36. Pain relief in labour
By Dr Joe Kabyemela, MD
Of all these, the epidural method is superior by a long way. It is the only method where complete pain relief can be promised and delivered. In a small minority of women, this is unfortunately not achieved. Moreover, in a small number of women, the epidural is not suitable or may even be contraindicated.
There are no absolute contraindications for any of the other methods.
Water birth may be unsuitable for some (see Chapter 40, "Water birth").
Overall, pain control in labour should be tailored according to the needs and wishes of the individual. One aspect that we have always regarded with dismay is a restrictive birth-plan. It is not unusual to find a birth-plan prepared antenatally which states categorically that "I do not wish to be offered an epidural under any circumstances at any stage of labour".
Such statements are commonly a result of pregnancy classes, where some so-called experts impose their personal opinions on unsuspecting and trusting women. Any such individual who influences such a decision deserves condemnation in the strongest possible terms.
It is the duty of anybody in that position to present the facts and facts only to his or her clients and allow them to make up their own minds. In the area of pain relief, the enduring wisdom is for the woman to be open-minded and to consider all the options, depending on her needs at the time. This is as long as she knows what each of the options entails.
Those are the facts she should be offered in the antenatal class and the facts that are presented here.