Here comes advice from the "Coach" again. Physical events like birth can be
prepared-for so that pain is minimized or absent. Drug use is illegal in the
Olympics where there is a lot more muscle work happening than during births.

Birth pain is mostly either muscular or bony. Muscles need oxygen, nutrients,
and fluids  - or else they contract painfully. Muscle-isolation practice
(also known as relaxation techniques), hydration and food during labor (even
marathon runners are given food and fluids in the middle of the race) will
aid the uterine muscle to get the oxygen, food and fluids needed for
effective and comfortable contraction patterns.  Bony pressure from the baby
moving through the pelvis can be well-managed by posture changes, massage,
counter-pressure on the sacrum, and movement (walking, squatting, etc).

Tissue-stretching of the perineum is different and can be best managed with
warmth, controlling the pushing, massage, lubrication, etc. There is a lot of
literature on this in the midwifery journals.

NAACOG (now AWHONN) published an excellent resource called
"Non-Pharmaceutical Pain relief" which is probably still available from their
headquarters in Washington DC. PTs, athletic trainers, and others who deal
with bone and muscle pain can provide helpful techniques on reducing or
eliminating most birth pain and also help with attitudinal issues about
effort; midwives can usually add the rest of the good information and the
psychological pieces.

Drugs should be a last resort, not a first option IMHO. And there's lots of
literature on this.

Linda Smith, still a jock at heart
IBCLC, FACCE in private practice