Alternative Pain Management for Birth
Alternative pain management: birth without the drugs.
Birth is painful. And while we wish we could tell you just how painful it is, a comparison to, say, passing a kidney stone just isn’t going to do it. In the research world, pain is a phenomenon that still isn’t completely understood yet and its clinical measurement is nearly impossible to determine. That’s because pain is a very personal experience, and everyone has a different tolerance. Doctors, of course, want birth to hurt less for whatever tolerance, but the most common way to do that is with drugs, namely anesthetics, opioids, and narcotics such as sufentanil, bupivacaine, morphine, and fentanyl through epidurals and injections. These drugs come with their own risks (many are statistically low; as few as one in 100,000 epidurals, for example, cause permanent nerve damage) — and some mothers just don’t want to take the chance. We spoke to two purveyors of alternative pain management techniques about the most popular methods of relieving pain drug-free during delivery.
Alternative Pain Management Technique #1: The Balance Method
It all starts with working with your body’s natural changes during pregnancy — and understanding why expectant mothers are hurting. “Pain in pregnancy and labor can come from any number of sources, but I find one of the most common reasons for that extra pain is from an imbalance of the musculoskeletal structure or from baby being in a funky, less than optimal position,” says Jesse Pournaras, a doula and yoga teacher. “In pregnancy, we produce a hormone called relaxin, that does literally what it sounds like: relaxes our muscles, joints, and ligaments to allow our pelvis and body to make extra space for our growing babies. When we produce lots of relaxin and our pelvis gets loose, our muscles have to work extra hard to create stability — leading to things like low back pain, sciatica, piriformis and psoas issues.”
So what’s a woman to do when her body’s all off-kilter? Find balance. And the best way to find balance? Practice yoga. “It’s one of the only exercises that’s definitively safe at any point during a pregnancy,” says Sage Caprice Abowitt, also a doula and yoga instructor. “Only through movement are you able to balance strength and flexibility and balance the pelvis. There’s a fallacy that doing 1,000 Kegels a day will get you ready for labor but the pelvis and hips move in a lot of different ways than just contracting. Yoga gives you access to more stability and balance in the pelvis and pelvic floors—which is movement that you can use in labor to reduce that pain as well.”
Alternative Pain Management Technique #2: Get Moving
So what movements are we talking about here? Both Abowitt and Pournaras utilize and recommend cat-cow. Mobilizing and strengthening back muscles that are subjected to the new pressure points of a dramatically curved spine are the only ways to create support that will alleviate those pressures. “There’s muscle discomfort, your neck feels crunched, your shoulders hurt, and your low back hurts because your abs can’t support you as they used to,” Abowitt says. “Besides cat-cow, I recommend practicing goddess squat, and squatting with a blanket under your heels.”
According to Abowitt, these positions access push abilities through the four base points of the pelvis —very similar to being on your knees. “Movies tell us that you have to be on your back with your knees into your armpits to give birth, and that’s not true,” she says. “There are several positions that can help alleviate birth pain — whether it’s being on hands and knees, or standing in a squat position.”
Alternative Pain Management Technique #3: Breathing
Breath is important for those times when moving around isn’t an option, but when it is, moving as much as possible can help manage pain. Abowitt suggests walking, swaying, and slow dancing to engage and strengthen muscles whenever possible. And when that doesn’t work, a message can. “Rubbing the outer thighs along the IT band, the soles of the feet, and the shoulder can relieve tension and pain,” Pournaras says.
But no matter what position you’re in—whether it’s your baby’s birthday or at the end of your first trimester—you have to breathe to feel better.
“Breathing is so important,” Pournaras says. “In labor, if you are scared or agitated your parasympathetic nervous system ceases to function — the brain redirects blood and oxygen to the brain and heart to allow you to react quickly. The uterus and all the muscles making contractions work inadequately, sometimes causing labor to stop or causing labor to feel extra painful. Try holding a squat while holding your breath — it sucks! Then try holding a squat while breathing deeply and exhaling with sighs — much easier.” No matter what kind of pain it is, increased oxygen relieves the muscles and lessens this pain.
Abowitt suggests practicing equal breath counts with your partner — this will help you both before delivery, and certainly during. “Make eye contact with your partner and say, ‘Breathe with me…1,2,3,4…’ and continue that breath in and out together. When things are challenging we hold our breath, so this practice is less about teaching someone how to breathe, but teaching them that they can breathe.”
Alternative Pain Management Technique #4: Meditation
As mentioned, experiencing pain is an incredibly variable and personal experience — but there is evidence that relaxation can reduce pain outcomes in both acute and chronic pain. There is also plenty of research proving that meditation decreases the body’s production of cortisol and adrenaline (which increase anxiety and stress) while increasing endorphins, which act as natural pain relievers in the body. During birth, it’s important to practice meditation and focus that brings you to a safe and comfortable place. “It’s important to bring your focus into the birthing room that you’re in,” Brooke Patmor, certified birth and postpartum doula, says. “Bring a photo that calms you or something that can be a focal point during labor so you can focus on just that familiar thing. It can be a labyrinth or a birthing statue — whatever works for you to create a visualization that you can meditate on.” Patmor also suggests that all of the dads have cue cards with their partner’s favorite mantras and affirmations to use during meditation to bring focus and comfort to their partner. “Knowing what to say is incredibly important for partners,” Patmor says.
Put It All Together
The key is having a deep toolbox so that when things don’t feel good, you have what you need to make it right — whether it’s doing twenty minutes of yoga together, breathing deeply for five minutes, giving a massage, or buying your partner a Snoogle pregnancy pillow to help her get a better night’s sleep.
“You’re not doing it wrong if you feel pain and it doesn’t mean anything about you as a person or a parent if you don’t love being pregnant, it’s okay to be uncomfortable,” Abowitt says. “But there’s always something to access and to try for pain relief.”
Sure, pregnancy can hurt, but we shouldn’t think about this as the curse of Eve. There are ways to manage it. So do your best to create more comfort for your partner.