Monique Rainford

Recently a close family friend shared a joke with me. She said that if men could have children, the average family would include three children. The man would allow the woman to have the first child out of politeness (ladies first); then he would take his turn and have another child. The woman would again take her turn and have the third child but when the time came for the man to have another child he would refuse.

Having delivered many babies and witnessed hundreds of women in labour, this is not hard to believe. Based on my patients' reaction, labour appears to be one of the most painful human experiences. However many a labouring woman insists that she cannot continue and that she is unable to bear the pain, she continues and successfully pushes even as long as an hour or more to deliver her baby.

A rare woman endures the discomfort quietly, stoic in the recurrent spasms of discomfort. One of my young mothers managed to smile between her contractions despite being advanced in labour. Even after enduring all this, many women willingly choose to have another child and some several children. It is no wonder that the musician Shaggy felt inspired to sing his hit song 'The Strength of a Woman".

Labour pain

However, fortunately for women who are less willing to endure 'natural labour', pain management options are available. An important component in the management of labour pain is a woman's state of mind. Pain is more intense if a woman is fearful or emotionally tense. She can better prepare herself for labour if she becomes familiar with the different procedures that may be required and understands that childbirth is a natural process.

This preparation can reduce her need for pain medications. Having the support of a spouse or other family member is another important component to pain management. It is even possible to hire a trained professional to offer individual support during labour.

Drug options

The medication options that are available locally include pethidine usually given with gravol (a medication that prevents nausea), no-spa, buscopan and tramal pethidine, a narcotic, may provide greater relief, it has to be avoided close to delivery as it may cause a sedating effect on the newborn baby.

The most effective form of pain relief in labour is the epidural. The medication is usually infused through a catheter injected in a space in the mid lower back below the spinal cord. It is usually administered by an anaesthesiologist who is trained in the technique. Epidurals have been widely and safely used in the United States for several years and they are becoming more popular locally. Unfortunately, it may be unaffordable for many women.

Potential risks

However, there are some potential risks with this method and they include a lowering of the blood pressure, headache, and retention of urine. More serious complications are also possible. The woman may also have a slightly higher incidence of backache, neckaches and tingling in the hands and feet. Epidurals usually prolong the labour process and may increase the need for a medication called oxytocin which stimulates contractions.

There are conflicted studies on whether or not an epidural increases a woman's risk for needing a Caesarean section but experts suggest that this should not prevent a woman from choosing this method of pain control.

I tell each labouring mother that she will get through labour and that she is strong enough to handle it. Nevertheless, preparing herself in advance and choosing a method of pain relief that is best suited for her, allows her to navigate the process much better.