Labor is the part of the pregnancy process that moves you from
pregnancy to delivery. Through labor, your body will open the birth
canal. Contractions will help push the baby from the womb through the
cervix, through the vaginal passage and into your arms. Labor is often
the most traumatic part of the delivery process for expecting mothers.
While no one knows the exact cause of labor, several factors come
into play during this final stage of pregnancy. First, the level of
prostaglandin, a hormone, increases, causing the cervix to soften.
Second, the levels of the hormone oxytocin increase, triggering
contractions. Third, the sac of membranes surrounding the baby ruptures.
In a normal pregnancy, these factors can occur any time from two weeks
prior to your due date to two weeks after it.
Discuss The Options
In weighing your options about pain relief during labor and delivery, educate yourself on all the different types available by talking to your doctor or other health care professional. There may be one type that is recommended for you specifically over another. Some pain relief options will allow you participate in the birth of your child while others will completely block out all feelings. Many women make the decision before going into labor to have natural childbirth and later change their mind. Others plan to get pain medicine and then arrive at the hospital as the baby is about to be born, and birth happens before they have a chance to get medicine. It is always best to know your options before you go into labor.Non-medical pain relief options for childbirth
Research suggests that adequate preparation can help to reduce pain or at least modify the perception of pain and reduce anxiety, which can help you to better cope with labour. There are several non-drug pain relief options:Breathing exercises
Breathing exercises are a traditional way of coping with pain; nowadays, there are many other methods of pain relief, which are more effective; however, breathing exercises are still important and they can help to make labour run more smoothly.
During the different stages of labour, different breathing exercises will be more useful than others:
Stage.1: during the early stage of labour you should focus on breathing deeply through each contraction; you should inhale slowly and then exhale gradually. Some women find it beneficial to count during these long breaths. As the labour progresses and the contractions become stronger you can start to breathe quicker; as the contraction reaches its peak, it is helpful to breathe in and out quickly, like a panting action.
Stage.2: during this stage breathing can help make contractions more effective; during this stage you feel an urge to push but your body will not be ready to push just yet. During this time, you should inhale deeply and then exhale slowly when the midwife tells you to push; this helps to encourage the baby to drop lower. After a deep breath, take a couple of shallow breaths and then you will be ready for another deep breath for the next contraction.
Breathing techniques and exercises help to maximise the oxygen available to both you and your baby and will help to reduce discomfort and focus your mind on something other than sensations of pain.
It is a good idea to practice your breathing technique throughout your pregnancy; it will seem natural doing it during labour if you do this. You can learn about breathing techniques from antenatal classes, books and DVDs.
Tens
Many pregnant women choose to use Tens as a way of controlling their contractions, as it able to effectively distract from the pain. Tens stands for Transcutaneous Electrical Nerve stimulation. It is a machine which is attached to your clothing during pregnancy, and gives out safe electric pulses of energy which can be used in conjunction with four pads that you can put on your back.
Each tens machine is different and it is best to read the instructions carefully and get help if need be. Your birth partner will be able to assist you with the use of the Tens machine during labour. The pads which come with the Tens machine are usually placed on your back, though you may only need to attach two pads at about bra level. The other two pads should be placed on your lower back or your bottom. The pads are coated in a gel to make it more comfortable, but this is also a means to ensure pulses reach the body effectively. The Tens machine typically contains dials which are used to adjust pulse output according to your individual needs.
Tens machines are available to buy in pharmacies and mother and baby shopping outlets, or as an alternative you could look on the internet.
Hot or cold packs, massage, a warm shower or immersion in a warm bath, and keeping active may all be helpful.
Medical Pain Relieve Options
There are three main ways to provide pain relief during labor and childbirth:
- Local anesthesia may be used by your health care provider during delivery to numb a painful area in or around the vagina if stitches are needed. Local medications do not reduce discomfort during labor.
- Regional anesthesia (also called an epidural or spinal anesthesia) is administered by an anesthesiologist (a doctor who delivers pain medicine) during labor to reduce discomfort. In both epidural and spinal anesthesia, medications are placed near the nerves in your lower back to "block" pain in a wide region of your body while you stay awake. Regional anesthesia greatly reduces pain throughout the birthing process. It can also be used if a cesarean birth becomes necessary.
- General anesthesia puts you to sleep during the birthing process. While safe, general anesthesia is rarely used and only during emergencies because it prevents you from seeing your child immediately after birth.
Gas and air (Entonox) for labour
This is a mixture of oxygen and nitrous oxide gas. Gas and air won't remove all the pain but it can help to reduce it and make it more bearable. Many women like it because it's easy to use and they control it themselves.How it works
You breathe in the gas and air through a mask or mouthpiece, which you hold yourself. You'll probably practise using the mask or mouthpiece if you go to an antenatal class. The gas takes about 15 to 20 seconds to work, so you breathe it in just as a contraction begins. It works best if you take slow, deep breaths.Side effects
There are no harmful side effects for you or the baby but it can make you feel light-headed. Some women also find that it makes them feel sick, sleepy or unable to concentrate. If this happens, you can stop using it.If gas and air doesn't give you enough pain relief, you can ask for a painkilling injection as well.
Pethidine injections in labour
Another form of pain relief is the intramuscular injection (into the muscle of your thigh or buttock) of a drug, such as pethidine or, less commonly, diamorphine. The injection can also help you to relax, which can lessen the pain.How it works
It takes about 20 minutes to work after the injection, and the effects last between two and four hours.Side effects
There are some side effects to be aware of:- It can make some women feel woozy, sick and forgetful.
- If it hasn't worn off towards the end of labour it can make it difficult to push. You might prefer to ask for half a dose initially to see how it works for you.
- If pethidine or diamorphine are given too close to the time of delivery they may affect the baby's breathing. If this happens, another drug to reverse the effect will be given.
- The drugs can interfere with the baby's first feed.
Epidurals
An epidural is a special type of local anaesthetic. It numbs the nerves that carry the pain impulses from the birth canal to the brain. For most women, an epidural gives complete pain relief. It can be helpful for women who are having a long or particularly painful labour, or who are becoming distressed.An anaesthetist is the only person who can give an epidural, so it won't be available if you give birth at home. If you think you might want one, check whether anaesthetists are always available at your hospital.
How much you can move your legs after en epidural depends on the local anaesthetic used. Some units offer 'mobile' epidurals, which means you can walk around. However, this also requires the baby's heart rate to be monitored remotely (by telemetry) and many units don't have the equipment to do this. Ask your midwife if this a mobile epiduran is available in your local unit.
An epidural can provide very good pain relief, but it's not always 100% effective in labour. The Obstetric Anaesthetists Association estimates that one in eight women who have an epidural during labour need to use other methods of pain relief.
What's involved in having an epidural?
To have an epidural:- A drip will run fluid through a needle into a vein in your arm.
- While you lie on your side or sit up in a curled position, an anaesthetist will clean your back with antiseptic, numb a small area with some local anaesthetic and then introduce a needle into your back.
- A very thin tube will be passed through the needle into your back near the nerves that carry pain impulses from the uterus. Drugs, usually a mixture of local anaesthetic and opioid, are administered through this tube. (An opioid is a drug that binds to special opioid receptors in the body, reducing pain.) It takes about 10 minutes to set up the epidural, and another 10 to 15 minutes for it to work. It doesn't always work perfectly at first and may need adjusting.
- After it has been set up, the epidural can be topped up by your midwife, or you may be able to top up the epidural yourself through a machine.
- Your contractions and the baby's heart rate will need to be continuously monitored. This means having a belt around your abdomen and possibly a clip attached to the baby's head.
Side effects of obstetric epidurals
There are some side effects to be aware of:- An epidural may make your legs feel heavy, depending on the local anaesthetic used.
- Your blood pressure can drop (hypotension); however, this is rare because the fluid given through the drip in your arm helps maintain good blood pressure.
- Epidurals can prolong the second stage of labour. If you can no longer feel your contractions, the midwife will have to tell you when to push. This means that forceps or a ventouse may be needed to help deliver the baby's head (instrumental delivery). When you have an epidural, your midwife or doctor will wait longer for the baby's head to come down (before you start pushing). This reduces the chance you will need an instrumental delivery. Sometimes, less anaesthetic is given towards the end so that the effect wears off and you can push the baby out naturally.
- You may find it difficult to pass urine as a result of the epidural. If so, a small tube called a catheter may be put into your bladder to help you.
- About one in 100 women gets a headache after an epidural. If this happens, it can be treated.
- Your back might be a bit sore for a day or two but epidurals don't cause long-term backache.
Please share your birthing experience with us..Did you get a pain relieve or you went all natural?