exactly what it is meant to do.
Once I have convinced myself that I can keep going, I need a tool.
I use music to help me push through that wall. I find a song that I love and I absolutely crank it. Instead of focusing on my body, I focus on the music. And when the song ends, and I tune back into my body, I have found my stride again, I am back in my zone, I can keep going.
So if you feel like you want an epidural, it might be an idea to wait 20 minutes or even just 10 minutes, to see if you can push through that labour wall using other tools.
If you can, great!
If after 20 minutes you still want an epidural, then by all means, get the epidural!
Water solves most labour problems, including pain!
Warm water immersion in labour helps to reduce pain by diminishing stress hormones and by increasing production of endorphins.
It also helps to easy general muscle tension, helping you to relax during and between contractions.
Evidence shows labouing in water may:
- provide significant pain relief
- reduce the need for drugs and interventions, particularly epidurals
- promote relaxation and conserve energy
- provide a feeling of weightlessness—relieving tired muscles and stress
- encourage a sense of control in labour and increase satisfaction
- speed up labour
If you can, fully immersing yourself in warm water is ideal.
But if there isn’t a tub available, a shower works too.
Most women opt for pain relief not because of the pain per se, but because they are exhausted.
One of the best ways to avoid exhaustion is to rest (ideally sleep) during early labour. As long as you are comfortable lying down or sitting down, do so.
You can use hot water bottles or rice bags against your stomach and back to provide comfort.
Just because you’re in labour, there is no need to jump up and start pacing around the house…that time will come but until it does, rest.
Labour is usually a marathon, not a sprint!
As labour progresses, continue to relax and rest as best you can.
Remember if you are tensing and holding your breath during a contraction, your body is actually doing extra work!
Try to avoid bracing against the intensity of a contraction and aim to breathe through it…long slow even breaths.
Make sure you are drinking and eating to help keep your energy up too.
Evidence has shown that acupressure reduces pain during the active phase of labour.
Hip squeezes and counter pressure on your lower back are particularly effective.
And never underestimate the power of the comb!
Squeezing a comb in the palm of your hand helps relieve pain in two ways.
The first is through the gate control theory of pain relief. This theory says that your brain can only concentrate on one sensation at a time. The idea is that when you feel a contraction come on, you squeeze the comb and your brain focuses on the sensation from the comb and so ignores the sensations from the contraction.
Also ,when you squeeze the comb, you apply pressure to points in the palm of your hand. These points have many benefits including easing anxiety, increasing feelings of control, and dulling other sensations, and stimulating endorphins.
I know the comb seems a bit weird or too simple…bit weird and simple things can still be effective!
5. Other Options
You might be able to try a TENS machine, sterile water injections, or gas and air.
These can be very effective and have less of an impact on your labour physiology and on your baby than an epidural does.
Hopefully you found this post helpful and have learned a few tricks that might help you delay or avoid an epidural!
Of course if you want an epidural, go for it! And make sure it is an epidural that works for you…there are different epidural effects that you can ask you’re an anaesthetist about (getting into all the epidural options would be a whole other post)!
Please let me know if you have any questions.
I love educating mothers-to-be about birth and I am happy to help!
And please visit me on social media…education as well as birth and postpartum real talk.
Scroll my feed for literally thousands of posts providing education and free tips!
And check out my YouTube channel for videos answering my clients most asked questions.
I am all about women feeling prepared for a positive birth and starting motherhood feeling really proud of themselves and what they accomplished.
You’ve got this!