Easing labor pains
Dealing With Pain During Childbirth (for Parents)
Learning all you can about labor and delivery is one of the best ways to help you manage the pain of childbirth when the time comes.
Pain During Labor and Delivery
Pain during labor is caused by contractions of the muscles of the uterus and by pressure on the cervix. This pain can be felt as strong cramping in the abdomen, groin, and back, as well as an achy feeling. Some women experience pain in their sides or thighs as well.
Other causes of pain during labor include pressure on the bladder and bowels by the baby's head and the stretching of the birth canal and vagina.
Pain during labor is different for every woman. It varies widely from woman to woman and even from pregnancy to pregnancy.
It's often not the pain of each contraction on its own that women find the hardest, but the fact that the contractions keep coming — and that as labor progresses, there is less and less time between contractions to relax.
Preparing Yourself
To help with pain during labor, here are some things you can start doing before or during your pregnancy:
Regular and reasonable exercise (that your doctor says is OK) can help strengthen your muscles and prepare your body for the stress of labor. Exercise also can increase your endurance, which will come in handy if you have a long labor. The important thing to remember with any exercise is not to overdo it — and this is especially true if you're pregnant. Talk to your doctor about what he or she considers to be a safe exercise plan for you.
If you and your partner attend childbirth classes, you'll learn different techniques for handling pain, from visualization to stretches designed to strengthen the muscles that support your uterus. The two most common childbirth philosophies in the United States are the Lamaze technique and the Bradley method.
The Lamaze technique is the most widely used method in the United States.
The Lamaze philosophy teaches that birth is a normal, natural, and healthy process and that women should be empowered to approach it with confidence. Lamaze classes educate women about the ways they can decrease their perception of pain, such as through relaxation techniques, breathing exercises, distraction, or massage by a supportive coach. Lamaze takes a neutral position toward pain medicine, encouraging women to make an informed decision about whether it's right for them.
The Bradley method (also called Husband-Coached Birth) emphasizes a natural approach to birth and the active participation of the baby's father as birth coach. A major goal of this method is the avoidance of medicines unless absolutely necessary. The Bradley method also focuses on good nutrition and exercise during pregnancy and relaxation and deep-breathing techniques as a method of coping with labor. Although the Bradley method advocates a medicine-free birth experience, the classes do discuss unexpected complications or situations, like emergency cesarean sections.
Medicine-free ways to handle pain during labor include:
- hypnosis
- yoga
- meditation
- walking
- massage or counterpressure
- changing position
- taking a bath or shower
- listening to music
- distracting yourself by counting or performing an activity that keeps your mind otherwise occupied
Pain Medicines
A variety of pain medicines can be used during labor and delivery, depending on the situation. Many women rely on such medicines, and it can be a huge relief when pain is quickly eased and energy can be focused on getting through the contractions. Talk to your health care provider about the risks and benefits of each type of medicine.
Analgesics. Analgesics ease pain, but don't numb it completely. They don’t affect sensation or muscle movement. They can be given many ways. If they are given intravenously (through an IV into a vein) or through a shot into a muscle, they can affect the whole body.
These medicines can cause side effects in the mother, including drowsiness and nausea. They also can have effects on the baby.
Regional anesthesia. This is what most women think of when they consider pain medicine during labor. By blocking the feeling from specific regions of the body, these methods can be used for pain relief in both vaginal and cesarean section deliveries.
Epidurals, a form of local anesthesia, relieve most of the pain from the entire body below the belly button, including the vaginal walls, during labor and delivery. An epidural involves medicine given by an anesthesiologist through a thin, tube-like catheter that's inserted in the woman's lower back. The amount of medicine can be increased or decreased according to a woman's needs. Very little medicine reaches the baby, so usually there are no effects on the baby from this method of pain relief.
Epidurals do have some drawbacks — they can cause a woman's blood pressure to drop and can make it difficult to pee.
They can also cause itching, nausea, and headaches in the mother. The risks to the baby are minimal, but include problems caused by low blood pressure in the mother.
Tranquilizers. These drugs don't relieve pain, but they may help to calm and relax women who are very anxious. Sometimes they are used along with analgesics. These drugs can have effects on both the mother and baby, and are not often used. They also can make it difficult for women to remember the details of the birth. Discuss the risks of tranquilizers with your doctor.
Natural Childbirth
Some women choose to give birth using no medicine at all, relying instead on relaxation techniques and controlled breathing for pain. If you'd like to experience childbirth without pain medicine, discuss this with your health care provider.
Things to Consider
Here are some things to think about when considering pain control during labor:
- Medicines can relieve much of your pain, but probably won't relieve all of it.
- Labor may hurt more than you expected. Some women who had said they want no pain medicine whatsoever end up changing their minds when they're actually in labor.
- Some medicines can affect your baby, making the baby drowsy or causing changes in the heart rate.
Talking to Your Health Care Provider
You'll want to review your pain control options with the person who'll be delivering your baby. Find out what's available, how effective they're likely to be, and when it's best not to use some medicines.
If you want to use pain-control methods other than medicine, make sure your health care provider and the hospital staff know. You might want to also consider writing a birth plan that makes your preferences clear.
Remember, many women make decisions about pain relief that they abandon — often for very good reason — at the last minute. Your ability to endure the pain of childbirth has nothing to do with your worth as a mother. By preparing and educating yourself, you can be ready to decide what pain management works best for you.
Easing Labor Pains
The labor and delivery team at North Florida's All About Women discuss pain management techniques all expecting moms should know
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- Easing Labor Pains
When it comes to labor, every woman is different. Some want pain relief as soon as possible, others want to wait as long as they can, others want to avoid medical pain relief altogether. Regardless of whether or not you choose an epidural or other pain medication, it’s likely that you will experience pain at some point during labor and so it's best to be prepared.
There are many different techniques that can provide women relief from labor pains. Here are some the most common techniques you should be familiar with before baby is on his way:
Childbirth Class
Preparing for what to expect during the birthing process is important for all women, regardless of how you choose to manage your pain.
When you understand the stages of labor and when pain relief measures can be taken, then you’ll be better equipped mentally for what lays ahead. And if you're planning a natural birth, taking a class will help give you the opportunity to practice the techniques you'll use on the big day.
North Florida Regional Medical Center has several recurrent childbirth classes for you to choose from.
Labor Support
Research on effective pain management in labor (summarized in the American Family Physician) has found that women who receive continuous labor support, often by a doula, have lower use of pain medication and increased birth satisfaction.
A doula is someone trained in labor support who stays with a woman throughout the labor process. Even if you don't use a doula, you should have a trained birth partner who knows how to help you when pain hits. A birth partner can be a spouse, family member, or friend – someone who you trust and are very comfortable with.
Whoever you choose, you and your birth partner should practice:
- Warm/cold compresses. You may appreciate cool cloths during the labor transition, or a warm compress to help relieve the discomfort of contractions.
- Comforting touch. Some women enjoy having their backed rubbed or being lightly touched during labor. Other women don’t want to be touched at all.
- Pressure on the lower back in case you have back labor.
- Breathing techniques. Your support person should be trained in helpful breathing techniques so they can help remind you to breath through contractions.
Changing Positions
Different positions can dramatically help women cope with labor pains while aiding labor progress. Here are some of the most common helpful positions:
- Kneeling on your hands and knees
- Swaying while supported by your birth partner, as if you were dancing
- Sitting on a birthing ball
- Walking (Besides helping manage pain, walking can also help labor progress.
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Your birth partner should know some of these helpful positions, but midwives and the nursing staff can also suggest positions depending on your pain.
Other Coping Mechanisms
There are many other ways to help manage labor pains. Here are a few common techniques:
- A quiet and dark environment. Many women appreciate a quiet and dark environment with minimal stimulus (including people in the room).
- Making noise. Pain can seem greater when you internalize it. Don't be afraid to make noise to help you cope.
- Using Water. Many women find that warm water baths, showers, or having someone pour water on them helps relieve pain.
Find a Maternity Team You Trust
Even if you’re just waiting for your epidural, learning about various techniques for dealing with labor pain is always a good idea, as is having a team of maternity providers that you trust.
The obstetricians and midwives at Gainesville's All About Women want to help you prepare for the big day and all that lies beyond.
Continue browsing our Knowledge Center to learn about breastfeeding support, maternal wellbeing and advice for transitioning your baby into your home.
How to behave in childbirth? Learning to give birth quickly and with problems
Childbirth is a natural process, laid down by nature. The whole sequence of events that take place during this period is predetermined, but by your actions you can either speed up the birth of a baby, or complicate his birth.
Childbirth is the final and most important stage of pregnancy. How you behave and how accurately and skillfully you follow the instructions of the obstetrician depends on how you will feel and how quickly your baby will be born. What does a newborn need to know? Let's try to answer the most important questions.
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1. When is it time to go to the maternity hospital?
Childbirth is a natural result of hormonal changes that occur in your body during the final stages of pregnancy. The sagging belly and heaviness in its lower part and the lumbar region speak of the imminent denouement of the story. Periodically, weak contractions occur, the stomach tenses and pulls down, but these sensations quickly pass, the uterus relaxes again and becomes soft. Such contractions are harbingers of childbirth, but they are far from real labor activity. nine0003
The signal to call an ambulance should be sufficiently strong contractions that are repeated at regular intervals, the appearance of mucous secretions from the genital tract, slightly stained with blood, or the outflow of amniotic fluid.
2. First stage of childbirth: we breathe for two!
From the moment the contractions become regular, the first stage of labor begins, during which the strength, frequency and duration of uterine spasms increases and the cervix opens.
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During spastic contraction of the uterine muscle fibers, the blood vessels that carry arterial blood to the placenta and fetus are compressed. The fetus begins to experience a lack of oxygen, and this involuntarily makes you breathe deeper. The reflex increase in the rate of contractions of your heart will ensure the delivery of oxygen to the child. Nature has provided that these processes take place regardless of your consciousness, but you should not completely rely on it.
In the first stage of labor, during each contraction, you need to breathe calmly and deeply, trying not to hold your breath while inhaling. At the same time, the air should fill the upper sections of the lungs, as if raising the chest. You need to inhale through the nose, slowly and smoothly, exhale through the mouth, just as evenly. nine0003
3. Auto-training in the prenatal ward
To speed up the opening of the cervix, you need to walk more, but sitting is not recommended, while blood flow in the limbs is disturbed and venous blood stagnation occurs in the pelvis.
From time to time it is useful to lie on your side, stroking your lower abdomen with both hands in the direction from the center to the sides, focusing on breathing and saying to yourself: "I am calm, I am in control of the situation, each contraction brings me closer to the birth of a baby."
4. To relieve pain
Acupressure of the lower back can help relieve pain. Find the outer corners of the sacral rhombus on your lower back and massage these points with clenched fists.
Monitor the frequency and duration of contractions and if they weaken or sharply increase, immediately inform your doctor. In case of severe pain, you can ask for an anesthetic, but you should remember that you should not take the medicine too often, this is fraught with narcotic depression of the newborn and a decrease in his adaptive abilities. nine0003
If dilatation of the cervix causes reflex vomiting, rinse the mouth with water and then drink a few sips to replace the lost fluid.
Do not drink a lot, this can provoke a recurrence of vomiting.
5. The maternity ward is not a place for tantrums
They say that difficult childbirth is a person's retribution for walking upright. Childbirth is actually a painful process, but the presence of reason allows us, representatives of the genus Homo sapiens, to control our emotions. Screaming, crying, tantrums and swearing have no place in the maternity ward. This creates a tense environment, interferes with the normal course of childbirth, complicates diagnostic and therapeutic measures, and ultimately affects their outcome. nine0003
6. Second stage of labor - pushing and expulsion of the fetus
After the baby's head slips through the dilated cervix and finds itself on the bottom of the pelvis, the pushing period of labor begins. At this time, there is a desire to push, as it usually happens during a bowel movement, but at the same time many times stronger. At first, the attempts are controllable, they can be "breathed", but by the beginning of the third stage of labor, the expulsion of the fetus, they become unbearable.
With the beginning of the straining period, you will be transferred to the delivery room. Having settled down on the delivery table, rest your feet on the special steps, firmly grasp the handrails and wait for the midwife's command. nine0003
While pushing, inhale deeply, close your mouth, clench your lips tightly, pull the handrails of the delivery table towards you and direct all the exhalation energy down, squeezing the fetus out of you. When the top of the baby appears from the genital slit, the midwife will ask you to ease your efforts. With gentle movements of her hands, she will first release the baby’s forehead, then his face and chin, after which she will ask you to push again. At the moment of the next attempt, the baby's shoulders and torso will be born. After the newborn is born, you can breathe freely and rest a little, but the birth is not over. nine0003
7. Third stage of labor and final
Third stage of labor - afterbirth.
At this time, weak contractions are observed, due to which the fetal membranes gradually exfoliate from the walls of the uterus.
About 10 minutes after your baby is born, your midwife will ask you to push again to deliver your afterbirth. The doctor will carefully examine it and make sure that all parts of the membranes have come out. After that, with the help of mirrors, he will examine the cervix and make sure that it is intact. If necessary, all tears will be closed with absorbable sutures. nine0003
You will have to spend another couple of hours in the delivery room with an ice-filled bladder on your stomach. To quickly contract the uterus, you will be given injections of special drugs. When the threat of postpartum hemorrhage has passed, you will be transferred to the postpartum ward to the baby.
Childbirth completed. Ahead of the postpartum period, during which your body will recover after pregnancy.
More details on Medkrug.
RU: http://www.medkrug.ru/article/show/kak_pravilno_vesti_sebja_v_rodah_uchimsja_rozhat_bystro_i_problem
Source: http://www.medkrug.ru/
Popular methods of pain relief during childbirth
Many pregnant women are very worried about the upcoming birth and are afraid of the pain associated with it. Of course, you ask yourself: “Will I be able to cope with this pain and will I be able to give birth without anesthesia?” I won't lie to you, childbirth is painful. But there are a number of reliable methods to relieve pain, both natural and medicinal.
Nature has endowed women with a special analgesic hormone - endorphin, which is synthesized during childbirth and relieves pain. If you are thinking about whether to use anesthesia in childbirth or not, then you should know that it suppresses the secretion of endorphins. Yes, the anesthetic effectively relieves pain, but at the same time blocks the production of hormones. Also, remember that we are all unique and our reactions to pain are different.
Some women perceive their childbirth as a unique experience, as something special. Other women reach the limit of their strength during childbirth and then try to erase this event from memory as quickly as possible. nine0003
It is very difficult to determine in advance which method is best for you, as each pregnancy is unique and the assessment of the current situation can only be made during labour. But getting as much information as possible about the methods of anesthesia of labor pain will not be superfluous.
Natural methods
Support for a loved one
Many women feel that you can help by simply holding her hand. A husband, friend or personal midwife can support you during childbirth. Sometimes just a word of encouragement or help with breathing is enough to get you through the tough times. The accompanying person should encourage you and constantly tell you about how the birth process is going. The feeling of security reduces tension and, accordingly, reduces pain.
The idea of calling someone close to the people is good because you know for sure that there is someone to support you, this thought alone already gives you strength. nine0003
Gradually, our maternity hospitals are getting acquainted with such a phenomenon as “dula”. A doula is an experienced woman who supports the mother emotionally and physically. She also acts as an intermediary between the woman in labor and the medical staff. Even during pregnancy, the doula learns about the needs and fears of the expectant mother. This is not a midwife suddenly hired during childbirth, but a friend, a person who is completely trusted by a woman in childbirth. A doula accompanies the mother during the entire birth process. At the same time, she does not need to work as a midwife, she just needs to undergo special training, have relevant experience and be able to establish a warm and cordial relationship with the patient. In our conditions, the function of a doula is best performed by midwives, although this is a fairly new direction in general.
In European countries, doulas have been known for a long time and are considered a necessary part of the birth process. Women who are accompanied by doulas feel better after childbirth, and the process of childbirth itself is less traumatic compared to traditional childbirth. nine0003
Water
Warm water relaxes. You can both take a shower and lie down in the bath. Of course, it all depends on the equipment in your hospital. A relaxing shower should last 15-25 minutes. While showering, point the jet of water at the stomach or lower back, this will relieve pain and increase blood flow to the muscles. After that, the muscles will be easier to stretch. While taking a bath, you will feel how tension and fatigue disappear, and you will feel a strong surge of energy.
Remember! The water should be either warm or slightly warm. Never use hot water. Remember that if you are not in the mood to take a shower or bath, no one can force you. nine0003
Massage
Massage of the lumbosacral area during childbirth can provide significant relief.
Lie down or sit comfortably and ask the person accompanying you to massage your lower back. Your partner should make circular movements in the painful area with the entire surface of the palm, first in one direction, then in the other. You can also apply pressure to painful points using the base of your palm or fists.
You may not want to be massaged at all, or you may prefer having a midwife massage rather than your husband. Remember that you can always talk about your feelings and what exactly you need. If you do not want the accompanying person to touch you, ask the obstetrician for help. Do not be afraid that in this way you will offend your partner. He should not be offended, thinking that he is a bad helper and that he is not needed. He must understand and respect the rights of the woman who gives birth. nine0003
Compresses
Compresses are very helpful in relieving pain. A cold or warm compress applied to the sacrum or lower abdomen will definitely give you some relief.
Breathing
Breathing is very important during childbirth. When you start to panic, your breathing becomes rapid, and this, in turn, can lead to hyperventilation. So try to focus on your breathing. This will greatly ease the pain.
Breathing in is important to your baby because your body is supplying oxygen to your baby, and breathing out is important to you because it helps you relax. Breathe deeply. Exhale the air completely, imagine that you are exhaling all the tension and pain. Synchronize the rhythm of your breathing with the rhythm of contractions. nine0003
Shout
During contractions, you may scream, moan, or even sing. This is quite natural. Do not suppress your emotions, otherwise you will overstrain the muscles involved in childbirth, and this will only increase the pain.
If you make any sounds as you exhale, you will not only relieve the pain, but also relax the muscles of the birth canal.
But everything is good in moderation.
Remember that loud screaming can make you tired, and fatigue slows down the birth process. If you scream instead of pushing in the second stage of labor, the pushing will be ineffective and the baby will not move through the birth canal. Therefore, moaning and screaming to relieve pain is possible only at the moment of weakening of the contraction. nine0003
Acupressure
For severe sacral pain, try acupressure. This is a technique from Chinese medicine. Your partner should press hard on the base of the big toe. This method does not require much effort on either your part or your partner's, so it's worth a try.
Movement
Change positions during childbirth. Movement reduces pain. Depending on what stage of labor you are in, completely different positions can alleviate your condition. Using this or that position, you can both speed up and slow down the process of childbirth. Your body itself will tell you exactly what to do in order to relieve the pain during contractions as much as possible.
Any posture is good - you can sit, walk, squat or get on all fours. Have a partner help you, or use the furniture and equipment in the antenatal room to help you. nine0003
TENS (transcutaneous electrical nerve stimulation)
A special device produces the hormone endorphin, which is needed to relieve pain. With TENS, four electrodes are attached to the skin in the lumbar region, through which current is supplied. Electrical impulses block the transmission of pain along the nerves, and as a result, contractions are easier to bear. This method has no effect on the child, but is not recommended for women with a pacemaker.
Music
You can listen to your favorite music during childbirth. To do this, simply download your favorite playlists to your phone before heading to the hospital. nine0003
As long as you listen to your favorite tunes, you will not think about pain, and this will bring you relief in difficult moments.
Pharmacological methods
Epidural analgesia
This is probably the most popular and most effective method for pain relief during childbirth.
An anesthetic needle is inserted between two lumbar vertebrae. You will not feel pain below the belt, but you will be conscious, able to move and push. However, remember that this method has certain disadvantages. Such anesthesia weakens contractions, which leads to a significant slowdown in the birth process. In general, the anesthetic does not affect the child, but sometimes, unfortunately, the baby's heartbeat can slow down for a while, which will be seen from the CTG records. This does not happen often, but before you ask for such anesthesia, you must weigh the pros and cons. It is also necessary to know that anesthetics administered through an epidural catheter are derivatives of cocaine, although they are administered in low and authorized doses. nine0003
Dolargan / Pethidine
It is an antispasmodic drug derived from morphine. It is recommended in the presence of contraindications to epidural anesthesia. It is administered either intramuscularly or intravenously.
However, this remedy is not recommended for use, because it penetrates the child's body and can cause depression of the respiratory system of the newborn. You may also feel drowsy after the injection, and you may experience nausea or vomiting.
Nitrous oxide
When using this type of anesthesia, you inhale the gas mixture through a special mouthpiece or using a face mask. This is a rather mild type of anesthesia that has a slightly relaxing and pain-reducing effect. This method is effective when you inhale gas before a contraction. In this case, the maximum level of gas in the blood is reached during the contraction itself. nine0003
Nitrous oxide is now rarely used, and maternity hospitals are phasing out this type of anesthesia.
Pudendal Anesthesia
In this type of anesthesia, an anesthetic is injected into a nerve in the perineum on both sides of the pelvis. Anesthesia of this type is also used extremely rarely.
As for me, I perceive childbirth as an exceptional and very difficult experience.
