Part 3 - Comfort Measures For Labour

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Welcome to part three of my Summer of tips and techniques to ease discomfort and manage the sensations of labour. By the end the series you are going to feel so much more confident and relaxed I hope about your upcoming labour and birth.

I've been running these each day on my For Modern Mothers Facebook page. In this post you'll find a range of comfort measures for labour including - TENS Machines, Doula's, Heat, Aromatherapy and Opioids. It's a balanced look at ALL your options.  



# 15 - Hypnobirthing

So of course this brilliant form of birth preparation was going to be in the list. 😊 Are you or your partner worried or fearful about birth? Then you need hypnobirthing in your life! Seriously. Not only does hypnobirthing give you a whole tool kit of simple yet really effective techniques to release fears and help you feel confident, calm and positive during labour but it provides complete birth preparation too. So there's no need for any other antenatal classes. You'll learn everything you need to know about birth, how your body work in labour, the hormones and the fourth trimester too. But in addition you learn how you and your partner can become a 'birthing dream team', and how you can work together using the same techniques that top sports people use to get your mind and body connected. It's all rooted in science, so it's not all some 'hippy nonsense'!! You'll practice simple yet really effective techniques so that you know how to deeply relax and feel calm and confident, and to 'step out of the way' of your birthing body - to let it do what it was designed to do. Many hypnobirthing women report that they find labour very manageable, or even pain free (although there are no guarantees), and you will certainly feel less fearful and more confident.

Hypnobirthing can sound a bit 'alternative' but there is a growing body of research to prove the efficacy of hypnosis in:
~ Reducing the length of labour
~ Reducing or removing the need for medication, including epidurals
~ Reducing the need for intervention including cesarean section
~ Reducing the rate of postnatal depression

It really is a total package for antenatal preparation. And it also helps to connect you to your baby and your partner during pregnancy too, so you have a more calm and relaxed pregnancy too. It really is all good. 😊

So do get in touch for more information. Come and learn how to rock your birth! Courses are for ALL parents-to-be, whether first or fifth baby. 


# 16 - Laughter

A sense of humour in labour is highly recommended. 🤣 You could think of it a bit like camping. Like camping, giving birth involves getting down and dirty, letting go of the trappings of modern western life, going with the flow, and some mild to moderate discomfort. Unfortunately you don't get warm wine in a plastic mug or charred sausages (unless you opt for a home birth and the other half gets the bbq out!). Laughing therefore may be essential. 
On the 'serious' side, it call also relieve pain by releasing beta endorphins (the brains natural morphine, but waaaay stronger but totally safe - amazing!). AND laughter helps you to relax your body, and to release oxytocin - the hormone that aids your surges (contractions). So in early labour you might want to watch a funny DVD, dance around being silly or anything else that works for you. 
So keep smiling, relaxing and laughing.


# 17 - Epidural

So look at another form of 'pharmacologic pain management' strategy (in other words the drugs). We've looked already at 'opioids' (day #13) and 'gas & air' (day #5) in previous posts, today is all about epidurals.

Most people have heard of an epidural, in fact it's so entwined with our cultural assumptions about birth that some people think that birth isn't desirable or possible without one. Whatever you might think you know, it's really good to know ALL your options - even if you think you do or don't want a certain type of pain relief. You might change your mind, so being informed in pregnancy about your options is really important.

What is an epidural?
It's essentially a local anesthetic that's administered by an anesthetist using a needle, and it's inserted in between the bones of your lower spine. Once the hollow tube is inserted through the hollow needle, it can be topped up as necessary. 
A full epidural is a total block, and a 'mobile' or 'low dose' epidural is the anesthetic mixed with opioids giving you more mobility.

Of all the drug methods of pain management during labor, the epidural is the most effective form of pain relief. It will usually completely stop the pain if you are not coping. With a mobile epidural you should still be able to move around and have some sensations of baby being born.
Epidurals carry fewer risks for the baby than injectable opioids (see day #13).

Epidurals do carries a number of potential side effects for birthing women and their babies. The side effects include a drop in your blood pressure, a longer pushing phase, a higher likelihood that you might need forceps or vacuum-assistance to get the baby out, a greater risk of needing artificial oxytocin to help speed up contractions, and a higher risk of the baby having abnormal fetal heart tones. You may need a catheter to urinate, and you'll have reduced sensations of your baby being born and will often, but not always, end up on your back on a bed being told what to do. It also carries other potential side effects such as itchy skin, nausea, and about a 1 in 100 chance of having a spinal headache.
Epidurals are usually effective in about nine out of ten people. This does mean, however, that one in ten will not have effective pain relief with an epidural.

Lots to think about here, and it's important that whatever you choose you do it from a positive place, having weighed up the pro's and con'd for YOU as an individual and your baby. Use your 'BRAINS' from the hypnobirthing course, as with all decision making.
We are all different, and nothing about anyones birth is 'right' or 'wrong' - it's what is right for them on the day.


# 18 - Clary Sage

Clary Sage as an essential oil is sometimes known as 'nature's gas and air' 😊 It's a profoundly relaxing essential oil that may reduce anxiety and stress, and some women say gives them a lovely floaty feeling in labour. This relaxation enables the reduction of adrenaline and a consequent increase in oxytocin which promotes natural physiological labour. It also is thought to be powerful enough to induce labour or to make surges (contractions) stronger - so great if labour slows down or stalls. But it's important not to use this oil before you reach term!
You can use it like other essential oils (see day # 11 ) in a vapouriser, in a massage oil, on a hanky to sniff, or in the bath.
It can be a useful part of your birth kit, and many doulas (see day #10 ) carry some with them too.  Do let me know if you want any more info on essential oils, or where to buy them. We cover this is more details on the hypnobirthing & birth preparation course and it's always really popular 😊


# 19 - Birth Partner

Applying In hypnobirthing we look at birth as a team effort. So even though mum's body will physically birth the baby, it's the birth partners role to support her (physically, mentally, emotionally) and to 'protect the space.' It's hugely important and a huge responsibility, so you need to have a fully informed birth partner who you totally:
- trust
- who is on your side
- who can advocate for you (where you are in 'labour land' and don't want to be in your 'thinking brain')
The birth partners roles are many! (Well to be fair you have A LOT to be getting on with, so only fair to share!!). They need to understand your birth plan / preferences fully, to stop any interuptions, get all the information from your care team so you can make informed decisions, and have the 'tool kit' of brilliant techniques your learned in hypnobirthing to support you (breathing, relaxations, massage, music, positions), and look after your birth environment too to create the best space for your body to birth - again really important.
So choose your birth partner well,it's often your partner - but it doesn't have to be. It could be a friend, sister or your mother, someone you know will be there and you feel totally as ease with. 
You can hear more about the importance of birth partners in my video here too - 
And that's also why in my Hypnobirthing & Birth Prepartion courses we make sure that your birth partner is fully informed and prepared, with their own cheatsheets to fall back on too, so you can leave feeling like you are the ultimate 'birthing dream team' 😊


# 20 - Massage

It could be your partner, doula or midwife that gives you a massage in labour. There are different types and styles that can be used. A 'light-touch massage' will stimulate endorphins (the bodys natural pain killers) or it could be hard counter-pressure applied to their lower back during surges (contractions). Essential oils can be part of the mix too, and there are also some acupressure points to relieve pain or encourage labour to get moving. (We look at different massage, aromatherapy, and acupressure points on my hypnobirthing & birth preparation courses - with useful guides and handouts too. I hate it when you don't get good handouts on a course! So I make sure you've got really good back-up material). There is also something called the 'hip press' which some midwives and doulas do, which involves squeezing you hip bones whilst you are standing or on all fours, to relieve pain and also open up the pelvis. 
And on the subject of massage, enjoying this in pregnancy can be so lovely too. A massage from your partner can be a lovely way to relax together, self massage over bump can be really nice to connect to baby. If you are looking for a specialist massage in pregnancy, as a well deserved treat (it can help you relax, aid circulation, ease any aches and pains and so much more) then I can whole heartedly recommend Michaela at York Mother Nurture .


# 21 - Reframing

So # 21 - Reframing
Reframing is a psychological technique where you look at the same experience through a different lens or 'frame', in order to transform the experience from negative to positive. It's used by lots of professionals from top sports people, actors, business people and celebrities to change and challenge the way they think. So with pregnancy and birth, it's all about challenging what you *thought* you knew to be true (from films, other peoples birth stories etc) and looking at it in a completely different way. You can use cognitive reframing (its full name) in different ways such as:
- To challenge your assumptions. Take something you thought you knew about birth and ask 'why do I think this?'. For example you may have thought that birth is 'the worst pain you can imagine'. So ask yourself, what evidence do you have for this and how do you know it will be true for you. Then reframe it: 'birth will contain interesting and strong sensations, I have no idea what they will be like for me until I get there. But I know they are bringing me closed to meeting my baby.'
- Ask what is good about this? So in labour a surge (contraction) may feel tough, but ask yourself - "what is good about this?". Which parts of your body do not hurt at all? What happens if you focus on them instead? Does it feel at all interesting, fizzy or sensual? Do you feel energised afterwards?
- Use different words. Lots of words around labour and birth are quite negative, and we talk about this on my course. By using more positive language you might be able to change your expectations. You can call a contraction a rush, a surge (my favourite, but yours may be different), a glow, a wave. Are you dilating or opening, expaning, unfolding? Find words that feel positive and powerful for YOU.
You'll learn more about all this of course on my Hypnobirthing & Birth Preparation courses (group and private). So do contact me if you want to know more, or head over to the ‘courses’ part of the For Modern Mothers website.


So that's the end of part three. I hope you find this series posts helpful and informative. There will be one final part - part four coming very soon! Do let me know if you'd like any more details on anything I've mentioned here. And don't forget that I run my For Modern Mothers Hypnobirthing & Birth Preparation classes every month in York. It's a complete birth preparation course covering everything you need to know for a positive and confident birth without fear.

Susan x