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Non-Pharmacological Pain Management

Non-Pharmacological Management of Pain and Discomfort in Labour

Natasha Singh
Humber College

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Non-Pharmacological Pain Management

Introduction
For decades, birthing specialists have been studying ways of
alleviating pain and discomfort during the birthing process. It wasnt until the
year 1912 a physician introduced using epidurals to relieve pain during
labour (Epidural, 2011). But what did mothers use before pharmaceutical
drugs were introduced for pain during this process? Why are nonpharmacological approaches and techniques being re-introduced, endorsed
and encouraged as a safer, healthier, better path of pain management
during labour? What effect do these measures have related to individual
health practices and coping skills and culture; two determinants of health
that are most applicable to this topic. This paper will discuss techniques as
well as their significance related to these determinants beginning with the
various non-pharmacological techniques most commonly used during labour,
how it relates to individual health practices and coping skills, how it relates
to culture, and ending with a summarization of the above.
Non-Pharmacological Interventions
There are numerous non-pharmacological methods and techniques
used to manage pain and discomfort during the labour process. These
include, but are not limited to: slow, deep, pursed lip breathing techniques,
hydrotherapy, relaxation techniques, hot and cold therapy, acupuncture,
soothing music, massaging the lower back area, guided imagery,
aromatherapy, the use of a TENS machine, the use of a bouncy ball, hot

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Non-Pharmacological Pain Management

water baths, walking, sitting in a rocking chair, getting down on all fours,
counter pressure (sustained significant force on the back), hot on cold
compresses, intradermal sterile water injections, distractions from the pain
or support from the spouse or birthing process to stay focused on the
birthing of the baby (Goh, 2011) and (Brown, 2001).

Determinants of Health and Its Relation to the Mother, Neonate, and Family
Culture can play a big role during labour when determining how to
alleviate pain. As one of the determinants of health care in Canada, culture
and ethnic factors influence peoples interactions with the health care
system (Potter, 2009). Although it is universally understood that the birthing
process is very painful, some cultures believe that this pain should be
endured naturally where as other cultures believe in using pharmaceuticals
to help relieve the pain. For example, some cultures deny the use of
pharmaceutical aid to relieve pain during the natural process of birth.
Because birthing is a natural process, some cultures believe that
pharmaceuticals do not belong in this process. In cases like this, nonmedicinal interventions are used (Vivilaki, 2009). Using non-pharmacological
interventions for pain during the labour process for some cultures leaves the
family and mother feeling more comfortable because it shows that the
caregivers are including their beliefs and traditions and leaves them feelings
more at ease. This type of care also forms a therapeutic relationship through

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Non-Pharmacological Pain Management

patient-centered care. Promoting non-pharmacological approaches to

managing pain while giving patient-centered care could be done by
encouraging the mother and family to use their cultural interventions that
they use for pain.
Individual health practices and coping skills is another determinant of
health that plays a significant role in non-pharmacological pain management.
This determinant describes ways and abilities for an individual to promote
health and prevent illness for them self (Potter, 2009). Pharmaceutical
interventions are very often used as a coping strategy for pain. This method
of coping with pain could lead to substance abuse, dependency, and
addiction. The birthing of a baby can with many other natural complications
and difficulties such as post-partum depression or the pressures of taking
care of a neonate and therefore should be especially encouraged to deviate
from the use of pharmaceutical pain management when other options are
available. Analgesics like epidurals can have side effects such as increased
maternal fever (Klein, 2006). This could lead to a decreased interest or ability
for immediate bonding. Recognizing that bonding of the mother and baby is
extremely important immediately following birth, the mothers conscious
state could be affected by the analgesics side effects, therefore affecting the
bonding process. If mothers and their families are more willing to invest time
and effort in exploring methods and lifestyle changes during pregnancy that
include non-medicinal interventions for pain, these efforts can go a long way
in ensuring a safe and effective delivery process and a healthy baby as well

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Non-Pharmacological Pain Management

as deviating from pharmaceutical interventions for pain management. Some

methods to practice before entering the delivery room are yoga, eating
healthy and breathing techniques. By promoting these individual health
practices and coping skills, the mother and the spouse or birthing partner
will feel empowered during the labour process and will feel more
independent. When a mother feels confident and in control of the process,
she will feel more comfortable and relaxed, therefore decreasing the
intensity of pain.
Conclusion
To conclude, the use of non-pharmacological interventions for
managing pain and discomfort during labour has many positive effects.
These include incorporating the mother and familys cultural beliefs so that
they feel comforted and more relaxed as well as promoting healthy lifestyle
changes and healthy pain coping skills that stray from substance abuse and
leans toward increased interest and ability to bond with the neonate. Nonpharmacological interventions for pain management are easy, safe,
affordable, and effective and should be encouraged to be used to the fullest
before resulting to pharmaceuticals.

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Non-Pharmacological Pain Management

Bibliography
Brown, S. (2001). Women's Evaluation of Intrapartum Nonpharmacological Pain
Reliefe Methods Used during Labor. The journal of Perinatal Education , 1-7.
Epidural. (2011, October 23). Retrieved October 28, 2011, from Wikipedia, the Free
Encyclopedia: http://en.wikipedia.org/wiki/Epidural#Historical_notes
Goh, J. (2011). Examination Obstetrics and Gynacology. In J. Goh, Examination
Obstetrics and Gynacology (p. 215). Austrailia: Elsevier.
Klein, M. C. (2006). epidural Analgesia: Does it or Doesn't it? birth: Issues in
Perinatal Care , p74-76.
Patricia A. Potter, A. G. (2009). Fundamentals of Nursing. Toronto: Elsevier.
Vivilaki, V. (2009). Pain relief and retaining control during childbirth. A sacrifice of
the feminine identity? Health Science , 1-6.

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Non-Pharmacological Pain Management