GOD BLESS ALL BABIES
Sample Chapter - First 5 Pages
Chapter 3:
DECREASING PAIN DURING BIRTH
I find with most of my clients and practically every Mom I meet, there is a very high rate of concern about labour and delivery. Aside for the overall concerns about baby’s and Mom’s health the focus is on pain, will it hurt, how much will it hurt and will I be able to manage the pain. In a nutshell the answers are; yes it will hurt. If you practice the pain control techniques, it will probably hurt a LOT LESS than you think. Lastly, if you do your homework as stated below, you will be prepared in advance with a plan and will most likely do very well.
To start your preparations I advise most moms-to-be to get a labor coach or someone with experience to help you. Dads are great, and I hope they are reading this book because 95% of this information is for fathers, too, but how many times has Dad helped deliver a baby? Dads are great right off, but soon most feel uncertain and depend greatly on hospital staff for assistance, which they may not get.
Let’s be fair, this event called labor and delivery can be full of surprises. Moms are usually uncomfortable and vocally so, putting Dads, who are already worried about them, in an unenviable position. It’s hard to see someone you care about in pain. Even if the discomfort is at a manageable level for Mom and she’s just ‘going through it’, it may look pretty bad to Dad. When I was training to be a labor coach, even though I was already a trained nurse and a mother, it took until my third clinical experience to feel comfortable and appear confident, supportive and ‘hands on’. Experienced labor coaches mentored me and I can tell you, there is a big difference between being told what to do and actually doing it. I highly recommend pre-natal classes as well, as they are of great help in getting Mom and Dad ready for the main event.
There are a lot of good books on labor and delivery, and I strongly encourage you to read some. Here are the basic points:
Wherever you deliver, keep upright as long as possible, standing, sitting up with feet on the floor, or walking. Put off any and all intervention as long as possible, subject to your doctor’s advice. This means minimal use of IVs and monitors so that you will be able to move around as you wish and remain as comfortable as possible. Talk to your doctor before and during labor and delivery and see what is optional and what is urgent. Everyone is always happier if the baby’s heartbeat can be constantly seen, but if that means strapping Mom down in bed so the monitor doesn’t slip, is it really worth it? What about checking every 15 minutes - as long as things are going well, is that really such a big risk? There is one thing for certain; lying in a bed slows down labor. A longer labor increases the chance of complications, including the need for caesarean section. Stand, walk, use upright holds as much as possible, use a birthing ball, even sitting upright in a chair, all are positive positions for labor. The more you can position yourself to open your pelvic bones, the better. Such positions usually are some form of supported squat, a good squat where your knees are as far apart as possible. A squat-like position can open your pelvic bones by as much as 30%, a fantastic help in promoting the baby’s head to descend.
Let me emphasize this point. It’s very common for any individual to feel helpless in a hospital setting. Relying on hospital staff may mean that your wishes for the type of labor and delivery you envision may be brushed aside. That being said, it is not the job of the hospital to read your mind and understand what you want. The labor and delivery department may be very busy, or the staff may be used to handling laboring mothers in a certain way. It is up to Mom and Dad to take charge in a nice way, and to keep the lines of communication open. To accomplish this, it is best to have a clear, written, labor plan prepared with your doctor, outlining your preferences for labor and delivery. You should be allowed to do anything you want as long as mother and baby are in no danger. The tendency to use a potential vague danger to guilt parents into allowing an intervention, which is not yet necessary, does occur sometimes and is very hard for parents to deflect. The best way to deal with this is to have your doctor onside with your wishes and yourselves well educated as to what you want and what to expect in labor.
By deciding with your doctor before hand, you will make sure your plans are realistic and within the capabilities of the hospital you will be going to. You also need to know that labor does not always go as planned and your feelings of success or failure should be measured on how well you adapted to the situation and ‘rolled with the punches’, not on how close you were able to stick to your plan. There is too much that is beyond your power to influence. Keep
going and keep being positive, this will always provide the best response, no matter what the situation.
HERE IS A GEM FOR YOU: Sitting, use a semi-squatting position. I help my clients with this position, and most find it very effective. Sit on the front edge of a chair, with pillows supporting your back, and spread your knees as far apart as possible, while still being comfortable. Place your feet on step stools (you should bring them with you to the hospital I recommend inexpensive plastic ones), one for each foot. You may want to place towels on top of the stools for comfort. Spread your legs apart as much as you can without discomfort. This puts you into a natural squatting position while supporting you at the same time. As stated before, a natural squatting position is one of the best positions to labor and give birth in, as it opens up the pelvic floor and uses gravity to assist in accelerating birth. See Figure A.
Figure A: Note that this laboring woman is well supported with pillows behind her back. This position pushes her forward, as close to the edge of the chair as is comfortable for her. Her feet are raised on footstools, approximately eight inches high, cushioned by towels. The legs are spread as far apart as comfort allows.
There are many different ways to cope with the process of labor. It really doesn’t matter which one you choose as long as you are comfortable with the method and you practice frequently so you are ready for the big day. This is a very big part for fathers; please make sure that the practicing gets done! How relaxed and in control you feel depends on the both of you being ready.
NOW ANOTHER GEM: It’s a piece of information that can change the course of your birthing experience. But you need to practice, practice, and practice! The secret to decreasing the pain of labor is to relax. Most techniques touch on this, but don’t go far enough. Distraction itself is not enough.
When discomfort or pain begins, it is a natural response for a person to tense up. This is what you must not do. It is this tensing of the muscles that increases pain and takes your energy away - energy that you and your baby need for the labor and delivery process. It is your partner’s and labor coach’s biggest job to make you concentrate on relaxing all your muscle groups from head to toe, especially in your lower back, abdomen and thighs. All your muscles must be limp during a contraction. Try doing this, and you will be amazed at how well it works. Those who are assisting you should verbally cue you during a contraction. A sample contraction starts: “Now, take a big breath in, and relax. Relax your head, down your neck, it’s limp, your shoulders are all mush. Relax your back, your stomach, down through your pelvis. Relax your legs. Relax, you’re limp, soft, relax.”
