Childbirth has been associated with pain since the beginning of time, and throughout history measures have been introduced to help relieve it. Various exorcisms can be found in the records from the ancient civilisations of Babylon, Egypt, China and Palestine. Primitive attempts to help relieve pain were based mainly on suggestion and distraction. The former embraced the use of rings, necklaces, amulets and other magical charms; while the latter included counter-stimulation i.e. the infliction of a painful stimulus sufficient to detract from a natural one.

In the Middle Ages various herbal concoctions based on extract of poppy, mandragora, henbane and hemp were introduced. There is evidence that alcohol was also used in labour.

At the beginning of the nineteenth century other ‘remedies’ were introduced. In 1806 a thesis by Miller, entitled "Means of Lessening Pain of Parturition", recommended vigorous exercise, bloodletting and a variety of medications designed to induce vomiting. One can imagine that treatments such as these would have been quite effective in distracting women from their pain!

Medical history abounds with episodes where new treatments have been embraced with well-intended but misplaced enthusiasm. The introduction of anaesthesia and pain relief in childbirth in the nineteenth and early twentieth centuries was no exception. Some practitioners were so seduced with the powerful effects of the new drugs available to them (chloroform, opioids, ‘Twilight Sleep’), that they used them indiscriminately. However, when revolutionary new remedies are promoted uncritically, they invariably lead to counter-revolution. The excessive use of sedative and analgesic drugs used during labour at the beginning of this century was a prelude to the so-called Natural Childbirth Movement.

The origins of this movement go back to 1914 when Behan wrote: "Like menstruation, childbirth should be a painless process. It is only as culture advances that the labour becomes painful, for in women of primitive races pain is absent.".

Dr Grantly Dick-Read proposed the same argument in 1933. Later, various modifications of the Dick-Read philosophy were introduced in other countries. Psychoprophylaxis was first described in 1947 by a Russian psychiatrist, Velvovski, and was modified by Lamaze and Vellay in Paris in 1952. Antenatal education, breathing patterns and relaxation also play a prominent role with this technique. More recently, Le Boyer has introduced a somewhat different approach - but based on similar concepts. Like the Twilight Sleep movement, most of the above approaches to childbirth have been consumer led.

‘Natural Childbirth’ techniques that depend upon the non-pharmacological management of pain are largely based on practices which were described centuries ago. These techniques are equally relevant today - whether used alone, or in addition to the use of analgesic drugs. However, they are not taught to be used exclusively or quite so rigidly as was originally described by Dick Read and Lamaze. Nowadays, women are encouraged to 'tune into themselves' during labour and adopt techniques which suit them best

So-called Natural Childbirth techniques have had a considerable influence on the management of childbirth pain - although it is not strictly accurate to describe them as being 'natural' because most of them are taught. There is nothing natural (instinctive), for instance, about counter-stimulation or adopting special breathing patterns. Unfortunately, some people have been led to believe that anything that is not natural must be 'unnatural' and therefore bad, or harmful. This rather romantic view of the natural world, however, defies reality: for Nature is far from being benign - especially during childbirth.

Nowadays, many women approach labour with the aim of coping for as long as possible by themselves before asking for any pain relief. This is a perfectly sensible and natural attitude to adopt because the intensity of labour pain is so unpredictable. Some mothers find that they are able to go through labour relying entirely on their own resources; while others prefer and need to have some kind of supplementary pain relief. How you choose to deal with your labour pain will be right for you and your situation - and for no one else.