topical thursdays #1: pain in labor and delivery

i'm starting with the topic of pain in labor and delivery b/c i think that is the top concern most women have when they think about having a baby. and with rising epidural rates (i've heard various figures from 60-80%) i think its important to give additional information. because "epidural" does not equal "birth plan" :lol



in fact heres an article from sara buckley (who i heard speak at the ican conference and she was so awesome....gave so much info my hand was sore from taking notes) this is about the risks involved in choosong epidural pain relief.



http://www.sarahjbuckley.com/articles/epidural-risks.htm i'll just quote the last paragraph here but ireally encourage you to read the full article



"Conclusion
Epidurals have possible benefits but also significant risks for the laboring mother and her baby. These risks are well documented in the medical literature, but may not be disclosed to the laboring woman. Women who wish to avoid the use of epidurals are advised to choose carers and models of care that promote, support, and understand the principles and practice of natural and undisturbed birth."





the best book i've read about pain in l&d is grantley dick-read's "Childbirth w/o fear" http://www.amazon.com/Childbirth-Without-Fear-Original-Approach/dp/0061092487/ref=sr_1_2?ie=UTF8&s=books&qid=1247773081&sr=1-2 in it dick-read describes the Fear-Tension-Pain cycle that leads to pain.





Basically women these days having not seen normal birth (or often any actual birth...only the highly dramatized tv variety) tend to fear what they don't know. Fear leads to tension which leads to pain.





The solution is to learn about normal birth.





One of the important things to realize is that not every birth is painful. About 20% of births are actually painless. A film i highly reccomend is "Orgasmic Birth". http://www.orgasmicbirth.com/ I saw it last summer and it is so, I just can't even describe it.... inspiring, educational, just a fantastic film!





For births that do include pain, it's usually managable. My last birth never felt worse than bad menstrual cramps. Actually what surprised me most about that birth was the leg cramps I got while pushing :lol I didn't even feel the "ring of fire" during crowning. (although i did have a very intense sensation at my clitoris....not orgasmic, but not painful either just intense)





Highly effective non-medical techniques are available for pain managment during l&d. Heres a sampling:





Freedom of Movement: laboring and pushing and delivering in the position that is most comfortable for you will significantly reduce your pain sensations.





Freedom of movement is one of the 6 Lamaze Care Practices that supports Normal Birth http://www.lamaze.org/ChildbirthEducators/ResourcesforEducators/CarePracticePapers/FreedomofMovement/tabid/484/Default.aspx





Now for freedom of movement to be the most helpful you should familiarize yourself with common labor and delivery positions.





heres a slideshow from the mayo clinic with some ides http://www.mayoclinic.com/health/labor/PR00141





and heres some others from about.com http://pregnancy.about.com/od/laborbasics/ss/laborpositions.htm


http://pregnancy.about.com/od/laborbasics/ss/partnerposition.htm


http://pregnancy.about.com/od/laborbasics/ss/ballpositions.htm





Other pain management options include





WATER:





You don't have to have a full water birth to take advantage of the pain relieving properties of water. Most hospital rooms have at least a shower if not a full tub. If a tub is available you can relax in the tub and if a shower is your only option you can let the spray hit your belly or your back and get some relief that way. This is an option you'll have to work out in advance with your dr or midwife but well worth it.





A word of caution: I have read that laboring in water can slow your labor so this is an option you may want to hold off on until you feel you need it. Of course if things seem slow you can always get out too.





RELAXATION:





I think the Bradley Method and the Hypnobirthing Methods offer a great deal of insight into the use of relaxation during labor and delivery.

i have this book at home and it has some good relaxation exercises http://www.amazon.com/Natural-Childbirth-Bradley-Way-Revised/dp/0452276594/ref=sr_1_1?ie=UTF8&s=books&qid=1247801922&sr=1-1

and if you can take a bradley class they'll do lots of practicing too http://www.bradleybirth.com/

hypnobirthing involves relaxation via a self induced state of hypnosis http://www.hypnobirthing.com/ i don't have any personal experience w/ it but lots of mamas swear by it

and of course there are plenty of stand-alone methods of relaxation.

this blog post from women giving birth naturally covers a few of the most popular
http://www.givingbirthnaturally.com/women-giving-birth.html

and heres a different site that gives more tips on different techniques http://www.womenshealthmatters.ca/centres/pregnancy/childbirth/relaxation.html

things like deep breathing (you don't have to learn anything complicated just in through the nose out through the mouth), progressive muscle relaxation where you tense then release muscle groups starting either at the toes, the fingers or sometimes the head/neck shoulders, visualization techniques, etc can all be useful helps to achieving a relaxed state.

okay well the kiddo wants the computer now so i guess i'll have to add more next thursday.....