Question about water birth and other pain coping methods

Question
Does a water birth really reduce the pain?
Natural birth seems like the right option for me. What are some ways to reduce the pain?

Also, when I get my period I have the most horrendous cramps in the world. Would that mean that labour would be pretty bad?


Answer
There are really so many ways to reduce pain in labor. What works for some women may not work for others. Every woman has a different background of experiences, and every labor experience is different. It would be helpful for you to talk with someone experienced about all your preferences, current coping strategies, fears, knowledge base etc.

Having a doula (professional labor support) to discuss things with before labor and to be with you in labor is very helpful. Several studies have shown that doulas reduce the need for epidurals, cesareans, and other interventions.

Another important factor is the doctor or midwife that you choose. Find out how they practice. If you have a doctor who practices with a high rate of interventions - cesareans, epidurals, inductions, etc, you may as well give up your hope for a natural birth.
Medical interventions are necessary and helpful in certain situations, but many practitioners overuse them.
If you choose a caregiver or a hospital that routinely restricts women to lying in bed, using continuous fetal monitoring, or inductions for no medical reason other than being past 40 weeks, then labor is going to be extremely painful. Lying back is the most painful position in labor, and induced labors are way more painful than natural labors.

Also, fear and the adrenalin that it produces increases the sensation of pain greatly. Feeling safe, cared for and supported helps women relax. Having caregivers they trust, and trusting that their bodies know how to give birth. Going within themselves and listening to their bodies is really helful for natural birth. When women in labor feel safe, they produce endorphin hormones. If you've ever run a marathon or something, you'll know that initially your muscles will hurt, but after a while the endorphins kick in and you start to feel euphoric. You don't notice the pain so much, you just feel great.
In labor that can happen too, and the baby gets all the moms hormones, so it feels it too.

Have you noticed how some women say the pain of labor was the worst experience of their lives, while some women say labor was the best experience of their lives.
This difference is due to the different hormones.
Fear, anxiety = adrenalin = slowing down labor and severe pain.
Safety, trust, support, love = oxytocin and endorphins = less pain and feeling great.

Once you've got the basics, you can try out some things women have found useful for dealing with the intensity of labor - moving, changing positions, upright positions, resting in side lying positions or kneeling forward over a chair or exercise ball or their partner, hot packs, ice packs, showers, warm baths, massage, counter pressure on the back and hips, moaning, swaying, making deep sounds, kissing, breathing, visualization, swearing :> , squeezing their partners hand till it turns blue :> ...

Attitude is important too -
The tendency is that when a contraction is starting, to tense up and
resist and think, "oh no, another one. shit!"
But tensing up makes the sensation of pain greater.
It's useful to think, "oh good, another one. That's one more contraction closer to having my baby in my arms. My body is doing great work." Then after the contraction take a deep breath and release all the tension in your body.

A lot of women have found laboring in warm water extremely useful in helping them relax into their bodies and re-energise when tired. The buoyancy helps them change positions easily too. It can help make it easier to move through labor in the water. On the other hand, if has a lot of anxiety, fear, or other issues, getting into water won't make a difference in and of itself. I hope that makes sense :>

As for your period cramps, I don't think that means a more painful labor. I think it means you've developed a bunch of coping strategies that can help you in labor.

Let me know if you have any more questions,

Kaurina JeerisRajan
Childbirth Central
childbirthcentral@gmail.com

Reply:


I greatly appreciate your response. I feel so much more relaxed after I had read your post and most of the information in regards to stress/pain relief I could relate to. Like taking a shower greatly relieves stress and pain for me.

There was not a thing that you had said that I didn't find useful.

Thank you again!

Choosing a Caregiver

One of THE most important determinants of what happens during your labour and birth is your caregiver's style of practice. Yet hardly any books, classes, or websites even discuss this topic. I say caregiver to refer to the physician, group of physicians, obstetrician, or midwife you choose to attend your birth. Writing a birth plan is entirely useless if what you want in the plan is at odds with the caregiver's normal style of practice.

Many people hoping for a drug-free birth, or not to cut the cord immediately, for example, don't find out until labour that their caregiver practices in a way which may be at odds with their wishes. At that point, it is too late to negotiate new decisions, or change caregivers. It is best to find out in early pregnancy what styles of practice various caregivers have, and which ones suit you best.

What people generally don't realise, is that different caregivers can have different protocols for the exact same situation. There is much disagreement about what is the safest and best ways to manage various birth situations. different caregivers have different viewpoints, just as different mothers have different viewpoints. Some women want epidurals, or cesareans, or a highly medically managed birth. Some women want to try to avoid epidurals, or cesareans, and have medical intervention only when necessary. Either way, women would be much happier choosing caregivers that matched their own philosophy. Being satisfied with the way you are treated during labour makes for an easier time post-partum.

People are under the impression that medical practice, being very scientific and all, is based on solid research and evidence into what is best practice for each situation. Shockingly this is not true. Studies in the British Medical Journal state that only around 30% of current medical practice is evidence-based. In hospital maternity care, decisions about how to manage normal labour is often based on what doctors before them did, and those before them and so on. So even when solid research emerges that shows those practices may be harmful instead of helpful, changes may take years or decades. It is quite difficult for individual doctors to keep up with the multitudes of research, some of which is contradictory. Some decisions are made based on what is convenient for caregivers, or what will protect caregivers from being sued, rather than what is best for mother and baby. Midwives also may or may not practice based on what is best practice according to the evidence. It is up to you to ask questions and suss out if what they beleive is in line with what you believe.

There are various ways of describing the general schools of thought. Among doctors, there are those who practice Active Management, and Expectant Management.
In addition there is the Midwifery Model of Care. Midwives and physicians only attend low-risk births. Obstetricians are trained to manage high-risk births.

Active management's philosophy is that labour is full of potential dangers, and medical intervention is necessary at every step of the way to prevent disaster.
Expectant management's philosophy is that labour is a normal process that usually works out well, but if problems arise, intervention is useful. The midwifery model of care is similar in that it believes that birth is normally safe and mothers are best left to follow their own instincts, but to intervene if problems arise.

Active management caregivers often have short prenatal appointments, make use of lots of technology such as frequent ultrasounds, and make the decisions for the mums. If this makes you feel comfortable and safe, then this is the caregiver for you. Having options and making informed choices can feel very overwhelming to some mums. They would prefer a caregiver who made all the decisions for them.

Expectant management caregivers usually use more hands on techniques to feel the baby, spend time discussing the mum's emotional well-being and support the mum's informed choices. Midwives often spend between 45 min - 1 hour at each prenatal session. If it is important to you that your unique preferences and needs be respected, find a midwife or a doctor who has a low inductions, low epidurals, and low cesarean rate, and is genuinely listening to your needs.

In choosing a caregiver, ask questions about things that are important to you. If you want to get an epidural asap, ask your potential caregivers how soon they are comfortable giving them. Some caregivers don't mind giving epidurals any time in labour. Some will only give them between 4 cm and 8 cm dilation. If you would prefer not to have an epidural as far as possible, but choose a caregiver who has a high induction rate, expects mothers to stay in bed, and uses continuous fetal monitoring, you can throw your expectations out the window. Inductions, and being confined to the bed drastically increase the pain in labour, making epidurals the only way to cope with the unnatural pain.

Most importantly, choose a caregiver that you trust and feel safe with. There is no one option that is suitable for every person. A good reference book to read is "The Birth That's Right for You" by Amen Ness and Lisa Marie-Goulding.