Breith
Áthas Childbirth
Support Services
Coping with
"Pain" in Labor
What's with
the
quotation marks?
Throughout this web site you'll notice
that I tend to use the words
"sensations" and "feelings" rather than pain. This is deliberate. We
are taught to believe that childbirth is a scary, painful and
potentially life-threatening event. And while childbirth can be all
those things under certain circumstances, scary, painful and
potentially deadly are
not the norm. Most women's lives are not endangered by childbirth, and
most of the scarier and painful aspects of childbirth can be avoided.
This is not to say that labor won't hurt. While there are many women
who don't experience labor as painful, the majority of women do feel
that it hurts, at times it hurts a lot. This may seem like a play on
words, but the difference is mainly in how you respond to the
sensation. The key to coping with labor is learning how to react to the
strong sensations of labor differently than you would to other types of
pain. With knowledge, preparation and confidence labor might still
hurt, but it won't be "painful." There are many things
you can do
for yourself, or have a partner or doula help you with to decrease the
"pain" of labor.
Why does
labor hurt?
Most
often
we feel pain as a message
from our body that something is wrong. The pain is a signal to DO
SOMETHING: take your hand away from the heat, get out of that position.
When we feel pain we instinctively think: something is not right. But
the sensations women feel during labor are normal, and, for the most
part, indicate that everything is proceeding as it should. In a normal
reaction to pain our muscles tense as we prepare for action - this is
part of the "fight or flight" response. It serves us well in life, but
not so much in labor. Labor is the
one time
when pain is not the symptom of a problem and tensing up is more of a
hinderance than a help.
When women tense up during labor, or react to the sensations of
childbirth as they would to other painful sensations, they trigger a
chemical response in their bodies, which in turn can put them on a
vicious cycle that just multiplies the pain:
PAIN
---> TENSION
---> FEAR ---> PAIN
Understanding that the intense
sensations of labor are normal and learning different coping techniques
during pregnancy can break this cycle, and turn labor from something
painful and scary into a powerful and empowering experience. Taking
childbirth classes and working with a doula can be extremely helpful in
learning to cope with labor.
There are
various sources of intense sensations during labor and birth:
Your uterus is
working hard. Like any hardworking muscle, your uterus needs
oxygen during labor and will ache and/or cramp if it is not
sufficiently oxygenated. In labor, this can happen if there is not
enough time between contractions for the uterus to replenish its
oxygen. Breathing techniques can be very helpful in assisting your
uterus in getting the oxygen it needs:
breathe slowly and
fully between contractions,
begin and end every contraction with a deep cleansing
breath,
breathe in an easy, relaxed manner during contractions.
Your cervix is
opening wide.
Uterine contractions and the baby's head pressing down stimulate your
cervix to dilate. Your cervix is very flexible and capable of opening,
but it takes time and you may find the stretching uncomfortable.
Breathing can help take your focus away from the sensation and changing
positions to make use of gravity can help speed dilation along.
The baby's
rotation and descent through your pelvis. Certain
hormones released during pregnancy and labor change the character
of muscles, tissues,
ligaments and joints in your pelvis to make them softer, more flexible
and more yielding. It is very rare that a baby is too big to fit
through a woman's pelvis, but even small babies can feel like they are
taking up a lot of space as they move through your pelvis and birth
canal. Again, breathing techniques and changing position can be really
helpful.
Pressure
on the urethra and bladder. The
baby's head (or other presenting part) pushes down on your bladder and
urethra as s/he moves through your pelvis, and anyone who's "had to go"
can tell you that a bladder under pressure is not comfortable. It is
helps a lot if you remember to empty your bladder as often as possible,
at least once/hour. Having a doula or partner remind you can be very
helpful!
Lack of
preparation. As
I've said, fear and tension can quickly turn strong or powerful
sensations into painful ones. Practicing breathing, relaxation,
visualization and other techniques during pregnancy will help prepare
you for coping during labor. A doula can be very helpful in suggesting
techniques to practice, as well as helping you and your partner (if you
have one) learn to work together. While a doula can help with these
techniques during labor regardless of what practice you've had, being
prepared makes it easier to focus on the experience of childbirth
itself.
How much you can tolerate has more
to do with how quickly the intensity increases than actual pain levels. Pain
levels are all subjective, and in my experience, how much a woman can
cope with is directly related to how prepared she is and how fast her
labor progresses. Most labors progress steadily with gradual increase
in intensity of contractions over time. However if a labor moves
rapidly or there's a sudden increase in intensity (due to ruptured
membranes, pitocin augmentation, etc.) coping can become difficult.
This is where a support person or doula can really be beneficial,
providing reassurance and suggesting new techniques to try.
Breaking the
Pain Cycle
Knowledge, preparation
and confidence are the keys to coping with the intensity of labor.
Reading books, taking childbirth preparation classes, and/or prenatal
work with a doula are all good ways to improve your knowledge and
understanding of labor and birth. By knowing what to expect, you are
less likely to be overwhelmed during labor and react with tension.
Preparation involves practice!
Teach
yourself how to relax. Learn different breathing techniques
(meditation, yoga, and other relaxation breathing techniques are all
valuable) and PRACTICE them. Reading about techniques is helpful, but
practicing them teaches your body what to do. Make it a reflex, so in
labor (when you don't want to have to think too much) you don't have to
think about it. Work with your partner or whoever is going to accompany
you to the birth, so you are both familiar with the techniques. The
following is a list of "tried and true" comfort techniques that can
help. Also have a look at this chart of
the
stages of labor, what to expect, and comfort measures to help you cope.
Tried and True Techniques for Coping with Labor:
- Try to be as
well-rested as possible before labor begins, it's called labor for a
reason - it's a lot of work!
- Create a
calm,
relaxed atmosphere; insist on only having people present who are going
to focus on you and the birth
- Squat, do
pelvic
rocks and change position frequently.
-
Relax during contractions - sounds like a contradiction, but practice
letting all the muscles in your body relax; during labor, let your
uterus do the work
-
Keep your bladder empty so that it doesn't
impair the baby's descent.
- Use a focus,
or a
visualization, to take your concentration off the sensation and put on
the work that needs to be done
- Stay hydrated
and
nourished; drink water and fruit juices and eat lightly as you can
tolerate it
- Use gravity
whenever possible, avoid laying
down, especially on your
back for long periods of time.
- Remember to
alternate between rest and activity.
- Hire a
professional
doula or labor assistant to help you (and your partner) prepare for and
cope through the difficult moments
- Have patience and trust your
body.....
every baby and every labor has its own schedule, stay confident that
your baby will come
out!
The Emotional Challenges
More
and more, the medical establishment is recognizing the mind-body
connection; the power of the human mind in healing the body. Midwives,
doulas, even some obstetricians have long recognized this connection in
the laboring woman. There is no doubt: pain and fear can interfere with
the progress of labor. Earlier, I mentioned that "fight/flight"
response and the release of certain hormones. Well, there's evidence
that those hormones can interfere with processes of labor when they are
over-abundant in the laboring woman's body.
A
woman in labor is very vulnerable. She is experiencing powerful
sensations and can feel like her body is out of control. In order to
feel safe, she needs confidence in herself and her ability to give
birth and she needs the unconditional support of loved ones, medical
staff and/or doula.
Once
again, knowledge and preparation can be of immeasurable value in
helping to build confidence in the process of labor and birth and your
ability to meet the challenges. With knowledge, preparation and
support, we can create a new cycle:
KNOWLEDGE
+ PREPARATION + SUPPORT --->
CONFIDENCE ---> RELAXATION
---> PROGRESS ---> CONFIDENCE
Some tips on preparing for the emotional
challenges:
- Get good support - ask for what you need and
surround yourself with encouraging and supportive people
- Deal with anxiety about labor before it
starts - talk about it with friends, doctor/midwife, partner, doula
- Prepare for difficult moments - some women
breeze through labor, but most encounter a moment when they don't think
they can do any more, work with your support person and/or doula to
prepare for those moments
- Let go - every labor has its own schedule,
trust your body and your baby; this is good practice for parenting:
letting go of the need to be in control
- Let your body do the work - breathe through
intense sensations, welcome the changes in intensity as signs of
progress - don't fight the sensation or try to wish it away
- Learn relaxation techniques!!
- Believe in yourself, your strength and your
ability to give birth - write down and say aloud affirmations
in the
last month of pregnancy to build up this belief in yourself
- Get enough sleep before labor begins - rest
up in your last month of pregnancy, nobody functions well on lack of
sleep
- Remember: Labor is hard work, Labor is
Intense, and YOU CAN DO IT!!
