Does labour have to hurt?

No it doesn't, according to Nikki Bradford in her new book on the subject. And if women knew all their pain-relief options, she tells Bill Tuckey, there would be less trauma ? and fewer epidurals

There are some things in life that one takes as a given: the sky is blue, the world goes round, and having a baby is agony. Not according to the health writer Nikki Bradford, though. In her provocatively titled new book, Childbirth Doesn't Have to Hurt, she argues that many of the 600,000-odd women who give birth in this country each year are going through a quite unnecessarily traumatic experience.

Bradford's assertion will no doubt provoke snorts of derision from mothers who have been through the whole white-knuckle experience. On closer inspection, though, it is not quite as glib as it sounds.

"There are 25 different ways of relieving pain during childbirth," says Bradford. "Some hospitals are very good – they provide women with advice about all the methods. But others only tell you about three or four, and some say virtually nothing about the subject – they don't see pain relief as very important, because they think you'll soon forget about it anyway."

This idea, she says, can be traced back to the Thirties, when doctors would give women in childbirth a morphine-based drug combination called Twilight Sleep, which did, indeed, induce a kind of woozy amnesia. More recently, pethidine, a drug with similar memory-altering properties (as well as other unpleasant side-effects), has been a staple form of pain relief in many labour wards. But without the help of such dubious concoctions, "all the research shows that women remember the pain of childbirth very well". Going into a labour ward, she says, can be "a bit like going to a dentist and saying 'I need root-canal work', and the dentist saying, 'fine, we do things naturally here, I don't use anaesthetic'."

Bradford believes that this is a scandalous state of affairs. And, incredibly, she says that her book is the first to list and objectively assess all the options available to women, from gas and air to aromatherapy.

So, were she to compile a list of the top five painkillers, which would occupy the number-one spot? Uncontroversially, Bradford opts for spinal injections such as epidurals. "They're the Rolls-Royce of pain relief," she says. "They knock about a third to two thirds off the pain, although one in 20 don't work properly and they can lead to backache." Her choice for second place, though, is more surprising: "That would be a trained birthing partner, or doula," she says. "Someone to stay with you and say, 'I'll rub your back, talk to the doctors – I'll do whatever you want'. Studies have shown that a doula's presence makes labour on average a third faster and reduces the need for pain-relieving drugs by five sixths."

More alternative approaches would make up the rest of Bradford's top five: aromatherapy, acupuncture, and water injections at the base of the spine – also known as lumbar reflexology – a technique commonly practised in Scandinavia, but unavailable over here. Bradford insists that it's not that she has any ideological bias towards complementary therapies, it's just that they should be more widely available.

"Anything that makes you feel calm and relaxed and safe is phenomenally good pain relief," she says. Complementary therapy can be very expensive, but there are DIY versions: for example you can buy a labour kit from a homeopath, you don't have to have them in the delivery-room with you. And you can hire a doula from around £5 per hour."

Many professionals who work in maternity units, though, remain dismissive of such techniques. One senior midwife at a London teaching hospital told me: "I see so many middle-class women come in here, they've got their birth plans, their aromatherapy bottles – they want to use the birthing-pool, with whale music or whatever. But as soon as the contractions set in, they're out of that water and screaming for all the drugs they can get their hands on."

Bradford admits that "three times more women have epidurals than originally say they will – which shows that, whatever plans you make, you have to be flexible: you don't know what labour is going to be like until it starts". She believes, however, that there is no class divide in attitudes to childbirth. "A study done by Lancashire University showed that it wasn't just middle-class women who wanted natural pain relief. Most mothers would prefer to manage without things that have side-effects, but, hell, who wants to be in pain?"

The notion that a growing number of women are "too posh to push" – opting for scheduled Caesareans at private hospitals to avoid the pain and inconvenience of natural birth – is another slur, she says. "Most of these women have been told that a Caesarean is a safer way to deliver their baby. Very few have chosen it for selfish reasons, and it's unfair to suggest they have."

Defending women's right to choose in such matters is something that has preoccupied Bradford since the Seventies. Back then, as a psychology student in Nottingham, she used to do casual work in hospital obstetrics and gynaecology wards during the holidays. "Women patients weren't being consulted – the doctors tended to treat their bodies like machines," she recalls.

But the politics of childbirth can be confusing. At the beginning of the 20th century, suffragettes campaigned for the right to pain relief during labour, and against the belief that the pain was woman's punishment for the sins of Eve. But in the Seventies and Eighties, another generation of feminists took a very different stance, demanding the right to experience childbirth as a natural process rather than the heavily medicated operation it had become.

"In some circles, it was thought that giving birth without drugs was a mark of being a woman," says Bradford. "You were like a warrior woman and you'd gone into battle and come out the other side." But a painful childbirth, she believes, can have negative long-term consequences: "It can affect how mothers are with their babies afterwards, the way they bond with them."

A mother of two herself, Bradford says that she had an epidural for her first birth. "It wore off after an hour – it was pretty unpleasant." For the second child, she tried a self-hypnosis technique called autogenic training, "and it didn't seem to hurt as much and the baby came quicker. If I had another baby, though, I'd go for a doula," she smiles, "but I'm a bit of a coward, so I'd make sure that there were plenty of drugs available, too, just in case".

Bradford's concluding thought might make a more accurate title for her book: "The truth is," she says, "that having a baby does hurt, and at some points it can hurt an awful lot, but it's also true that there's always something you can do to make it better." Not quite as snappy though, is it?

'Childbirth Doesn't Have to Hurt', by Nikki Bradford, is published by Vega, £7.99