Another ‘don’t plan, but prepare for anything’ mom…
We learned Bradley Method (from the books, BTW, not a class). Deep relaxation is the key to that method. Practice early and often, and it really kicks in (three months of practice to get really REALLY good at it). However, it is no guarantee that you will have a great labor.
In my case, I was in labor (3.5-8 minutes apart, 45 sec to 3 minute contractions) for 66 hours without needing meds at all - actually, I never needed them for pain (as far as I can tell). I needed meds to sleep. Just for fun, I had only had a nap the full day before labor started (just after I went to bed), so I was basically going on around 80 hours without sleep by then. Can you say EXHAUSTED? So we went to the hospital (walked over from the birth center), I had an epidural (already decided in the backup plan, since I don’t do bloodstream narcotics well), and slept for 12 hours or so, in two-hour increments (between top-ups of the epidural). After that, I was nearly ready to push, pushed for 2+ hours, and there was my boyo. 80 hours start to finish (of labor, that is). And not at all bad, as long as I kept relaxed. But only your wife will be able to say what is or is not too much for her to cope with. Don’t let anyone tell her how she feels!
Lamaze works for those who deal with pain by focusing away from the pain (go outside themselves). I know people for whom it worked like a charm, and others for whom it did less than nothing.
Bradley works for people who work better WITH their bodies than outside their bodies, as well as adding the deep relaxation part. I honestly felt the difference between fully deeply relaxed (even hands and face) and even a micron NOT relaxed. The former (relaxed) had as strong contractions, but they just did not register as pain at all. The latter was horrible. Having someone tell me when I was tensing was paramount - I couldn’t tell, myself. Bradley also will tell you what the risks of any meds are, at each stage of the game. This is useful, because making a decision in the middle of a situation is sucky if you don’t already have a clue why you might want one option over another, let alone what other choices you might have (that haven’t been mentioned yet). The Unofficial Guide to Having a Baby also lists meds with their impacts.
Hypnobirthing and New Way Childbirth (the home-audio/video hypnosis/NLP method) are excellent for people who are decent hypnosis subjects, and outstanding for such people who tense up under stress. I’m going to be using the New Way program for the next one (bought it two miscarriages ago). It is new-agey, kind of spiritually oriented (lots of divine love and soul bonding), but not offensively so (to me). The speaker has an annoying voice, but you get used to her pretty fast. According to a birth instructor (who listened to it with me to check it out) it is a general deep-relaxation and positive attitude program, open to pretty much any ‘training’ program you want to use with it (from Lamaze to Bradley to Active Birthing to Spiritual birthing programs). Best point is that it teaches deep relaxation really well. Not as expensive as Hypnobirthing can be, but not as individually tailored, either. Both Hypnobirthing and NWC have good reputations for pain management and smooth progession of labor. Worth exploring. Both have web sites.
Birthing from Within (spiritual birth method) and … um, there’s one based on Christian scripture, can’t remember the name. Both have decent reps, but again, depends on who you are. If reading scripture will make you relax when you are feeling out of control, then go for that one (if not, then run!). The Birthing from Within one is a very healing approach for people who have traumas around self, birth-expectations, motherhood, etc. Also relaxation-based, with more emphasis on trusting yourself, IIRC. Also very practical attitude about meds - you’ll know if you need them, and then you decide based on that situation. Hard to find teachers, in some areas.
Water birth (laboring in water, usually, rather than actually birthing there) - even the shower, a bathtub (ask the OB/midwife first), the jacuzzi at the hospital… some people get no releif, some get as much pain releif as an epidural (complete releif). Worth a try, if the option is available. No practice needed, though if you want to rent a birthing pool, you will have to do that ahead of time. Bathtub helped me a LOT, as did the Jacuzzi.
I also cannot recommend doulas too highly. Hire one, they are worth every penny. I had two (both volunteers, but still … ). They helped immensely, and they allowed epeepunk to be there for me as fully as possible, without making him fear for me if he had to go pee or eat. Plus, they could fetch and carry, run messages, run errands, get food, get the nurse, help encourage, massage the other leg (very helpful for baby’s heart rate when the epidural makes the legs numb), pass wet rags to the sink for refills, take notes on what happened when, offer suggestions on position changes, remind you about things in your birth plan, and so forth. Please consider one!!! (You can also hire postpartum doulas to help with the first few days or weeks at home, also invaluable! They cook, clean, encourage, guide, they can be there a few hours a day to all day long, and they aren’t your mom or MIL!)
As for meds, please do your research, and know what your risks are going in. Epidurals (as with other interventions) do have risks, which can impact the baby (even if not always directly). If you know what the risks are, you can make an appropriate judgement about using them, when, and how. You may need them. I’d probably have died or gone psychotic without meds (if my son didn’t give up first). They were necessary, but I was glad I knew what the risks were before choosing, so I didn’t later spend time second-guessing the choice. I ended up with some side effects, and in my notes from after the birth (1 week, and again three months later), I note to “NEVER HAVE AN EPIDURAL AGAIN (unless necessary)”. I won’t be signing up for any meds in advance, but I’ll use them if I need them. I really really hope I don’t need them (assuming I ever get pregnant again and actually carry to term).
My last advice: even if you think she’ll go for meds, please learn (and practice) a ‘natural’ method of some sort. Too often the meds don’t work, they don’t get there in time, or they don’t kick in all the way - and then if you don’t have some other backup, you are shit-out-of-luck. The most traumatic natural births I know of were where the meds didn’t get there and they had NO other coping mechanisms.
Labor and birth was really cool, amazing, powerful, transforming - hope your wife has a good one.