Before a woman can savor the joy of holding her baby in her arms, she normally has to go through the tormenting pains of labor. Most women experienced severe or extreme pain quoting “the worst pain of my life”, while others reported minimal pain sensation. The intensity of labor pain varies widely among different individuals, and from different pregnancies of the same individual.
Labor pain, like any acute pain, has two components. First is the sensory or physical component, wherein the pain stimuli is transmitted to the brain; second is the affective component, which refers to how an individual subjectively interprets the painful stimuli through the interaction of external factors such as emotional, social, cultural, and cognitive variables distinct to the individual. [1]
Nowadays, any pregnant woman can opt for a painless labor and delivery by utilizing conventional medicine. If available in the hospital, she has a choice from epidural anesthesia, inhalation anesthetics, or administration of injected drugs. All of these procedures have the same mechanism of action – to block the first component of the pain pathway, the physical side.
However, due to the limited availability of these conventional methods, complementary and alternative methods exist. These are theories and practices that wish to address the second component of pain. These alternatives do not necessarily replace the conventional medicine, but only attempt to supplement it.
Here are some known alternative ways to lessen the pain during labor.
1. Psychoprophylactic Methods
This is based on physiologist Ivan Pavlov’s concept of classical conditioning. The pregnant woman is taught the anatomic and physiologic facts of childbirth and she is familiarized with the process. She is then instructed to do some mental relaxation techniques which may include focusing on certain breathing patterns or a specific concentration point, such as a mark in the wall. Employing such techniques could possibly block pain messages to the brain.
2. Leboyer’s Method
Instead of the usual environment where there is so much noise and light, this method offers comfort to the mother during delivery by providing serenity and a calm atmosphere during labor.
3. Hypnosis
Hypnosis seems to reduce awareness of pain, fear and anxiety; and raise pain threshold during labor. Here, the pregnant woman is initially subjected to hypnotic experiences making her relatively unaware, but not completely blind, to her surroundings. Few negative effects reported include headache, nausea, and dizziness. There can also be failure to dehypnotize the patient properly. Its use must be avoided in patients with psychotic decompensation.
4. Yoga
Yoga has an Indian origin, which suggests control of mind and body. It involves special training of breathing, which achieves relaxation and inner peace. Although there has been no scientific confirmation for these assertions, users of yoga noted decrease in pain sensation and lesser need for analgesic medication.
5. Music Therapy
It is believed that pregnant women can achieve sedation and relaxation during the early stage of labor by playing a slow and restful type of music. On the other hand, music with a continuous beat is a stimulant that can promote the active stage of labor.
6. Acupuncture
This includes stimulating specific anatomic parts of the body with the use of needles. It is hypothesized that by stimulating acupuncture points, the level of chemical neurotransmitters in the body is altered. For instance, there is an increase of endorphin level, which like morphine, has analgesic property.
7. Therapeutic Touch
This refers to application of hand pressure to the pregnant woman’s back, hips, abdomen, thighs, sacrum or perineum. The purpose of therapeutic touch is to communicate caring and reassurance.
8. Hydrotherapy
Women who used water immersion during the early stage of labor reported statistically significant less pain than those not laboring in water.
9. Herbal Medicines
This includes the use and application of plant materials which are believed to have a calming and relaxing effect. The downside of herbal remedies though, is that they have less scientific inquiry regarding its pharmacologically active ingredient and toxicity potentials.
10. Aromatherapy
This uses essential oils extracted from botanical sources. Combined with massage, it enhances relaxation and helps relieve anxiety and stress.
Alternative methods may be useful during the early stage of labor. As a distracter, it diverts the woman’s attention from the source of pain. But during the delivery itself when physiologic pain is at its peak, a woman may need additional conventional intervention.
Reference:
Tournaire, Michel (2008). Complementary and Alternative Approaches to Pain Relief During Labor. http://www.medscape.com/viewarticle/570648
Posted on 02 December 2008 by Edelita R. Jamis, M.D. in Pregnancy & Labor
I fear much of the above is irresponsible advice and over-stated claims. Few of these practices have had any reputable research demonstrating benefit, and a number are based on fanciful notions that aren’t even worthy of the status of hypothesis, as when mystical energy fields are invoked.
Thank goodness pregnant women steer away from herbal concoctions and drugs in general during pregnancy.
The common understanding of “Therapeutic Touch” (with caps) is manipulation of the “human energy field” by waving hands through the air above the patient. The better the research design, the less effect you see with TT.
Actual hand (counter) pressure to the back/hips is used for pain, not merely “to communicate caring and reassurance.”
Thank you for your comment. I certainly agree that the alternative methods have no proven scientific efficacy. That’s why, I mentioned that they are just “theories and practices that do not necessarily replace conventional methods”. I’m not in any way, advising or claiming that these practices are effective because there’s no doubt about it, conventional methods like epidural anesthesia and IV drugs are still the first line used in managing labor pains. I hope you understand that, what the above article is trying to impart is, because conventional methods aren’t available in ALL clinical settings at ALL times especially in remote or rural areas, such alternative methods exist (even if its efficacy is questionable).
I guess it’s an innate response for people to look for alternative ways when the ideal management is impossible to find in the place where they belong.
Good of you to reply. Thank you. I’m glad you stated: “…these are just ‘theories and practices that do not necessarily replace conventional methods.’” However, I fear that writing about alternatives for pain relief certainly gives the appearance to the public that the author believes these practices are safe to use and offer some measure of effective relief. But if practices have no established benefits/risks, how can it be ethical to suggest their use? Assuming practices have no risks can be a dangerous assumption. Are they being advanced for their placebo effect? That is considered unethical as it robs patients of being fully informed consumers. It is alarming that more and more unvalidated, fanciful, and ineffective practices (i.e. substandard care) are used as a solution to providing the poor and people in rural communities with health care. Thank you for your consideration.