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Whether you are super woman and wanting to go natural, or if you are truly frightened of the coming pain of childbirth, there are many alternatives to pain relief that you should consider. Know your options when it comes to birth and labour pain relief

Relax, breathe and move

Panic and tension will make you struggle against your contractions, rather than letting your body use them to push out the baby.

Antenatal classes teach breathing and relaxation techniques that will help you relax, both body and mind. Many women attend antenatal yoga classes to strengthen muscles beneficial for childbirth, but also to learn how to focus, breathing and relaxation techniques. Fear, anxiety and panic can make your adrenaline surge, which can prolong the labour by interfering with contractions. Tense muscles and mind, will also wear you out prematurely. You will not avoid the pain, but keeping calm and focus will help you deal with it.

Unless you are using an epidural, try to move around and find your optimal birthing position. Traditionally you would lie on your back, primarily to facilitate a doctor's examination. But squatting, standing or kneeling will make gravity help out a bit. As with anything, it is easier to push something down, than lift it up.

All this might sound great before hand, but you will likely need a birthing partner that will help you stay focused. During a long labour you might be too tired to cope without any other pain relief.

With no drugs

TENS (transcutaneous electrical nerve stimulation)

The TENS will stimulate your body to increase the production of endorphins, the body's natural painkillers. The battery run machine, which is the size of a pack of cards, transmits mild electrical impulses into the muscles of your lower back through four pads that you stick on. You will be able to control the current and its strength. You can use TENS with other pain relief options.

It is usually used for early stages of labour, but try it out in advance, about two weeks before the birth, to make sure it works on you. You can also try turning the TENS off during labour to see if it is effective on you. TENS might be available in your hospital of choice, but can also be rented.  

Gas and Air (Entonox)

Entonox is probably the most widely used pain relief  for childbirth. A mixture of oxygen and nitrous oxide gas (laughing gas) that is breathed in through a mask or mouthpiece, which often makes your mouth feel dry. While the gas will help you cope with pain and relieve you, it will not take it away. The gas will not harm your baby, or interfere with the birth, and you will be able to add other pain relief options if the gas is not enough.

Can be taken at any time or stage of the birth, but is used mainly to help you deal with the build up pain during a contraction and intense pain when it peaks. You will start breathing in the gas when a contraction starts and keep breathing it in until the contraction peaks. The gas will kick in within 15-30 seconds and wear out within minutes after you stop breathing it in.  The gas has different settings, where you can increase its effectiveness as your pain intensifies during childbirth and labour.

Using gas might make you feel nauseous and light headed. Some women also feel slightly detached from the childbirth and have a hard time focusing, which is positive or negative depending on your expectations.

With drugs

Pethidine

A midwife will give you a narcotic injection into a muscle, either in your bum or thigh, that will relax, reduce anxiety and make you feel somewhat detached from the pain and the childbirth itself. It will last between two and four hours, will take about 20 minutes to work and can be topped up. It will not alleviate the pain fully, rather take the edge off and help you to relax.

Can make you feel drowsy, and is usually only given in early stages of childbirth since the drowsiness could affect your baby's breathing and making him drowsy. The effects of the pethidine might make it harder for you to push during childbirth and your baby could need an antidote when he is born to counteract the drowsiness caused by the drug. 

Epidural

The epidural is the most effective pain relief option. It will take about 30 minutes to kick in, and will need to be topped up every 90 minutes.  After getting a local anaesthetic, a thin tube (catheter) is inserted in the epidural space of your spinal cord. The accessible entry for anaesthetics makes urgent changes in your deliveries, such as caesarian, safer for your baby. You will be able to get immediate top ups of anaesthetics through the catheter. With an epidural you will also need an intravenous drip to regulate your blood pressure.

There are two types of epidural, regular and mobile. With the regular epidural, you will not be able to move and is therefore often given while you lie down or sit on the bed. You will be numb and will need a catheter to avoid a build up of urine in your bladder. A mobile epidural gives a lower dose of anaesthetics and will let you move and feel contractions.

Because an epidural can slow down the labour, many hospitals will not give epidural until you are between four and five centimetres dilated. After a certain stage of labour, when the vagina is almost fully dilated at nine to ten centimetres, it is unlikely that you will be given an epidural.

There are more cases of instrumental delivery, forceps and vacuum, when using an epidural. There are some possible side effects, such as falling blood pressure, prolonging labour, headaches and back ache where the epidural was introduced. There are cases when epidural does not work fully or at all. You will probably be advised to take an epidural if you have a long and hard childbirth, are very anxious,  have high blood pressure or pre-eclampsia.

Alternative options

Most alternative pain relief options focus on relaxing and soothing the mother and her muscles during childbirth.
Aromatherapy – relaxes and soothes, muscles and mind, through the inhalation and use of essential oils. Make sure you are advised on the oils that are not suitable during pregnancy.
Hypnotherapy – a relaxation technique helps you deal with pain and fear by teaching you focus and how to detach your mind from the pain. It could be hard to focus, but with preparation you might not need a practitioner with you. 

Alternative therapies

Using most alternative therapies will require you to have a practitioner present during childbirth. Not only can this be difficult to achieve, but it can also be costly. There is not enough research done to verify that alternative therapies do work, but that is not to say that many women find comfort and release taking advantage of them during childbirth. When considering an alternative therapy for your birth, make sure you use them in advance during your pregnancy to see if you find it effective. 

Acupuncture - relieves pain by sticking very thin and flexible needles into specific points of your body.
Reflexology – certain points on hands and feet are massaged or pressured, to relieve pain, release endorphins, stimulate the uterus and the contractions.
Hypnotherapy – helps you deal with pain and fear by teaching you focus and how to distance you from the pain by reaching a trance-like state. It could be hard to focus, but with preparation you could manage.

Whether you are super woman and wanting to go natural, or if you are truly frightened of the coming pain, there are many alternatives to pain relief that you should consider. Know your options when it comes to labour pain relief