Whereas systemic medications or various anesthetic techniques are aimed at eliminating the physical sensation of pain, alternative or non-pharmacologic methods are directed toward preventing the suffering associated with labor pain. These approaches to pain management emphasize labor pain as a normal side effect of the normal process of labor. Women are given reassurance, encouragement, and guidance to help them build self-confidence and maintain a sense of control and well-being.
Many hospitals offer some of these techniques, although others require special training and may not be available in all birthing facilities:
Continuous labor support: This refers to nonmedical care given to a laboring woman, often by a doula or trained professional.
Maternal movement and positioning: Sometimes walking or changing positions can alleviate some of the pain associated with labor. Your caregiver or nurse may suggest different positions to try.
The Birth Ball: The Birth Ball is a large inflated exercise ball used to help in movement and relaxation during labor. During labor, you can sit or lean against the ball, which provides stability and soft support. The ball also increases the number of positions you can find for comfort.
Touch and massage: These techniques provide encouragement, reassurance, and a sense of love, and may be used to enhance relaxation and decrease pain.
Acupuncture and acupressure: Acupuncture involves the placement of needles at various points on the body, whereas acupressure (or Shiatsu) refers to the placement of pressure with fingers or small beads at acupuncture points. In some studies, acupuncture use during labor was associated with more relaxation, but no difference in pain intensity.
Hypnosis: Usually hypnosis during labor involves self-hypnosis, where the woman herself is taught to induce the hypnotic state. Studies have shown that the use of hypnosis does lead to less use of pain medication and epidural anesthesia.
Transcutaneous Electrical Nerve Stimulation (TENS): This technique involves the transmission of electrical impulses from a hand-held generator to the skin through surface electrodes. During labor, the electrodes are placed near the spine, and the woman controls the intensity of the current through a dial. TENS causes a buzzing sensation that may reduce awareness of contraction pain.
Most studies have not shown a real reduction in pain, but some do suggest less use of pain medication, and increased satisfaction.
Intradermal water injections: This technique involves injecting a small amount of sterile water into four locations on the lower back. This has been shown to reduce severe back pain for 45 to 90 minutes, but it does not seem to help the abdominal pain associated with labor.
Application of heat and cold: Often this is a matter of personal preference, as no scientific data suggests that one is better for pain relief than the other.
Music and audioanalgesia: The idea behind this method is that music, white noise, or environmental sounds may help to decrease the perception of pain. Although not clearly beneficial for pain relief, it may help to increase pain tolerance via mood elevation, or help the woman to breathe more rhythmically (heavy metal is probably not the best choice, though!).
Aromatherapy: The use of aromatherapy appears to be on the rise. We could only find one study looking at its effectiveness for pain relief. In that study, about half of the women felt it was helpful in reducing pain, anxiety, and nausea, while improving their sense of well-being.