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PAIN RELIEF
TENS
- Transcutaneous
electrical nerve stimulation:
 This
is another method, which is coming up now-a-days.
Here small pads are placed on the lower back (on specific
areas) and the nerves are stimulated by giving small
electrical impulses. These impulses then join
the other pain impulses coming from the cervix and
the uterus and thereby decreasing the pain perception.This
acts by '' distracting" the pain fibres so that you
feel more comfortable.
Hypnosis
Contrary
to the misconception that people have regarding this
technique, hypnosis in qualified hands, provides legitimate
and medically acceptable method for pain relief.
There is nothing mysterious about hypnosis.
Technically,
it is just suggestions and power of mind over matter.
This depends upon the individual susceptibility and
the method of hypnosis used. It is done over a period
of weeks to months before labour.
Accupressure
and Accupuneture:
These are
old Chinese methods where pressure over specific body
parts and skin punctures with needle are used respectively.
The
action is similar to TENS.
Accupressure:
Involves applying pressure, heat or
cold over certain pressure points. Pressure is usually
applied with thumb / finger tips kept stationary or
moved in small circles. It can be done yourself
or by your spouse. For details refer to books
recommended for Accupressure. Few techniques
for relieving the discomforts of labour and postpartum
are:
-
For
relieving head / neck and upper backache apply
circular pressure on the muscles at the top of
the shoulder in vertical line with the nipples
near the back.
-
Massaging
the center of the sole, below the ball of the
feet will relax the lower body.
-
To
relieve low backache, pelvic discomfort or pain,
press firmly in an inward direction on either
side of the vertebral column, below the waist
level. Circular pressure is applied during contraction
and intermittent pressure between contractions.
-
Heat
and cold applied to the upper and outer part of
the buttocks relieves hip and upper thigh pain
on the same side.
Accupuncture
is using needles and puncturing specific
sites on the body to relieve pain. This can be done
only by an expert.
Physical
Therapy:
(i)
Massage: given by a professional masseuse or your
spouse can provide pain relief. Massage can be
customized to individual requirements. You can
ask your spouse to massage more over areas, which
provide most relief.
(ii)
Counter pressure: There are various ways to give
counter pressures.
-
Your
partner / spouse can use the fist or heel
of hand on your back to reduce pain. You can
direct him to the exact location. The point
will move lower as labour progresses.
-
 You
can go on all fours and your partner can squeeze
your hips with both hands from the sides.
-
Another
counter pressure for relieving backache is
called “knee press”. You sit on a straight
back, chair with a folded towel / small pillow
behind the small of
the back. Your partner sits in front
of you with hands on your knees.
 During
contractions your partner leans forward, presses
your upper legs towards the back of the chair.
(iii)
Hot and Cold Compresses:
Heat
provides soothing relief and cold provides pain
relief by numbing. For this, hot water bottle
/ electrical pads / warm and wet towels / ice
bag / rubber glove filled with ice, etc. can be
used. This can be applied to your back by your
partner / spouse.
(iv) Light
stroking or “Effleurage ”:
This
can be done by your own or by your partner / spouse.
Ask
your partner/spouse to:
-
Gently
stroke your arms and legs with full hand along
the entire length.
-
Gently
massage your face and lower jaw
-
Grasp
and release from great toe and adjacent 2
toes during labour.
-
Gently
stroke neck, shoulders and back during contraction.
Distractions
You
can distract yourself from the pain using music,
listening to jokes, playing cards, etc. This can
to a certain extent make the pain bearable.
Intradermal
Injection of sterile water
This is a new technique where small amounts
of sterile water are injected directly under the
skin to form blisters like bumps. These cause
intense stinging followed by relief of backache
for 60 – 90 minutes. This may be due to release
of substance called “endorphins” in the blood, which acts as natural painkillers.
Which
method to use?
Of all these techniques,
some are “Do it Yourself” but others may or may not
be available at the place where your deliver. So you
may have to speak to your doctor regarding the availability
of the techniques or any substitute for the same if
not available.
In the majority of cases, where
delivery is in a large institution or hospital with
all facilities available, epidural analgesia is preferred.
This is because it does not interfere with your level
of consciousness, allows you to participate fully
in the labour process and does not lead to any major
complications. You must realize that you may not be able to ‘push’
as effectively in the second stage of labour. This
is because part of the natural reflexes may be blocked.
Hence you will require constant supervision and encouragement
to ‘push’ or bear down. This is done by your doctor
and / or the anaesthesiologist. There may be an increased
need for assistance with vacuum or forceps to help you deliver your baby.  This should not cause any additional problem
in well-selected cases.
In most cases of ‘first time’ labour,
some form of pain relief is helpful as the duration
of labour is longer. The second (or further) time
around, labour tends to be shorter and you may not
require pain relief. It is a question of individual
choice, however, and you should discuss all these
options with your doctor well in advance. Most importantly,
keep your calm and resolve,
do not lose control in labour. Prepare your
mind that motherhood is a pleasure – and some amount
of pain in worth it. Labour is not as painful as shown
in movies or described by some – It is your journey
and you are the caption of the ship! Your doctor is
your navigator and will guide you in the best possible
manner!
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