FTM: advice about natural birth vs. pain meds

chickklit · January 2013

I am very early in my pregnancy, but of course already thinking about my options for delivery. I am a FTM so everything is new to me. I was just wondering how to make a decision on how to deliver. I honestly don't have the highest pain tolerance, but it seems trying to go med free is a beneficial way to go. I can be a very determined person and can be mentally tough (when it comes to working out or competing in races) But....when it comes to childbirth, I have no clue if I am mentally tough??

Can anyone who has had experience just give me any helpful advice? Also if anyone has a lower pain tolerance, I'd like to hear from you, too! Thanks so much!

KateLouise · January 2013

I've often likened childbirth to climbing a mountain, in that it's the pain of hardwork and fatigue, rather than the pain of injury.

I think, in some ways childbirth is easier than running a race in that once it starts you have no other option than to go with it. You can't stop or back out. Yes you could have an epidural but they don't always do everything you might hope for in terms of eliminating pain.

I think it's the exhaustion that gets many woman rather than the pain. If you've had a very long labour with a poorly positioned baby then that's a lot harder than a woman who has a shorter labour with a well positioned baby. Not more or less painful (although back labour is painful), more just the exhaustion of coping with the pain.

To that end, I think that is the benefit of an epidural. It can give a woman a break and a rest when they have absolutely hit the wall. So I don't think you need to decide for or against the epi before labour. I think it's good to know why you'd like to avoid it, and to have some coping techniques or strategies in your mind.

Coping strategies can range from massage techniques for your partner to, positions to labour in, staying at home as long as possible, asking not to be offered drugs unless you ask for them, and not being told how dilated you are so you don't get discouraged.

My advice differs from some on this board who think you need to absolutely take the epi out of the equation as an option if you are to succeed at a natural birth, but that was not my experience. I've had two epi free births and I never once considered an epidural whilst in labour, because I just never hit that wall. I don't consider myself mentally tough, and you won't catch me running any races. I think I was fortunate with the length/difficulty of my labours and made lots of use of the shower and tub.

Good luck with your decision.

bripratt2 · January 2013

KateLouise:
I've often likened childbirth to climbing a mountain, in that it's the pain of hardwork and fatigue, rather than the pain of injury.
I think, in some ways childbirth is easier than running a race in that once it starts you have no other option than to go with it. You can't stop or back out. Yes you could have an epidural but they don't always do everything you might hope for in terms of eliminating pain.
I think it's the exhaustion that gets many woman rather than the pain. If you've had a very long labour with a poorly positioned baby then that's a lot harder than a woman who has a shorter labour with a well positioned baby. Not more or less painful (although back labour is painful), more just the exhaustion of coping with the pain.
To that end, I think that is the benefit of an epidural. It can give a woman a break and a rest when they have absolutely hit the wall. So I don't think you need to decide for or against the epi before labour. I think it's good to know why you'd like to avoid it, and to have some coping techniques or strategies in your mind.
Coping strategies can range from massage techniques for your partner to, positions to labour in, staying at home as long as possible, asking not to be offered drugs unless you ask for them, and not being told how dilated you are so you don't get discouraged.
My advice differs from some on this board who think you need to absolutely take the epi out of the equation as an option if you are to succeed at a natural birth, but that was not my experience. I've had two epi free births and I never once considered an epidural whilst in labour, because I just never hit that wall. I don't consider myself mentally tough, and you won't catch me running any races. I think I was fortunate with the length/difficulty of my labours and made lots of use of the shower and tub.
Good luck with your decision.

I really like how you worded this I tell all my friends Its hard work more than pain

clariknittist · January 2013

I think just like pre-birth, getting wrapped up in numbers is one of the worst mindtraps you can fall into. When you're waiting to go into labor and your OB is telling you how dilated (or not) you are, how effaced (or not) you are, you might feel like you see the light at the end of the tunnel but it's farther than you think, or that it's nowhere in sight and actually it's right around the corner.

A friend of mine wanted to give birth naturally and labored really well for something like 9 hours. They told her she could expect to dilate "A cm an hour" after that, and since she was only 3cm after such a long stretch, she figured best case scenario she would be laboring at least 7 more hours...well, I don't think that was too accurate, because I know in my experience I moved faster than that at certain points - 2cm an hour, for instance, and most women you talk to will tell you labor is highly unpredictable. She ended up getting an epi as a result of that logic, and regretted it later. If I had been looking at the clock at all or thinking about how long it had been, I would have driven myself nuts. Just like you're told to take the labor one contraction at a time, I think for me I just had to focus on coping rather than how quickly things were moving along. Time had to become totally irrelevant for me, but if you are delivering in a hospital, it might be at the top of the list of concerns for the OBs/nurses. In my case, they kept pushing pitocin on me because of the clock. I declined and was in labor for 24.5 hours, but it was completely worth it and the only time I felt approaching unmanageable was when they wouldn't let me push - that was trying because I couldn't stop my body from doing what it was naturally doing!

I took an "advanced labor techniques" class offered by the hospital, and the nurse who taught it had us think about how we personally would handle pain or discomfort. Were we the type who would be vocal about it? I knew I wouldn't be, that I would just need to keep to myself and be left alone. That helped my husband more than me, so he would know what to expect in the delivery room. To be totally honest, I felt like I had a lot of tools in my toolbox so to speak - relaxation techniques, different positions we had learned, inspirational phrases in mind, etc...I did not use any of them, but it made me feel super-prepared to have them at my disposal walking in. In the moment, I found myself mostly walking the halls and mindlessly doing what came naturally to me to relieve the pain, which was a lot of awkward half-standing by the bed for a really long time...I never once considered the meds, but that's because I knew they were off the table for me since baby was never in distress or any danger. The same is going for breast-feeding at the moment - formula is just not an option I'm considering in my mind unless he has some kind of health problem we can't resolve, so those nights when I'm frustrated and tired and he's fussy and not ever satisfied and I feel really stressed out...well, that's just the way it is right now and it will pass, just like labor did, and I'll have a healthy happy baby at some point on the other side.

Good luck with your birth!!

chickklit · January 2013

Thank you ladies for such great insight! I am one that is organized and likes to know what to expect so I have read a lot on natural childbirth. But I really enjoy hearing everyone else's experiences and advice. I like the idea of not being informed about every number. I, too, would probably get discouraged or my hopes up, only to be dashed. I will speak with my OB about that. I am also praying my DH and close friends and family do not discourage me against med free. I know a few will, and that will be discouraging to hear them tell me their opinion. I want to do what is best for me and baby! I appreciate your encouragement!

pdilly2b · January 2013

I don't think "pain tolerance" has much to do with it. For me, it was about mental toughness and being able to remain calm through contractions. Calmness for me came through preparation and confidence that I could birth my baby. Having a care provider who is on board is also extremely important. I switched to a hospital-based midwife practice at 32 wks because my OB was very condescending to me and not supportive of even simple requests like wanting a heplock instead of an IV. It's also very important to try to set yourself up for success, which can be various things, but for me included getting DS in a good position (see exercises at www.spinningbabies.com), informing myself about various interventions, when they may be necessary, and how they can lead to other interventions (like epidurals can lead to pitocin and v.v. and both can then lead to c-sections), and having DH be knowledgable and supportive of my wishes.

cattynine · January 2013

I think the PP have made some great points. I think a lot of making it through labor is mental preparation and being able to relax as much as possible.

I don't have a very high paint tolerance, but it seems like that has no bearing on whether or not you can do it without meds. I have lots of friends who I would say are pretty tough and planned to go med free, but ended up with EPIs.

I planned to go without an EPI, but then after laboring for 12+ hours and only being at 2 cm, I decided to get one as soon as I hit 4 cm. Well the next time I was checked ( maybe 3 hours later) I was 7+. So I knew right then that I could do it and I pushed ahead sans EPI. During most of that time from 2-7 cm I had been in a tub at the hospital. I swear I only remember like 5 contractions during that time, but obviously my body was doing something if I was able to progress so much. I didn't study hypnobirthing, but I wonder if my being able to relax so much in the tub was similar to what hynopbirthing aims to achieve.

Joyfullnoise · January 2013

The PP have said it fabulously.
Contractions aren't constant, if you stay relaxed, so you just have to make it through little windows of intense cramping, like a Charlie horse, on repeat.
Knowing that it wouldn't stop until I held a baby helped me.

Xles10 · January 2013

Water helps to relieve the pain, so a shower or tub can help with pain management. I honestly think that labor is very situational. And while we can all prep for our ideal unmedicated birth you do want to be aware of when certain interventions make sense.

I had a surprise induction with my first. I worked with midwives, had a doula, and had prepped for an unmedicated birth, but the induction threw some of that out the window. I decided to last as long as I could. I made it to 7 cm. It was terrible pain with no break. There was no rest period beyond contractions. I do have a high tolerance for pain and I was absolutely losing it. But I wanted to wait as long as I could in order to get baby in position. I got an epi and I know it was good decision for me. Allowed me to rest, breath, and get oxygen to my son who had the cord around his neck.

I think more than focusing on dealing with pain, it's best to read up and become as informed as possible. Avoiding unnecessary intervention is just as much of the battle as learning how to cope with pain. For example, if you're in labor but not progressing, you're likely better off if you know that you'd rather have your water broken then pitocin administered. Your OB may not offer that option, but if you're informed you can ask. Or if you're having bad back labor, progressing slowly, and in major pain, you'll likely be better if you know that you need to get moving and try to get baby to turn instead of opting for an early epi.

ally2011 · January 2013

I would strongly encourage you to read Ina May's Guide to Childbirth. It has helped my confidence level and sense of calm tremendously.

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