Childbirth is one of the most natural and wonderful events a woman can experience especially when the mother is in the right frame of mind. Many mothers have been taught to dread the labour pains by relatives and friends. As soon as one resists pain it becomes more painful. Dr Kelly Loi, Singapore Obstetrician & Gynaecologist at Mount Elizabeth Hospital shares on how to enjoy a less painful childbirth the natural way.

ou've heard the claims - women can have wonderful, painless birth experiences. But is that possible? Yes, it is certainly possible to have a wonderful natural childbirth experience, according to Dr Kelly Loi, who is also a mother of three. However the degree of pain felt will vary from one woman to another. A 'painless', albeit 'natural' childbirth cannot be guaranteed but there are certainly some techniques that you can use to help make childbirth more comfortable and efficient.

The female body is specifically designed to conceive, carry and birth the child, as well as to nourish the child in the months following birth.

The process of childbirth involves periodic contractions of the uterus. The contractions occur as the uterine muscle tightens and relaxes, helping the baby pass from inside the uterus into the birth canal for delivery. Many mothers describe the contractions as similar to menstrual cramps but the pain levels reported vary greatly.

"Some will describe it as the worst pain of their lives while others will say it was manageable with little or no pain relief needed," Dr Loi says, noting that nobody knows exactly how labour will feel for them - until it starts.

So how can you cope better with the pain of childbirth?

First, it's important to understand that your physical condition plays a part in a healthy pregnancy. Good prenatal care is essential. You need to take good care of yourself. Eat a good pregnancy diet. Get moderate exercise (walking is good) and spend time outside in the fresh air frequently.

Next, realise that you've been conditioned to think of birth in a certain way. All through your growing-up years, you heard stories of birth, you saw birth on television and in the movies, you may have even read about birth. You probably remember scenes with

panicked women screaming all the way to the hospital. You probably heard your female relatives share horror stories of their births.

Every woman is unique with different pain thresholds and different ideas of how she would like to manage her labour. Pain levels in labour appear to be influenced by a variety of factors, including fear and anxiety. Being prepared for the childbirth process may help to alleviate the fear and anxiety, and influence your perception and response to pain.

"It is important for a woman to understand what labour may entail," Dr Loi says. Knowledge of the childbirth process and options for pain relief will allow you to feel more empowered and less anxious about the events of labour. A few ways to prepare for labour include talking to your obstetrician about what to expect, reading up on childbirth, and attending antenatal classes and talks.

The next thing is to ensure that you have good support through your labour. A woman who has someone supportive at her side gives birth more quickly and easily. Having good support has been shown to be effective in decreasing the need for analgesia. The chosen birth partner may be your husband, sister, mum, a good friend or a doula. Be aware though that some hospitals may not allow two birth partners in the delivery room at the same time due to lack of space.

"Then once you go into labour, you should try to rest and relax," Dr Loi advises. "The entire duration of labour can last between 14 and 30 hours or more for a first-time mother. So in early labour, when uterine contractions are usually somewhat milder, the best thing you can do to prepare yourself to cope with pain is to conserve your energy. This is a time to make yourself as comfortable as possible. Play some music or watch television, and try to rest! Save the energy for the harder labour to come."

As the labour intensifies, using specific breathing techniques can be helpful. The theory behind childbirth breathing patterns is based on the concentration required to focus on breathing. During a contraction, thought processes are redirected from a pain response such as tension and breath-holding to a learned relaxed breathing response. Being able to develop a relaxed response to painful stimuli requires practice to be effective.

There is actually no right or wrong way to breathe. The breathing techniques only serve as guidelines and can be adapted to your individual preference and comfort.

Alternative forms of pain relief which have been tried include acupuncture, aromatherapy, homeopathy, hypnosis, water baths, massage and reflexology. Most of these techniques don't provide very effective pain relief. However, if you wish to try, you should ask about the availability of such techniques and make sure that the practitioner is properly trained.

Despite all the planning, labour can take on an unpredictable course. Although it is good to have a birth plan to provide some guidelines on your personal preferences for that special day, it is important to be open to changes and take it one moment at a time. Often it is difficult to predict whether pain relief will be needed until labour pains set in. Requiring the use of pain relief should not mean failure on the part of the mother. And sometimes intervention such as an emergency Caesarean may be recommended as ultimately, what we want is the safe delivery of a healthy child.

As you take action to have a healthy pregnancy and good birth experience, and as you reprogramme your old, false beliefs about what childbirth is, you'll be well on your way to a positive childbirth experience.

At ParkwayHealth, our patient and family-centred care philosophy ensures that mothers and newborns receive high quality, compassionate care. With our integrated facilities and a multi-disciplinary team of specialists and dedicated nurses, we offer comprehensive support to all women, including those with the most delicate pregnancies and newborns. For specialised maternal and neonatal care, our hospitals are equipped with Intensive Care Units (ICU) to provide adult emergency care; Neonatal Intensive Care Units (NICU) to care for infants with complex medical problems; as well as blood transfusion services.

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