Wondering about labour pain 1973

Lady Penelope Creighton-Ward

My personal opinion is that the need for pain relief has almost nothing to do with your pain threshhold, and not very much to do with your preference to have or not have an epidural. I think there are a few key factors:

1) It's important to have an understanding of labor pain as something that's not indicative of danger. A million and one people will tell you you're crazy not to have an epidural, but how many people tell that to marathon runners, who certainly experience quite a bit of pain during training and races? You've got this, so that's a good thing.

2) Your caregivers are really important. Caregivers can manage you into needing pain relief in a jiffy. If they have no confidence in your ability to manage without drugs, and keep offering them, and tell you there's no need to be a martyr, that creates a very negative environment. Furthermore, there's a *lot* caregivers can do to recommend techniques that will help you cope. Caregivers who aren't used to employing those techniques aren't going to be as helpful to you as those who effectively support unmedicated births frequently. Also, it's sad to say, but it takes more work from staff to support an unmedicated birth. Hospitals with staffing shortages (or a really busy night) have a powerful motive to get you an epidural. They might not even realize it consciously, but it can be a factor.

3) Your environment also matters a lot. Fear and tension will increase your perception of pain a great deal. Hospital policies like mandatory IVs or heplocks, electronic monitoring (especially continuous monitoring), food and drink restrictions, and so forth can inhibit your ability to cope well with labor pain. Even if you know that you can get up and move around, you can start to feel like you're bugging the staff when you do so, or that it's just too much trouble. There are so many little things. For example, maybe you can get them to agree to no IV or heplock, but then was pushing for you to drink fluids because they're used to women being hydrated by IVs. That's not to say you can't get an unmedicated birth in an environment that's not used to it. You just have to be realistic about the fact that it's going to be more challenging and you probably won't be able to rely on the staff and the environment to push you along in the direction you want to go.

Really, I think those things are what really counts when it comes to being successful with an unmedicated birth. If you look at first time mothers who choose homebirth (and are thus in the same boat as you in terms of not knowing what labor pain will be like, what their labors will be like, or how they'll cope), well under 10 percent of them transport for pain relief. Sure, they obviously have a pretty high motivation to go unmedicated or they wouldn't have chosen homebirth in the first place, but that figure says to me that it's *not* just a question of internal forbreastude or other factors beyond your control that make the difference. If you want an unmedicated birth and you choose caregivers and environments carefully, the odds are very much in your favor that you can do that. Just be realistic about your caregivers and environment. The best predictor of results in past results, so take that into consideration when making those choices.

For myself, I had three unmedicated births (a 45 hour labor with a 7lb 2oz baby, a 2.5 hour labor with a 9lb 6oz baby, and a 5 hour labor with an 8lb 2oz baby--and nary a sbreastch with any of them). So, I certainly think that labor pain is bearable and I was definitely capable of rational thought during labor and wasn't panicking. I did choose to birth at home, because for my situation, I felt that gave me the best odds of getting the low intervention births I wanted. I do think that's generally the easy way to get an unmedicated birth, but I understand that not everyone is open to that option.

Best wishes, Ericka