Pain in labour is a normal physiological reaction; it is
there for a reason. Unfortunately Westerners are reluctant
to accept that it is normal and they do a lot to relieve it.
In a normal labour, pain can be used in a positive manner.
We react against the pain by tensing and fighting it.
Labour pain is positive pain that will have a positive
end--the baby. It is not the same kind of pain that suggests
illness or problems. The pain of each contraction will not
be experienced again when it passes; each pain is a step
nearer to birth.
The midwife is there to help and support the woman through
her labour and through the pain... Contractions build
gradually and allow the body's natural endorphins to reach
their peak and allow the mind to accept the pain as it
increases. Pain changes with each stage of birth. In the
first stage, pain needs to increase as the contractions
increase to allow the physiology of labour to progress. In
the second stage the pain is different, less intense, more
expulsive. When the head crowns, pain is there to tell the
woman to take it slowly, to gently birth her baby, to allow
the perineum to stretch. In the third stage, the pain is
there for her to know when to birth the placenta.
If the woman is allowed to relax and is allowed to believe
that her body can birth, she is more able to accept the
pain.
We all find it difficult to see a woman in pain, even at
normal levels. Each woman has different reactions to pain,
so pain relief should be individualised and not a routine
offer from a list.
Most pain relief does not take pain away as completely as
the name suggests. It makes pain easier to accept and can
help a woman relax and concentrate on the birth if it is
used positively. Pain relief can come in many forms. A
supportive, positive midwife who believes in a woman's
ability to birth can be a great form of pain relief! A
comfortable position, to be able to adopt that position,
mobility, feeling supported--all can be pain relievers.
The midwife does not have to resort to pharmacological forms
of pain relief--they often lead to a cascade of
intervention. We all know of births that are going well
until the epidural is sited, the pain goes, the contractions
are not felt, the woman does not know when her body wants to
push. She needs to be told, she needs to be "helped," she
needs further intervention. Pethidine does not relieve pain;
it takes the woman away from her body, out of her control
and into the control of others. Pain relief can make the
labour ward more manageable--contact and support for women
is not needed if they are quiet. Pharmacological pain relief
has its place, but it should be used wisely.
The pain of labour is there for a reason. We need to
understand it and accept it, and not be afraid of it.
-Helen
U.K.
Reprinted from Midwifery Today E-News (Vol 2 Issue 24 June 14, 2000)
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