My fairly useless summery of types of pain relief and the difficult of writing a birth plan

At my midwife appointment this morning, I got told off for not having written a birth plan yet.

This is kind of like being told off for not finishing your homework 14 weeks before it’s supposed to he handed in, but nonetheless I promised I’d have it done in time for the next appointment.

So, it got me thinking about pain relief, and I thought I’d summarise my current thoughts here and see how wildly they differ from everyone else. Some of my opinions here are informed by the fact I am doing a medical degree but I should be clear that I am a very, very long way from knowing what I’m talking about! These really are just my opinions.

Ok so pain relief. Here we go - my book lists the following forms of pain relief during labour, and these are my thoughts on each one. (I might just submit this as my birth plan.)

Water (i.e. going in the pool)

Clearly, this is going to be completely fucking useless. What earthly use is a bath of warm water going to be in the face of agonising pain? If you arrive in hospital with the bones sticking out of your leg, do they put you in a bath, tell you to relax and play some whale music? No, they fucking don’t. They give you morphine. Next...?

Gas and air

Nitrous Oxide is undeniably excellent stuff and will probably help distract from the pain even if it doesn’t actually relieve it. But the trouble is, breathing it is a bit like eating sushi or giving blowjobs: the first time you try it will probably make you feel sick. Getting the best benefit from gas and air takes practice - I’ve had it twice and each time it took me a while overcome the nausea.

On the plus side, once you get the hang of it, it’s fucking brilliant. Like being instantly at that perfect point of drunkness where you are really funny and attractive, except instead of descending into jabbering incoherence and waking up on a park bench with a hangover and a traffic cone instead of trousers, you sober up 30 seconds later and feel great.

Unfortunately you can’t just rock up at hospital in advance and ask to have a go on the Entonox, (I’ve tried), so my plan is to ask for gas and air way before I need it. Get a bit of practice under my belt before the contractions really kick in. Fuck knows whether it will actually help with the pain, but at least it will make all my jokes seem really hilarious.

Pethadine

Oh yeah, now we’re getting onto the big guns. Pethadine is an opiate and will make you stoned and sleepy so you don’t notice what the fuck is going on. This sounds great, sign me up.

Except, the book says it also makes the baby stoned, so they won’t give it within three hours of excepted delivery in case the baby comes out stoned and, I dunno, starts being really boring about Hendrix or something.

So in practise this means that when you really want the drug (like, say, at the point something the size of a mini-fridge is about to come out through my vagina), you’re not actually allowed to have it. What is this, some kind of joke? Got any more damnfool suggestions? Fucking doctors...

Epidural

When I qualify as a doctor (assuming that ever actually happens) my first choice of specialism is anaesthesiology. So this is the one form of pain relief I should really get behind.

In theory, this is bloody marvellous. Anaesthetist comes in, injects lidocaine into your spine, you jiggle around a bit until it hits the right spot then, boom!, you feel the contractions but no more pain. You kick back, slap on some Netflix, do a bit of light pushing - couple of episodes of Breaking Bad later, the midwife hands you a baby. High fives and cigars all round.

Trouble is, to paraphrase several thousand pages of my anatomy textbooks: the spine is really fucking complicated. Lidocaine goes into the wrong place, it may work only partially or not at all. It involves shoving a needle into your spine during which it’s really fucking important to stay still, which might be tricky during a contraction. And it might make labour go on longer (though it if works, who cares? I’ve still got like three series of Breaking Bad to get through). Also, if there is no anaesthetist available when you need one, you might be bang out of luck.

Still, on balance, this is what I’m going to ask for. My birth plan is basically going to say ‘natural birth preferred, gas and air, when I shout for an epidural, make with the spinal needle and don’t fuck about’.

TENS machine

Oh, fuck off.

Others

Under ‘others’ my book lists ‘hypnotism’ (see ‘TENS machine’), ‘paracetamol’ (yeah ok I’ll take some of that if I get a headache during labour), and ‘breathing’ (I do that anyway).

Have I missed any? I think that’s pretty much the lot, at least offered by the NHS. The trouble is, like every aspect of labour, there is zero consensus on what is best. There are thousands of stories from mums out there who had different forms of pain relief work perfectly for them, thousands more who says the exact same things didn’t work at all. And I’m supposed to sit here with 14 weeks to go and write down what I want...? Perhaps I’ll put it off for a few more weeks and do some anatomy coursework instead.

EDIT 9.40pm:

Thank you everyone so much for your really lovely comments and stories. This has actually made me feel way happier about labour.

It seems I have been way too quick to discount the pool, with loads of PMs saying how great it is - and I’ll really take that on board. Thanks again!