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Is pain an essential part of labour?
It would be presumptuous of anybody to try to answer this question in a few short sentences. Labour and delivery are unique and very personal experiences. The concept of "whose body is it, anyway?", so flagrantly abused in various settings, is probably quite valid in labour. This is a physiological process where the individual undergoing it ought to have the final word on how she wants to go through it.
A purely medical perspective is that no pain is ever necessary for any process: physiological, pathological or therapeutic.. The only exception is where pain acts as a warning of potential injury.
Over the centuries, the primary and immediate aim of a physician was and remains to relieve pain and make the individual comfortable. This is why doctors will almost always positively encourage labouring women to have effective pain control in labour. However, if the woman feels that relieving pain will make the birth experience somehow less profound, this view will be respected. After all, as the cliché above goes: whose body is it, anyway?
Is labour always painful?
There is only a small percentage of women who experience very little or no pain at all in labour. The overwhelming majority of women find labour painful or very painful. It is very difficult to grade such a subjective thing as pain and making comparisons of the amount of pain among individuals is a futile exercise. Suffice to say, most women feel that labour pain is severe enough to require strong pain control. The individual woman concerned may decline this as a matter of choice.
Non-medication pain relief in labour: TENS Machine
Are there any methods of pain control in labour which are not medication-based?
Yes. The most popular one to date is the TENS machine. TENS stands for Transcutaneous Electrical Nerve Stimulation. This is based on the theory that by repeatedly stimulating sensory receptors in the skin using light electrical impulses, the pain arising from the womb and cervix will be inhibited. TENS works well for some people but is probably only effective in the latent phase and in early labour. Very few women find it sufficiently effective in established labour, unless it is supplemented with something else. It is also used by some women in the immediate period after delivery to control after-pains. The main attractions are its non-invasive nature and being non-pharmacological.
Other non-pharmacological pain control methods are hypnotism, the use of which is not widespread; and psyche prophylaxis, in the form of exhaustive antenatal education about pain in labour. This may positively influence the perception of pain.
How good is ‘gas and air’ (Entonox) in labour?
Entonox - or ‘gas and air’, as it is popularly known, is a mixture of oxygen and a gas called nitrous oxide. It is the latter component that is aimed at the pain.
This is a rapidly acting agent but the action lasts only a short duration, usually no more than 60 seconds after the last inhalation.
Probably the main attraction of gas and air is the fact that it is inhalational (no needles involved!) and is self-administered. This means the mother can have it if and when she wants it.
Many women find it quite helpful but are rather frustrated by its short duration of action. This means, if a woman uses it exclusively, she has to keep breathing on it practically continually. Others find it disagreeable because of the sedative effect it produces. In fact, some women fall asleep between contractions because they have been pulling energetically on the gas and air. The majority of women will probably be of the opinion that at the height of labour pains, especially with pushing in the second stage of labour, gas and air is hardly adequate.