Pain and pain relief in labour

[MayMi]

Hi everyone,

I am a Brit living in Japan, where medicated pain relief is not commonly offered to women during childbirth.

If you feel you have something to share about pain and pain relief during labour, please read on and let me know. I have given birth one time without pain relief, and the experience has had quite a big impact on me. Sorry my post may be a bit long but I’m trying to avoid a drip feed.

Some of the reasoning behind pain relief not being accessible to labouring women in Japan includes the claim that these medicines actually work by weakening the contractions which makes them feel less painful.
However, weakened contractions are said to prolong labour, thus increasing risks to the baby. The baby's safety takes precedence in the situation, and the only time that a mum may be offered pain relief during childbirth is if the contractions are so strong that it is causing distress to the baby.

Although gas and air does not have any known impacts on the baby, people here who have some knowledge or experience of it usually claim that it is not very effective at relieving labour pain, which is why it is not widely used. Yet it is very popular in the UK and other places, so I think there surely must be some benefit to it. Just for reference, I've never used it myself.

In the UK , there are multiple options for pain relief, e.g. gas and air, pethidine, epidural and nonmedicated options such as a tens machine etc. People are generally in support of women having access to these during labour, and many women choose to use these things with apparent benefit. However it seems to be the opposite in Japan, with many people seeming to think that these options either isn't necessary or safe, or they aren't actually aware that such options exist.

The contradictions are very confusing to me and I would really like to hear real women's experiences with pain and pain a a relief in childbirth.

I'll start by sharing my story:
I had my first/only pregnancy and birth in Japan a couple of years ago while covid restrictions were still on.
I spent 2 days in induced labour after my waters broke naturally at full term. I wasn’t getting strong contractions so I was started on oral induction drug. Day 1 wasn’t fun but I could cope.
Day 2 however was awful, I still hadn’t dilated much so I was put on a pitocin drip. It got increasingly worse until I finally delivered my baby in the late afternoon. The pain was excruciating for about half of the day and I wasn’t given any pain relief no matter how many times I asked or how much distress I was clearly in. I honestly feel I went beyond my mental limit and the experience still affects me now. I truly feel that I would have benefited from having medicated pain relief, even if it did happen to prolong my labour.

My baby was fine throughout the labour and birth, which of course I am deeply grateful for.

Thank you so much for reading. Please let me hear your thoughts and experiences about pain and pain relief in labour.

Epidurals are wonderful.
Could you consider a private hospital where maybe you could pay to choose your own form of pain relief?

I can only say what I know from my experience. I’ve had two labours with no pain relief given. The first I went into labour myself and it was intense and scary but manageable because everything was in my favour ; baby in correct position etc). My second was induced on the drip. The contractions were light years away from my first experience. Really horrendous. Induced labours using pitocin can be hell on earth. Nobody should be put on one of those drips without an epidural imo. They say pain relief slows labour down but if you’ve been in labour hours, not had sleep and in a lot of pain you’re not going to have the energy to push effectively anyway.

My first labour, I had zero pain relief by choice. I didn't think the contractions were actually that bad for me.
Woke at 3am and contractions had started and by time I got to hospital at 6am they were 2 minutes apart. DD was born at 10:20am. The most painful part for me was pushing her head out and I wish I'd had something for that.

Second labour, woke at 5am with a fish and ran to the bathroom saw lots of blood. This was 5 weeks early for DS due date so I panicked.
Got to hospital and was told it was waters gone. Contractions so slow, not doing anything for hours. Midwife had to burst fore waters as it was hind waters that had gone. Got out on a hormone drip to help speed it along and omg, it was the worst thing ever. The contractions just came on so much faster and as I had to push DS out I had a panic attack and couldn't stop screaming. No pain relief! But I think the quickness of the pain is what I couldn't cope with. I also think I had flashbacks to how painful it was pushing DD head out and just went into a massive panic.
DS was born within an hour of active labour but 10 minutes of pushing.

If it helps at all your second birth should be a lot easier. I wanted an epidural first time but it didn't work and the pain was like nothing I could ever describe. It genuinely traumatised me and I was terrified going into my second birth. Everyone told me second time would be easier and it really was, it really really was, and I wish I had listened more to people who said that and worried less. As a caveat, I had gas and air with both and to me it really did help, it doesn't take the pain away but it takes the edge off. Not sure if this is helpful or not but good luck either way. As an aside it's crazy to me that they don't give pain relief but they do induce and give Pitocin.

I think there's a balance somewhere between the two. Most Women I know in the UK don't seem to understand that lots of pain relief options can prolong labour and increase the chances of intervention, which the Japanese seem to make very plain that this is not in the interests of the baby, which it's obviously not.

I've given birth twice. Due to some complications I could only have Gas & Air although I could have requested an epidural if I felt I needed it but again, that can come with complications.

The first time I managed fine in Gas & Air, although I'm not going to lie, it was painful and the second time I started on gas & air and then stopped it as I could feel it weakening my contractions and I just wanted to get the baby out as I figured that would stop the pain more effectively!

I did have fairly short births though and I wasn't induced, which I understand can be more painful.

Didn't want an epidural either time.
With my first I had 2 paracetamol, a birthing pool and gas & air. Had to get out the pool as the midwives wanted me walking around to try and get things moving and had to stop the gas and air because it was making me feel sick. I remember asking for pain relief but being told it was too late by that point, so while pushing I didn't actually have anything and it was horrible.
With my second I had my waters artificially broken. The contractions felt more painful than my first and I had gas & air to begin with and when closer to pushing I had the diamorphine injection which definitely took the edge off.
I think as a pp said, there's probably a middle ground to be had between the UK idea and the Japan idea, but I don't know what that would be.

Thank you everyone so far for your responses.

I have spoken to a UK midwife who has brought me some new information which indicates that the obstetrician I spoke to before said something a bit misleading about drugs during labour.
Sorry I didn't mean to drip feed or change information, I'm just bringing forward new information as I receive it.

So the types of pain relief used in labour do actually work as pain blockers, that is their purpose and what they can achieve. The risk about them possibly slowing down labour is a potential side effect of these drugs.
There is another type of drug called a tocolytic which is used to relax uterine muscles - which weakens contractions - and these may be used when the baby is in distress. Pain relief medication would not be used in this instance, however the effect of the tocolytic drug may seem to relieve pain as the contractions become weaker for a while.

The obstetrician was referring to tocolytic drugs as the type that has pain-relieving effects and would be used in a labour setting, but only if the baby was in distress, not actually to help the woman manage her pain. However they said this is how 'all' pain-relieving drugs for childbirth work, which is inaccurate.

I don't think the obstetrician meant to mislead anyone or get their wires crossed - I think this is another thing to demonstrate the lack of pain relief options as well as the lack of education present here on this subject.

Thank you everyone for sharing your stories about your experiences with and without pain relief as well as pitocin for first and second births.

I have heard that subsequent labours are usually much easier than the first, so I think I should feel more comfortable about any future labour of mine. But some women do need to be induced for subsequent labours and we never know how things go and I am afraid of ending up back in a similar situation.

The difference of giving birth with or without pitocin really does seem to be huge, whether the woman has pain relief medication or not. I know someone in the UK who had to be induced for all four of her children (different reasons each time).

I am considering getting an epidural for my next one just so that I don't have to think about having to deal with the pain of labour again. I know my second time might be quick and easy etc so it may seem unnecessary but they just don't have other options here. Even the places that offer epidurals are few and far between.

That's just me personally - I'm really interested in hearing other women's experiences because there's so much conflicting medical information depending on whether I'm looking at a UK or Japanese source. So I thought it might be better to hear women's actual experiences.

Just to add - I am in support of women who choose to not have any pain relief as well. My point is that women should be able to choose and not be forced either way like the system seems to be here.

Thank you everyone who has contributed so far.

I know some people find second births easier but not everyone. Mine was quicker but no less painful. I was very grateful to have an epidural both times so I think it’s great to have that option during labour

The system of not allowing pain relief sounds barbaric and rather misogynistic.

I have given birth to two children in the UK. First time was horrendously painful but I then had an epidural which was just wonderful.

Second time, the contractions were much shorter and I found it bearable and managed on just gas and air.

I'm pregnant with DC3 but due to complications with DC2's birth (nothing to do with pain relief, she was a big baby and had shoulder dystocia) I am going for an elective c-section.