Thinking about where and how to give birth
Ideas about where and how women should give birth are constantly evolving. Many women, midwives and doctors feel strongly that the natural process of birth...
Many women worried about pain in labour and what kind of pain relief to use, if any, especially in a first pregnancy. It was difficult to imagine what the pain would be like and how effective the different types of pain relief would be. Some people wanted to try giving birth with as little pain relief as possible, but most felt it was important to keep their options open and some emphatically wanted it to be as pain-free as possible.
Common choices included inhaling gas and air, pethidine injections, using a TENS machine and having an epidural anaesthetic. Some chose to relax in a warm bath or birthing pool, and some asked their midwife or birth companion for massage, sometimes with aromatherapy oils.
Each of these approaches worked well for some people but not for others. It is hard to predict how individuals will react. Looking back, many people said they had not anticipated how exhausting the effort and pain of labour could be, and several were glad to have an epidural to get through the final stages, even if they had not planned it. Some people had firmly intended to have an epidural, including a woman who was concerned that getting too exhausted might trigger an epileptic seizure.
Epidurals did not work well for a few people, including some who felt pain mainly in their backs. For some people it took the edge off the pain but they could still feel the contractions through it. Others felt completely numb and needed help to know when to push.
One mother chose an epidural because she was trying a vaginal delivery after a previous caesarean and thought if she needed another emergency caesarean the epidural could be topped up, avoiding a general anaesthetic. A few people were worried about possible side effects from epidurals or afraid of needles.
One woman was pleased to manage without an epidural because she wanted to be fully aware of the sensations of birth. Pethidine helped her more than gas and air, but some people liked gas and air. Other people found pethidine or gas and air could make them feel disoriented or sick, and a few vomited.
Several people who tried a TENS machine said it had little effect or only worked for a while, but a few were very happy with it, including one woman who used TENS and gas and air to help with a painful induction.
Several people who had an induction said the contractions seemed especially painful and intense (see Interview 16 above). One woman was in so much pain she could not keep still enough for an epidural, and also had a painful episiotomy (a cut in the skin between the vagina and anus to help the baby’s head out).
Having stitches or internal examinations can also be painful. One woman said the midwife’s attempt to rupture her membranes to speed up labour was very painful, so it was postponed until she had an epidural.
A few people were upset that staff did not seem to realise how bad the pain was and seemed unsympathetic.
(See also ‘Looking back – vaginal birth’ and ‘Looking back – caesarean birth’).
For more information see our pregnancy resources.
Ideas about where and how women should give birth are constantly evolving. Many women, midwives and doctors feel strongly that the natural process of birth...
Most of the women we interviewed had a vaginal birth, although levels of pain relief and interventions differed widely. Some went into labour spontaneously and...