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Labour Pain

Women often ask me: Okay, so how much does labour really hurt? Well, how long is a piece of string? It depends. Labour pain seems to be unique and subjective. Every woman experiences it differently. For some women, labour pain is excruciating, especially towards the end. Others say they expected worse. It was intense, but it was manageable.

Medical researchers haven’t come up with much support for the pain threshold theory. It seems that the amount of pain you’ll experience depends not on your ‘pain threshold’, but rather on something else. Question is, on what?

If I’m asked the ‘how sore is it really’ question in my antenatal classes, I ask a question of my own. I say: “Labour is a lot like sex. The hormones and body parts involved are very similar. Is sex painful or pleasurable?” The first few women normally say that it is pleasurable. But is sex always pleasurable? What about rape? It is probably one of the most painful experiences a woman’s can experience in her life. Why? What makes it painful?

The answer I’m looking for, of course, is resistance. Sex becomes painful when a woman resists it. The same tends to be true for labour. Sure, the baby can be in a position that causes additional pain, like when he is lying posterior, but in general labour coping tools and techniques are all designed to minimise resistance.

Klaus and Kennell writes:

“Every aspect of labour support must start with the idea of reducing stress – mental, emotional and physical. The goal is to enhance the woman’s ability to relax. The body’s stress system is called the sympathetic nervous system, which produces what we call the ‘fight or flight response’. The opposite of the sympathetic nervous system is the system that creates calm and a feeling of well-being called the parasympathetic nervous system. The hormones of the sympathetic nervous system are epinephrine and norepinephrine. The parasympathetic nervous system produces a hormone called oxytocin. Reducing the stress response enhances the body’s own production of oxytocin, as well as natural opiates called endorphins.

When the woman can relax, oxytocin strengthens the contractions of the uterus. It also allows the muscles to function properly, the longitudinal muscles to expel the baby and the lower uterine muscles to relax, stretch, and open to release the baby. When a mother’s body is tense, the opposite occurs; the upper muscles of the uterus loosen and stop contracting, and the lower muscles tighten to retain the infant. This is perhaps nature’s way of stopping labour if the mother has to flee from a frightening experience … The fight-or-flight response occurs and the body gears for defense, sending blood to other organs of the body. If blood flow is reduced to the uterus, the uterine muscles constrict, causing the circular muscles of the cervix to tighten up, and dilation is impeded [and remember, the less blood flow to the uterus, the more pain]. Also, there may be less oxygen sent to the fetus. When the vertical muscles of the uterus continue their attempt to expel the baby, and the cervix resists, the baby’s head pushes against tense muscles. This causes more pain and lengthens labour.

When labour is not impeded by undue stress and fear, the woman’s own natural oxytocin is secreted from the posterior pituitary gland into the bloodstream. At the same time, her brain also secretes oxytocin to other areas within the brain itself. This has four effects. First, it markedly increases the pain threshold, so that the mother has reduced sensitivity to pain. Second, it results in drowsiness. Third, it results in some relaxation or calming, and finally, after the birth it helps the woman feel closer to the baby.” (The Doula Book, Klaus, Kennell & Klaus 2002: 70).

In other words, relaxation creates a positive feedback loop. The more relaxed the mother is, the better her secretion of oxytocin. In its turn, oxytocin leads not only to stronger and more effective contractions, but, paradoxically, also to less pain! The key to a less painful labour is increasing relaxation and reducing resistance.

But how do you reduce resistance? My top ten tips are:

  1. Practice relaxation techniques before labour, preferably with your partner. You can take a course like Hypnobirthing or The Mama Bamba Way, you can buy CDs on the internet, or you can practice yoga, meditation and/or visualisation. These techniques will all teach you how to relax into the intense experience that is labour, instead of resisting it.
  2. Support yourself with people that you love. Research has shown over and over that a mother who is supported experiences less pain. Consider hiring a professional doula to take some of the pressure off your partner and to support him as well.
  3. Ensure that you are labouring in an atmosphere that feels safe and comforting. If you are one of those people who tense up as soon as you step into a hospital, you should consider birthing at home or in an Active Birth Unit.
  4. Use water to relax you and to relieve pain. A birth pool is probably second only to an epidural in terms of pain relief. It really can provide extremely effective pain relief.
  5. Remember that your breath is your best friend in labour. You don’t need to learn a lot of complicated breathing techniques. You just need to breathe in a natural and relaxed way: in through your nose, out through your mouth. Try to make your out-breath a little longer than your in-breath and purposefully relax and let go while breathing out.
  6. If you find labour painful, tell yourself that this is healthy pain and that you welcome it. We are so used to resisting pain, to taking pain killers and rushing to the doctor. We are used to seeing pain as a message from our bodies that something is wrong. In the case of labour, however, pain has a purpose.
  7. Take it one contraction at a time. You can handle this one contraction, can breathe through an intense minute or minute and a half. What you may not be able to do, is cope with the idea of the contractions that have gone before this one (I’ve been in labour for fourteen hours!) or with the ones that are still to come (How long is this going to take?). The moment you start thinking of the past or the future – the moment you step out of the present – you are in trouble. See each contraction as one less, not as ‘oh no, not another one!’.
  8. Keep your mouth, your neck and your shoulders soft. It is almost impossible to hold tension in your body if these areas are soft. Blow soft raspberries with your lips, roll your neck, ask your partner for a shoulder massage in between contractions. Some soft, smoochy kisses will also do the trick.
  9. Make low-pitched sounds from deep in your belly. This increases endorphin release. If you find yourself crying ‘no’ and shaking your head from side to side as a contraction starts, try doing the opposite. Chant something like ‘yes’ or ‘open’ instead. Embrace the pain instead of resisting it.
  10. Use tools that will get you out of your normal state of consciousness into a more embodied, instinctive state. Lower the lights or close your eyes. Play relaxing music and move rhythmically with it. Dance with your partner. Spiral your hips.
 
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Posted by on March 12, 2012 in labour and birth, Natural Birth

 

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