Epidurals vs. Unmedicated

I was talking to someone today who was trying to decide if an epidural was right for her in her upcoming labor.  She was well read and still had some concerns on the topic.  But in part of our correspondence she said something that made me realize that she felt it was the epidural or do nothing.  We had a long talk about how women who choose to go without an epidural don’t just sit there writhing in pain until the baby suddenly falls out – they prepare and actively participate.

I explained that if she had any intention of going without an epidural, even a slim chance, that she should find a childbirth class that was designed for women who did NOT want an epidural.  Then she would be prepared, but that if she changed her mind and wanted an epidural she could always have one.  I told her that there were many things that women do to cope with pain in labor including:

• positioning
• movement
• massage
• relaxation
• encouragement
• water
• heat
• cold
• TENS

What would you have told her?

Move, Walk Around & Change Positions Throughout Labor

Moving in labor is something that we don’t often think about these days.? After all, if you give birth in a US hospital, you walk in and see a bed.? If you were following the live birth on the Internet the other night, we were all amazed at the size of the room (it was small) and it was the VIP room!? What did you see prominently featured in the center?? he bed, of course.? Unfortunately freedom of movement in labor has come to mean, you can lay on your right or your left side.

I’m here to tell you that moving around in labor helps a lot.? When my leg hurts, I shake it out, I stand up and move, changing how I put pressure on it.? When my back hurts, I stretch, bend and fold until the pain subsides.? Labor pain is no different.? And yet by restricting movement we take away a woman’s freedom to alleviate that pain without medications.

Now, some hospitals will claim that they are not actively restricting movement of their laboring patients.? And while we do not hand cuff women to their beds very often anymore, we do tether them with physical items like IV poles and fetal monitoring equipment.? Then add the psychological aspects of the bed and being a good patient and throw in a poorly designed hospital gown that shows your buns at every turn and you’ve got a woman who is more likely to stay in bed.

So here are my tips for freedom of movement:

• Begin this discussion early and often with your practitioner. Ask lots of questions that can only be answered with open responses.? “Can I move?”? elicits the answer: “Sure!”? But you’re thinking hands and knees, squatting and roaming the halls and? your practitioner is thinking, on your back and sitting up. Try something like, “What positions have you seen women give birth or labor in?”? You might also try, “What positions do you recommend for pain relief in labor?”

• Tour the hospital or birth center. Other than a bed, what can they provide you to help you move?? Do they have birth balls?? Do they offer an early labor garden or path? These hospital tours are given in groups or in private.? Try both if you can.

• Exercise and practice. Just as with anything, if your body isn’t ready to use muscles that are required to squat, you’re not going to be very successful at doing so. It will also help you and your partner feel more comfortable as the movements become familiar to you and your body.

• What tips would you add?

For more information on this healthy birth practice, you can see:

Lamaze’s Handout | Mothers Advocate Handout | Mothers Advocate Video