Pain relief. Or physiological disturbance?
I know.
It’s been a really long fucking time. You’re probably thinking I got all hyped up starting this blog and then I got over it. But it’s not like that. Actually I started writing this entry in October.
Yes. October.
Honestly. Wasn’t it September just yesterday? Halloween spooked by. Then we were balls deep in Christmas deco’s. Now we’re halfway through January 2025.
I just need an extra 3-4 hours a day. Please?
Now it’s no secret I cried and complained the whole way through 2024. Anxious and unsettled. Finding peace only when I’m with my son. But I’ve made progress. Adjusting and accepting. Consolidating the pros and cons. Hating to admit that I know I have more time with my son flying around the world than working 9 to 5.
That sugarcoats it until I have to leave in the middle of the night or go on a layover. Then poof! It’s all over. LOL I’m not ok guys.
Anyways I want to carry on from where we left off a few months ago. Because if reading my blog may help you or someone you know advocate for themselves and make informed decisions, then every second spent writing it is worth it.
As far as my pregnancy was concerned, it was uncomplicated. And although my birth wasn’t negative, not much of my preferences were actually followed. If I could sit with my OB and midwives on duty today, I would have a lot to ask them.
Like why was I inserted a cannula without any explanation or consent? It wasn’t used for anything. Why didn’t I get the chance to labour in the water? It was CLEARLY expressed to everybody. Why did I have to push on my back? Could that have avoided my episiotomy and further tearing? Why was I given a painful, unnecessary fundal massage without permission? Plus much more.
As my time post partum progressed, I became alot more aware of my own birth experience. Learning that there is a very big difference between a natural birth and a physiological one. And mentally picking at several things I now know better.
So where were we? Making our way down the list of birth preferences that may be available at your location of choice (within the maternal healthcare system), remember?
Now when I say “maternal healthcare system” I refer to hospitals, birthing centres or anywhere with labour and delivery protocols and policies that staff must adhere to. Where often your’s and your baby’s best interest is put on the back burner to convenience your healthcare provider.
Please don’t get me wrong. There are incredible professionals and facilities out there. But the reality is that as soon as physiological birth is disturbed (which it usually is), things may spiral in ways you were trying to avoid. Directly impacting your immediate post partum journey.
Imagine you’re in the labour room. You’ve got your favourite comfy outfit on. Your sprayed your space with orange and geranium essential oils. Fairy lights are twinkling, draped across the wall. Your partner/support person is irritatingly breathing (sorry haha, I had to). And you’ve been keeping track of time, anticipating another powerful surge.
On the menu you’ve got lots to choose from in terms of pain relief. Epidural? Pethidene and Phenergan? Entonox gas? There’s also relaxation techniques, massage, water, birth ball or the option to do absolutely nothing and ride the wave.
Well I felt more relaxed even just typing the latter. First of all, they sound like plain English. Secondly, they’re non-pharmacological. And finally, they don’t disrupt the natural process of labour, birth and postpartum.
But for the sake of being informed. Let’s get on with it. What exactly is an epidural?
Epidurals are regional analgesics, meaning they provide medicated pain relief to a specific region of the body. During labour, an epidural is placed in the lower back area where the spinal cord ends, to block feeling in the lower part of your body. It’s given via a needle through a small plastic tube called a catheter to guide it to a space in your back. Once there, the needle is removed and the catheter stays in place. This allows for medication or further pain relief to be administered if required.
Depending on the dosage, you may or may not be able to move your legs, but you’ll be alert and awake. It takes about 10 to 20 minutes to start working and can be infused continuously, intermittently, or self controlled via a button (allowing only a certain amount at a time).
Epidurals are considered the most effective pharmacological form of pain management during labour. They can help you relax and get some rest. And if God forbid you need an urgent c-section, the catheter can be used immediately by administering a higher dosage of medication while saving time.
On the downside, epidurals alter the hormones that support birth, which could slow down labour or make it stop. It impacts the way you push as it reduces the effectiveness and strength of your uterine contractions. This is because it numbs or decreases the feelings from nerves on your cervix and pelvic tissues, which would normally send messages to your pituitary gland in your brain to release more oxytocin as baby’s head descends and puts pressure on the cervix.
But what’s oxytocin? It’s a hormone known as the “love drug” or “cuddle chemical” that builds up during labour to help the uterus contract and facilitate childbirth. It’s a natural pain reliever and assists in stimulating the flow of breast milk once baby is Earth side. Epidurals obstruct the natural release of oxytocin, so synthetic oxytocin (known as Pitocin or Syntocinon) is often administered through an IV to counteract this. The problem here is that it can cause longer, more frequent and painful contractions, leading to abnormalities in fetal heart rate and increasing the risk of operative delivery with forceps, vacuum or c-section - which all come with their own potential series of unfortunate events. See how everything is connected?
Moving on to Pethedine. Pethedine is an opioid medication, or in other words, a strong narcotic. If given, it will usually be administered in the early stages of labour so that hopefully it’s out of your system by the time you are fully dilated.
Wondering why? Because it can linger into the baby’s system and suppress their breathing. It makes them limp and drowsy which affects their suckling reflexes, hindering lactation and breastfeeding from the get go. Pethedine won’t impede your mobility, but isn’t nearly as effective for pain management as epidurals are.
Phernergan on the other hand is a sedative, and when taken with Pethedine it sedates, calms and alleviates labour pain. The combination of these drugs may aid in rapid dilation of the cervix (due to its ability to relax the muscles) which can expedite childbirth - again putting mum and baby at risk of unnecessary complications or would be interventions.
And lastly, Entonox gas. This is nitrous oxide mixed with oxygen and is administered through a mask on demand. It can be provided throughout all stages of labour and even immediately postpartum if further pain management is needed. It can be used independently or as a supplement to an epidural and does not require as much monitoring, giving you the freedom to keep moving around.
Entonox can ease anxiety and create a sense of pleasure and relaxation. Having said that, it may cause dizziness, nausea, vomiting and obviously won’t numb the pain like old mate epidural can.
You know what else eases anxiety, creates a sense of relaxation and dare I say it - even a pain free birth? Your beautiful mind, knowledge and power.
So as you can see. Lots to choose from so far. Or lots to take into consideration?
Talk soon x
References:
Epidural during Labor for Pain Management - Evidence Based Birth®
Effects of Epidurals on the Second Stage of Labor
https://eipmh.com/impact-of-epidural-on-bonding/#
EBB 245 - Evidence on Pitocin Augmentation, Epidurals, Cesarean - Evidence Based Birth®
https://www.phsmedicalsolutions.com/blog/epidural-risks-mother-baby?hs_amp=true
Effects of IV Opioids during Labor - Evidence Based Birth®
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