Alternative Methods of Pain Reduction During Pregnancy and Labor

Not all women want medication administered to them during labor and would rather opt to have a natural childbirth. The term natural childbirth was coined by an English obstetrician by the name of Grantley Dick-Read in 1914. His view was that a natural childbirth would use education and relaxation techniques rather than medication to ease the pain during labor (Santrock, 2008). Some of the alternative pain reduction techniques used today include hydrotherapy, acupuncture and hypnosis.

Hydrotherapy

Hydrotherapy, also known as water birth, is one alternative pain reduction technique available to laboring mothers. By definition, hydrotherapy is the use of water during labor and/or birth to reduce pain (Hughes). Water birthing has been around for centuries and is often used in many home births and it is becoming a more popular option in America. According to the Global Maternal Child Health Association, there were only two United States hospitals that offered water birthing as an option in 1995. Now there are over 120 hospitals that have done at least one water birth and many more that at least offer showers to contribute to relaxation during labor (Hughes).

A study found that more than 2,000 of 5,900 vaginal births in Switzerland were done using the hydrotherapy technique, which is used worldwide. The findings of this study had many advantages (Hughes). The first advantage was that the hydrotherapy births had a much lower rate of episiotomy; only 12.8 percent versus 35.4 percent for those mothers who gave birth in bed (Hughes). Not only that, but there was less blood loss and the newborns scored higher on the Apgar scale than babies born not using the water birth method (Hughes).

When deciding whether or not hydrotherapy is the best option for pain reduction, one must take a few things into consideration. Hydrotherapy is not the best option for everyone. The expecting mother should be assessed by her physician to rule out any criteria that may cause complications during a water birth, such as multiple babies, maternal fever or the need for fetal monitoring throughout the labor process (Hughes). Keep in mind that the use of hydrotherapy does not necessarily reduce the length of labor (Johnson, 1999). Another disadvantage is the potential for more physician or caregiver injury due to the floor around the birthing area being wet and having to remove the fetus from underwater (Johnson, 1999).

The list of advantages far outweigh the list of setbacks, as the benefits can be very rewarding. Hydrotherapy causes the laboring mother to relax and not be so anxious, which in turn will lead to a better labor experience (Hughes). A more efficient labor will then result in a slimmer chance of needing to administer pain medication, including epidurals and other intravenous medications. Hydrotherapy has also been found to lower blood pressure, most likely due to the fact that the laboring mother is more calm and relaxed (Hughes). Enhanced fetal rotation and increased muscular stretching are also advantages of this technique (Johnson, 1999).

There are a few other things to keep in mind. Due to the water being between 99 and 101 degrees, the laboring mother will most likely experience an increase in pulse (averaging seven beats per minute). The fetal heart rate will also rise between ten and twenty beats per minute during the first 15 minutes and then return to normal after the patient leaves the water (Johnson, 1999). It is best to limit the time the laboring mother is in the water during the early stages of labor. Saving this technique for the active phase is best (Johnson, 1999).

Acupuncture

Another alternative form of pain reduction during pregnancy and labor is acupuncture, or the insertion of very find needles into specific locations in the body (Santrock, 2008). Acupuncture has been a standard procedure for reduction of pain during childbirth in China for centuries and has only recently been introduced in the United States for this purpose (Santrock, 2008).

Researchers claim that acupuncture helps to ease pelvic and hip pain during pregnancy as well as relief of nausea (Hitti, 2005). Acupuncture treatments are usually started after the first trimester, due to the safety of it, and last throughout the pregnancy. The reason it is dangerous to apply acupuncture during the first trimester is due to the higher rate of spontaneous abortion because the baby has not stabilized at this point (Hitti, 2005).

Acupuncture can affect contractions of the uterus, so even when a woman in the later stages of pregnancy gets acupuncture treatments, the acupuncturist will normally avoid instering the needles deeply or using them anywhere in the lower back region (Hitti, 2005). Acupressure, or gentle massage, is often used in conjunction with the acupuncture treatments to reduce pain. Acupressure applies pressure to specific points on the body, but does not use the administration of needles (Hitti, 2005).

Some studies have shown that acupuncture can be more effective than other forms of alternative treatments of massage, heat, or exercise. A Swedish study showed that acupuncture actually reduced low back pain and disability with just a few treatments (Acupuncture Helps, 2000).

Three-quarters of all pregnant women fall culprit to lower back pain during their sixth and ninth months of pregnancy. Although the cause is not yet known, it is believed that smoking, strenuous work, and previous back problems could be contributing factors (Acupuncture Helps, 2000). Pregnant women with lower back pain often having trouble sleeping and find difficulty in performing daily tasks, sometimes resulting in time off from work (Acupuncture Helps, 2000). This classification of pregnant women could benefit greatly from acupuncture treatments.

Kaj Wedenberg, MD, PHd, the assistant chief of the Ob-Gyn at Central Hospital in Vasteras, Sweden, along with two nurse-midwives, conducted a study on 60 pregnant women with lower back pain. Each women received ten treatments of either acupuncture or physical therapy over a four to eight week period. They rated their pain on a scale of zero to ten before, during, and after their treatments (Acupuncture Helps, 2000).

Both treatment groups had similar ratings for pain before their treatment, but there were remarkable differences afterward. Of the acupuncture group, the women had an average pain reduction of 2.5 points in the morning, and six points in the evening compared to the physical therapy group which had only 1.5 points in the morning and 2 points in the evening (Acupuncture Helps, 2000). The acupuncture group also had an easier time performing daily tasks after treatment, whereas the physical therapy group noticed no significant difference in their performance (Acupuncture Helps, 2000).

Hypnosis

Hypnosis is another alternative pain reduction method used in pregnancy and labor, although not in the way that some may think. Hypnosis is the "induction of a psychological state of altered attention and awareness in which the individual is unusually responsive to suggestions" (Santrock, 2008). Referring again back to Grantley Dick-Read's view of birth without fear helps to support hypnobirth due to the relaxation of the body which alleviates fear, tension, and pain (Weiss).

Hypnobirth is achieved by teaching and administering relaxation techniques and cues to the laboring mother. This helps to bring the mother into a state of complete relaxation, resulting in more awareness of what is going on around her without the fear of pain (Weiss). Many childbirth classes are often believed to be of use only to those mothers who are having a vaginal, unmedicated birth. Whether the childbirth class is hypnosis based or not, it has been proven that childbirth education in general helps to reduce the length of labor and the fear of pain on some level (Weiss).

Anyone can benefit from the techniques and suggestions taught with hypnosis, whether they are high risk or not, and whether they are planning on a medicated or natural childbirth. Hypnosis can increase trust in one's own body and birthing ability, therefore resulting in a more efficient pregnancy and fewer high risk cases (Weiss). While hypnosis does not necessarily relieve pain in the way that some of the other alternative techniques do, it increases self assurance in the laboring mother so that she is more aware of her body and its abilities.

Conclusion

The benefits most often outweigh the risks of alternative techniques for pain reduction during pregnancy and labor. Being able to have options for pain reduction as a laboring mother can result in a more pleasant birthing experience. Pain medication is not for everyone, and more and more hospitals and doctors are offering alternative forms of pain reduction for laboring mothers.

In all cases, one must talk with their physician to ensure that the techniques they have in mind for their birthing plan are safe and practical. Talking to the physician in advance to get as many details as possible, and to weigh the advantages against the disadvantages, is the best idea when seeking an alternative route to pain reduction.

References

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Hitti, M (March 17, 2005). Acupuncture May Cut Pregnancy Pelvic

Pain. WebMD Medical News, Retrieved October 13, 2007, from http://www.webmd.com/baby/news/20050317/acupuncture-may-cut-pregnancy-pelvic-pain

Hughes, C. A. Hydrotherapy for Labor & Birth Can Mean Smooth

Sailing for Mother & Child. Retrieved October 13, 2007, from Expectant Mother's Guide Web site: http://www.expectantmothersguide.com/library/connecticut/ECTwaterbirth.htm

Johnson, K (November 1, 1999). Hydrotherapy Greatly Eases

Deliver Stress, Pain. OB/GYN News, Retrieved October 13, 2007, from http://findarticles.com/p/articles/mi_m0CYD/is_21_34/ai_61621176

Santrock, J. W. (2008). Life-Span Development. New York, NY:

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from Pregnancy & Childbirth Web site: http://pregnancy.about.com/cs/naturalchildbirth/a/aa082501a.htm