Pain or no pain - a mother's decision.

Once viewed as "a woman's lot," experiencing pain during childbirth has become a personal choice. For the 1990s, most seem to have decided that "Pain is out," according to Warren Crosby, professor of obstetrics and gynecology, University of Oklahoma Health Sciences Center.

"Natural," meaning medication-free, childbirth was a reaction to two events--the 1960-70s women's movement and the medical obstetrical practices of the 1950s, in which women were treated like children and drugged into unconsciousness during labor. The babies also were affected by strong anesthesia, many showing the effects of drugs for hours after birth.

However, recent improvements in anesthesia have made it possible for the mother's pain to be dulled and for her to remain alert and able to participate in the birth. Newer medications can be administered locally, in smaller doses, with much less impact on the baby, reports Thomas Tinker, director of obstetrical anesthesia, Oklahoma Memorial Hospital. "Hormonal changes occur in a woman's body during her pregnancy which prepare her for giving birth and leave her, in effect, already partly anesthetized. We also have discovered that these changes make the nerves more sensitive to anesthesia, so smaller doses are required during labor."

This natural pain-blocking system can collapse under the influence of fear. Because of this, Crosby indicates, natural childbirth classes are extremely helpful, especially to first-time mothers, because they teach breathing and relaxation techniques.

When no anesthesia is used, the outcome may go two ways. If the labor is uneventful and not overly long, the mother usually feels much more of a sense of accomplishment and is prouder of her role in the birth than if she had used anesthesia. If the labor is extended, however, hyperventilation and...