Childbirth without an epidural: a different way to relieve pain
Whether you can’t or don’t want to have an epidural, other techniques can help you relax and cope better with the intensity of the contractions. But this needs to be discussed with the pre-birth maternity team to determine what is possible and what is not possible.
Medical contraindications
Coagulation disorders, an allergy to the anesthetic product, certain neurological diseases are formal contraindications to epidural anesthesia. Just like a skin infection at the puncture site or a flare-up on the day of delivery. Certain lumbar pathologies can also be an obstacle. Finally, a strong overweight or a vertebral malformation can cause difficulties during the insertion of the catheter. The presence of a tattoo in the area where the anesthetist will inject the anesthetic does not pose any problem. Mandatory consultation with an anesthesiologist during the 8th month of pregnancy ensures that there are no contraindications to the epidural.
Personal motivations for refusing an epidural
In France, nearly 1 in 4 women consider giving birth without an epidural. Among the reasons for this refusal, we can find:
- The desire for a less medicalized childbirth. Epidural anesthesia requires the installation of an infusion and a catheter which will limit the possibility of getting up. However, it is recognized that being able to walk and position yourself as you wish during labor, or even during expulsion, facilitates the exit of the baby.
- The fear of not fully experiencing childbirth. Even if it is increasingly rare, it can indeed happen that the dose of painkiller is so strong that the mother-to-be no longer feels the flare-ups.
- Fear of the side effects of the epidural. It can happen that the epidural causes headaches lasting sometimes a few days.These headaches are explained by the perforation of the dura mater, a membrane surrounding the spinal cord, and the discharge of a little cerebrospinal fluid. It is not dangerous but it is then necessary to remain lying down as often as possible during the days following childbirth, until everything is back to normal. If this is not the case, a slight intervention to plug the breach in the dura mater may be necessary.Other possible pain, lower back pain, but they are not resistant to conventional analgesics. As for the fear of remaining paralyzed, this event has become extremely rare. Finally, if it is true that the newborn receives a dose of analgesic product, the latter passing into the maternal circulation, this has no impact on his health and development.
It should be noted
It is possible to change your mind at the last moment. This is, among other things, why it is mandatory to meet with an anesthetist before childbirth, whether or not an epidural is planned. It happens that women who have considered an epidural do without it because childbirth is rapid and the intensity of the contractions bearable. Conversely, despite excellent preparation, everyone has the right to be overwhelmed. It is therefore reassuring to say to yourself that nothing is set in stone and that you can change your mind, keeping in mind, however, that the product takes about fifteen minutes to take effect.
Is childbirth without an epidural faster?
It is impossible to tell if a delivery without an epidural will be any faster. It is true that theThe epidural may slightly decrease the intensity of contractions and therefore lengthen the duration of labor. But it can also help to relax and therefore dilate the cervix more quickly.
Possible alternatives
Although less effective than epidural anesthesia, other techniques, used separately or simultaneously, can help manage pain during labor and delivery. Here is a non-exhaustive list.
Preparation for birth and parenthood
Preparing to experience childbirth more serenely is one of the main objectives of the 8 birth and parenting preparation sessions offered to all expectant mothers. These preparations can be based on sophrology, hypnosis, prenatal singing, haptonomy …
Inhaling nitrous oxide
A mask to be applied to the nose delivers nitrous oxide, an analgesic gas mixture. Inhalation should begin 30 seconds before contractions if they are regular and at the time of contractions if they are irregular. Inhalation should stop when the contraction begins to subside.
Transcutaneous nerve stimulation
A small device, the TENS, is connected by 4 electrodes to your back. By delivering a weak electric current that is absolutely painless, it will block pain messages sent to the brain and stimulate the production of endorphins, a natural pain reliever. The mother-to-be controls the intensity of the current herself on the keyboard of the device.
acupuncture
Acupuncture is a great help in relieving all the little ailments of pregnancy. On D-day, it is just as useful: it acts of course on the pain, but also on the dilation of the neck and the flexibility of the perineum. Some midwives are trained in acupuncturist. It may even happen that maternity hospitals agree to welcome the mother-to-be’s acupuncturist doctor in the labor room. Provided of course to have discussed it beforehand.
A physiological position
It is not compulsory to remain lying down during all the work. The main thing is to listen to your body. Some women experience contractions better when walking. And provided that the medical team is receptive to this type of approach, nothing prevents the baby from being taken out by lying on his side or by crouching. These positions are indeed known to facilitate expulsion.
A hot bath
Some maternities are equipped with bathtubs, not for giving birth in the water, but to allow mothers-to-be to spend part of the labor there. They can thus benefit from the soothing and relaxing virtues of hot water when the contractions are a little hard to manage.
Massages
With bare hands or with an essential oil suitable for pregnancy, a light massage of the legs and arms allows to relax the knotted muscles and thus to better withstand the tensions caused by the contractions. A massage of the kidneys, pelvis and sacrum can relieve lower back pain. These massages are usually performed by a midwife, but they can also be performed by the future dad.