doppler

The hands down best book I read about labor and delivery was The Birth Partner by Penny Simkin. It was required reading when I began training as a doula and I wished I had read it before the birth of my son.

Of course one of the big considerations when preparing for birth is pain management. I've observed or studied quite a few birth education methods and across the board this is one of the most thoroughly addressed topics and one that moms (and dads) are most concerned about. And that makes a lot of sense. First-time-moms have never experienced these sensations before and it's impossible to know how it will feel and to what degree you will feel it.

You don't know what's going to happen during labor. You don't know if it will be fast and intense or a long and tiring marathon. You don't know if baby is going to be posterior, causing most of the pain to be in your back. You don't know when your water will break.

So in preparing for labor and birth, it's great to focus on what you do know, and what you think you will prefer in terms of pain management and labor support.

As parents prepare for a birth, they are gathering tools they will need to cope. They gather knowledge of the process, wisdom from mothers who have given birth before, methods for coping, and learning the options that may be presented to them by their medical caregivers.

Especially when giving birth in a hospital, you know there will be many options for pain relief via medications. And it seems that the topic that is often fraught is the epidural/no-epidural debate.

Penny Simkin suggests examining your pain medication preference (found on this chart), because everyone falls somewhere on the continuum. One extreme (Simkin puts this on a numerical scale as +10) is a mother who has no wish to feel any pain and would wish to have an epidural even before labor begin (or even to be put under general anesthesia). This extreme is not very likely.

On the other end of the spectrum (listed as -10) is a mother who, even when faced with a cesarean birth, would decline any anesthetic. This extreme is also not very likely.

A zero on this scale would be total neutral, or having no preference which is also rare. Likely a mother would be able to identify on which of side of zero she lies. From there, she can narrow down exactly how much help she would like from medication.



Going in to both of my births, I was probably around a -7 or a -8. Which is to say, I absolutely did not want pain medication. I would have been upset if that had been offered to me during labor. (Which led to my planning a birth center birth and a home birth, where an epidural was not even an option. I wanted it off the table.) But, obviously, with extenuating circumstances, I would have accepted some. (Such as a cesarean.) It helped my husband and my caregivers to know this. In all our birth preparations, we focused a lot of energy on natural coping methods.

Someone at a +7 would wish for an epidural as soon as they arrived at the hospital and before labor became terribly painful. A +5 would be willing to cope with labor for a while, but want medication when it became difficult. And so the scale continues

One way to determine your own preference is to ponder: how disappointed will I be if I receive medication? Or, alternatively: how upset will I be if my wish for medication is not taken seriously or is delayed?

There are so many options in childbirth these days. When faced with these options, examining your pain medication preference is a great first step. Example: if you know you fall on the positive side of the continuum, you might like to birth in a hospital and choose your medical caregiver accordingly. This will also help inform your choice of childbirth preparation. If you know you have a preference for medication-free birth, you'd likely benefit from Bradley Method or Hypnobirthing classes, instead of the ones offered by a hospital.

It's never too early to start the process of building your birth plans, and this is a great place to start.