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Childbirth

Many future mothers lose a lot of sleep over labour and related pain. Certainly, you ask yourself whether you will be able to cope with it. Will you be able to get through the labour without anaesthetics? I will not deceive you, labour hurts. There is, however, a number of reliable methods to ease that pain, either naturally or pharmacologically.

Mother Nature provided women with a special anesthetising hormone - endorphin, which is secreted during labour, relieving the pain. If you are considering anaesthesia, you should know it inhibits endorphin secretion. The anaesthetic effectively stops the pain, but it also blocks hormone production. You should also remember that each of us is different and our reaction to pain differs. Some of us remember childbirth as an extraordinary experience, something really special. Other women reach limits of their strength during labour and try to erase the memory of the childbirth as quick as possible.

It is difficult, however, to determine in advance, which method will suit you best, as each pregnancy is different and the actual situation can be evaluated only during labour. It is worthwhile, however, to extend your knowledge with information on methods for management of labour pains.

Natural methods

Support of a close person

Many women think that simply holding someone's hand helps. A husband, a friend or a personal midwife will support you during labour. Words of support or assistance in breathing will help you to get through the hardships of labour. The accompanying person should inform you regularly about the labour progress, encourage you to be active. The sense of security reduces the tension, and, consequently, the pain. It is also a good idea to have with you someone close,  because awareness of support gives you strength.

The institution of doula is gradually being introduced to our hospitals. Doula is an experienced woman providing emotional and physical assistance to a woman in labour. She also mediates with medical personnel.  Already during pregnancy she learns about needs and fears of the future Mum. She is not, therefore, an accidentally hired midwife, but a friendly person, fully trusted by the woman in labour. She accompanies the woman in labour from the beginning to the end of childbirth. She does not necessarily have to be a midwife, but is a woman who underwent special training, having appropriate experience, who can establish a warm and cordial relationship with the patient. In our circumstances the function of doula is best fulfilled by midwifes, as it is rather new function. In the Western countries a doula has been known for years and is considered a necessary part of childbirth. Women giving birth in her presence have a greater satisfaction with labour, and it is less traumatic to them.

Water

Warm water relaxes. You can take a shower or use a bathtub. Of course, everything depends on equipment available at a hospital. A relaxing shower should last 15 - 25 minutes. During it you pour water over your belly or lower back, relieving the pain and significantly improving blood supply to muscles. Thus the muscles will stretch more easily. During the bath it will feel as if you were washing strain and weariness away, and you will feel a boost of energy.

Remember! Water should be warm or lukewarm. Never hot. However, if you do not feel like taking a bath or a shower, nobody can force you to do that.

Massage

During labour, a massage of the lumbar-sacral area may bring a lot of relief. Lay or sit down comfortably and ask the accompanying person to massage your lower back. Your partner should make circular movements in the painful area, using his/her whole palms, alternately in one direction and then the other. The massage can also be done using the wrist or bones of the fist to press on painful spots.

You also may not want anyone to massage you, or you can prefer a massage done by a midwife to that by your partner, or the other way round. Thus you should always remember to talk about your feelings and needs. If you do not want your accompanying person to touch you, ask a midwife for assistance. Do not be afraid you will offend your partner this way. He should not get offended, feeling his aid was bad or unnecessary, but should understand and respect rights of a woman in labour

Poultices

Poultices are really helpful in easing the labour pains. A cold or warm compress applied to the sacral area or the lower belly will certainly give you some relief.

Breathing

Breathing is very important during labour. When you start to panic, your breathing becomes rapid and accelerated, and this, in turn, may result in hyperventilation. Therefore, try to focus on breathing. It can relieve the pain to a large extent.

Inhalating is important for your baby, as then your body provides him with oxygen, while exhalating is important for you, helping you to relax. Breathe deeply. Exhaling, extend your breath as if you wanted to let all strain and pain out with it. Adapt your breathing to a pattern of your contractions.

Scream

During contractions, you may want to scream, moan or even sing. This is quite normal. Thus, do not supress your emotions as this way you only tense your muscles more.

By making noises while exhaling you ease tension, and, additionally, relax muscles of the birth canal.

But everything in moderation. Remember that intense and loud scream can also cause fatigue and will not accelerate the delivery. When in the 2nd stage of labour you scream instead of pushing, the labour is prolonged, because pushing is ineffective. You can groan and shout to ease tension, e.g., when a pushing contraction eases

Acupressure

When you feel strong pain in the sacral area, you may try acupressure. It is a technique taken from the Chinese medicine. Your partner should press your foot strongly at the base of the biggest toe. This method does not require any significant engagement either on your or your partner's part, so it is worth trying.

Movement

It is worth to change your position during labour. Movement reduces the feeling of pain. At each stage you may feel comfortable in a completely different position. Depending on your position, you can accelerate or slow the labour. Your body itself will signal to you what you should do to reduce the pain during contractions to minimum. Thus you should sit, walk, crouch and kneel. Each position is good. Use your partner, furniture and all equipment available in a delivery room to support yourself.

TENS

Using a special device, secretion of endorphin, a substance mitigating pain, is induced. Four electrodes are attached to the lower back, and then power is transmitted  through them. Electric pulses  block transmission of pain through nerves, and in consequence contractions are milder. That method does not affect a baby; however, it is not recommended for women with a pacemaker.

Music

During labour you can listen to your favourite music. You just have to take your mp3 player to a hospital.

While listening to your favourite melody you will not focus on pain, and that may bring you relief at difficult moments.

Pharmacological methods

Epidural analgesia

It is possibly the most popular and the most effective method to eliminate pain during labour.

A needle is inserted between two lumbar vertebrae and anaesthetic is injected. Thus you do not feel any pain from your waist down, but remain conscious. You can also move and push. You must remember, however, that there are some disadvantages related to this method. It may weaken contractions, significantly prolonging the whole labour. Generally, anaesthetic does not affect the baby. Unfortunately, sometimes the baby's heart rate may slow down for some time resulting in changes in CTG records. It does not happen often, but before you ask for an anaesthetic you should know all pros and cons. It is also worth knowing that anaesthetics injected to an epidural catheter are cocaine derivatives. However, they are administered at low and verified doses.

Dolargan/petidin

Is an anti-spasmodic anaesthetic, a morphine derivative. It is recommended in case of any contraindications to epidural anaesthesia. It is administered either as an intramuscular or an intravenous injection. It has the anti-spasmodic effect. It is, however, not recommended as it penetrates into the baby's body. After injection you may be sleepy; nausea and vomiting may also occur. It can depress the respiratory system of the newborn.

Nitrous oxide

This method is based on inhaling a laughing gas through a special mouthpiece or facial mask. This mixture has a mild effect. It has a slight relaxing and pain-reducing effect. The method is effective when you inhale the gas just before a contraction. Then its maximum level in blood is reached during the contraction.

Currently, nitrous oxide is used very rarely. Hospitals gradually stop using that method of anaesthesia.

Pudendal anaesthesia

In this method the anaesthetic is injected into the nerve in the perineum area, on both sides of the pelvis. Anaesthesia of this kind is also used rather rarely.

For me, labour was an exceptional, but also difficult experience. I had known from the start that I did not want to use pharmacological agents. I was very scared, but at the same time believed that everything would end well. And so it was. With the presence of my husband and his support I got through the hardest moments, and I forgot the pain very quickly. When you see your baby and hear its first scream, nothing else matters. You only know it was worthwhile. That happiness cannot be compared with anything else!

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