"I gave birth three weeks ago to a bouncing, 9kg baby boy. I went to Hypnobirthing classes and it was my dream to have a drug-free water birth, but unfortunately things didn't go to plan. I couldn't take the pain the way I thought I would be able to and I ended up opting for an epidural, despite all my preparations. The drugs worked well and I was able to give birth without any other interventions - however, although I know you can never really plan for these things, I still feel I've let myself and my little boy down, and I can't help wishing I had been stronger. I also worry about the potential side effects both for my baby and for me."
Shani Dean, midwife and parenting educator, responds: "You are absolutely not a failure. My outlook as a midwife and support for women will always be ‘pro-choice’.
"When we start to ask what is better; a normal delivery versus C-Section, a normal delivery with pain relief or a normal delivery without pain relief, a normal delivery without pain relief where the mother ate organic foods and drank no caffeine, etc, it can start to get a little out of control. What is better? The simple answer is: whatever is best for that family.
"Yes, we know that medication given in labour does tend to travel to the placenta and, of course, to the baby. Depending on the medication, some side effects for the baby can mean that he or she is drowsy after delivery and may need help with breathing and assistance with ‘waking up’. However, in most of these cases, this episode is short-lived.
"In labour, the body tends to be more efficient when the woman is mobile, using gravity, and this is normally best achieved without medication, which restricts these efforts. “However, the body is also more efficient when a woman is relaxed, and empowered and this is sometimes achieved with appropriate pain-relief choices made in consultation with her midwife or doctor.
"If a woman is well informed and supported, I believe she has the right to choose what is best for her family. When we celebrate the baby’s first birthday, we celebrate this wonderful little cherub - not the way he or she was delivered. If you had a medication-free labour, I salute you, and if you had a wonderful birth experience with an epidural, my salute remains firmly in place for you too."
Obstetrician and Gynaecologist Dr Elsa De Menezes of New Concept Clinic Dubai agrees, adding: “A stressful labour is not good for the mother or for the baby. Pain relief medication from the opiate group, such as pethidine, whilst effective, does cross the placenta into the baby and causes some heart rate changes meaning that babies can be born with respiratory depression, which requires further medication to reverse it. Epidurals, however, are regional blocks that, at low doses, are amazing as they dull the sensory pain fibres without affecting the motor nerve fibres. They do not dope mum or baby and allow mums to have great, safe, pain-relief without sedation and therefore without the risk of missing or losing enjoyment of one of the most precious experiences of her life – giving birth.”
What pain relief is available during childbirth in the UAE?
As with everything to do with your body and your family, whether or not to have pain relief during labour is a purely personal decision - however, the problem arises when mothers feel pressure either to have pain relief, or not to have any pain relief at all, due to external influences; perhaps your doctor pressing you to take an epidural, or you feel you 'should' have "all-natural", drug-free birth because of what you were told in antenatal class.
There are several different forms of pain relief available to mothers in the UAE during labour, and it's important for you to be informed of the different options so that you can make the choice that's right for you.
Some of the non-drug pain-relief options include:
Warm water - Being in warm water can help the body relax and quell the impact of your contractions. In many of the private hospitals in Dubai it is possible to labour in a warm water bath, and at Al Zahra hospital, Medicilinic City Hospital and Mediclinic Parkview Hospital Dubai it is possible to give birth in a birthing pool once again if you meet the criteria (waterbirth had previously been paused due to the pandemic).
Hypnobirthing - this is a system of meditation, visualisation and relaxation, which many women find helps them to manage their 'surges' and to stay focused and relaxed during labour. There are various different types of hypnobirthing methods, all of which use very similar techniques. You can download hypnobirthing apps, buy books about it, or take classes in the lead up to your birth.
Tens machine - This machine is attached to your back and stimulates your nerves with small amounts of current through the electrodes. Tens is believed to work by stimulating the body to produce more of its own natural painkillers, called endorphins. It also reduces the number of pain signals sent to the brain by the spinal cord. There may be a Tens machine available at your hospital, but you can also rent one from Health Bay Polyclinic in Al Wasl.
Gas and air - This is a mixture of oxygen and nitrous oxide gas, which you breathe in just as a contraction begins through a mouthpiece that you hold yourself. It won't remove all the pain from your contractions, but it can help make it more bearable. Many women like it because it's easy to use and they control it themselves.
Pethidine injections - The drug pethidine is injected into your thigh or buttock to relieve pain, the effects of which last between two and four hours. If given too close to the time of delivery, it can affect the baby's breathing – if this happens, another drug to reverse the effect will be given.
Epidural - This is one of the most popular and well-known forms of pain relief during labour. It is a special type of local anaesthetic, which numbs the nerves that carry the pain impulses to you brain. It is administered by an anaesthetist through a small tube into your back and usually provides full pain relief for labour.