Vaginal delivery: Pain coping and relaxation:
Pain can worsen because of:
• Tension
• Fear
• Fatigue
Breathing:
• When you are tense and frightened, your breathing becomes shallow and rapid (Panic breathing)
• This cuts down oxygen supply to mum and baby
• You feel light headed, get pins and needles and feel out of control
• Baby needs plenty of oxygen to cope with the stress of being born
• Breathing techniques help you cope with the pain of contractions
• Rhythmic breathing in labour maximizes the amount of oxygen for mom and baby
• Being stressed and tense in labour reduces the release of the important hormone, oxytocin, thereby possibly lengthening labour
Breathing in early stages:
• Easy rhythmic breathing
• Close your eyes , focus on your breathing and follow your breath
• Your breath in must match your breath out in length and depth
• Breathing is steady and gradual
• Slowly inhaling and exhaling
• In through the nose and out through the mouth
• Count breathing: In 1,2,3 out 1,2,3
• Focus on breathing out, it can be slightly longer. Sigh out gently with every breath and relax to release the tension in the muscles
Breathing in Active stage:
1. As contractions get stronger, breathing becomes shallower
2. This is fine as long as breathing does not get faster and faster and turn into panic breathing
3. As intensity increases, shallow, quicker breaths occur
4. When contractions peaks, breath in and out through the mouth as if you panting to avoid bearing down
5. Pant and blow through a contraction
6. There is no right way of breathing in labour
7. Experiment and experience what feels comfortable and what works for you
Coping skills for labour:
1. Breath awareness is essential
2. Focusing on breathing does not take the pain away but rather takes the mind of the pain
3. Hydro therapy: Warm water soaks in the bath have shown to be the most helpful drug-free method for coping with labour
4. Shower: water is the second most effective analgesic; it helps with relaxation and gives pleasant stimulation of the skin all over the body.
5. Different pain coping positions, use of birthing / Pilates ball
6. Effective pregnancy massages: stimulate the release of natural pain killers (endorphins) that helps you to cope with anxiety
7. Wearing your own clothes and bring your own pillow if you want
8. Resting: The best you can do to help yourself cope with pain is to conserve energy by resting
9. Groaning and moaning: making noise in labour is a great coping strategy
10. Your favourite relaxation music
11. Meditation or pregnancy yoga
12. Breath awareness with ice cubes
13. Relaxation, breathing and visualisation exercises reduce the awareness of pain by distraction, thereby minimising tension that increases pain
14. Constant caring emotional support and encouragement from your birth partner, in the form of kindness, reassurance and being present. Someone that believes you can do this and that won’t panic or joke around.
15. Self talk: Thinking positively- Every contraction brings me closer to the birth of my baby
16. Circular movements of the pelvis and rocking of the pelvis like on Pilates ball
17. Bringing spirituality to your birth space can be comforting and strengthening
18. Trusting that your body can give birth
19. Imagining your baby moving down your pelvis with every contraction
20. Homeopathy: Natural remedies or favourite scents in massage oils
21. Reflexology: Art of relief from pressure points
Pushing breathing:
1. Breath in normally until the urge to push is present
2. Inhale deeply and let out a small amount of air gradually as you push
3. Take a few shallow breaths to catch up
4. Then another deep inhalation repeating the above
5. Push as many times in a contraction as you wish
Other pain coping mechanisms:
1. Entonox gas inhalation
2. Pethidine injections
3. Epidurals: For most effective pain relief
Entonox gas
Inhaled Entonox can be used during early labour to help mothers cope with the pain during contractions and, if required, for uncomfortable examinations. The gas mixture allows, as near as possible, the mother to experience the sensation of a natural birth. Mothers can adjust their intake to suit their own individual pain thresholds.
• Self-administered under the supervision of midwives
• May enable a woman to avoid, postpone or limit pain medication.
• Has a rapid onset and offset of action.
• Can be used at any time in labour up to birth.
• Does not interfere with the progress of labour.
• Enables a woman to choose when to administer analgesia.
• Does not affect the baby’s condition at birth.
(International Association for the Study of Pain. Obstetric pain. September 2007.
Epidural:
An epidural is the injection of local anaesthetic into the epidural space. This is the area where the nerves supplying sensation to the uterus are located. You must have a drip in situ and will have a urine catheter. You will have to stay in bed. A thin drip will be given into the epidural space (back) to make sure that the epidural works until you deliver. This will reduce your pain during contractions.