Valerie Gommon Midwife’s Blog

Archive for the ‘birthing pool’ Category

Having spoken previously about “pharmacological” methods of pain relief, I thought I would mention the whole host of “natural” methods of pain relief:

Movement – Walking, pacing

Changing position – squatting, kneeling

Using a chair/birth stool/birthing ball

Having a bath or shower

Using a birthing pool

Massage – oils, talc, ball

Music

Chanting, singing, nursery rhyme

Breathing, relaxation, visualisation techniques

Encouragement

Homoeopathy

Acupuncture

Hypnotherapy

TENS – Transcutaneous Nerve Stimulation

Distraction – go for a walk, bake a cake

Having a midwife you know and trust!

Having a homebirth, or at least staying at home for as long as possible!

So you can see there are many more “natural” things to help than pharmacological, so try these first!

Send me your ideas if you have more!

I confess that I’ve been quiet – I’ve actually been away!  As I have no babies currently due (in my Independent Midwifery Practice www.3shiresmidwife.co.uk) we took advantage and went up to the wilds of Cumbria for a week and had a great time staying at Dent railway station www.dentstation.co.uk – my husband is a train spotter!  So lots of walking, snow, eating and drinking for a week – fantastic.

Whilst away I saw a couple of interesting items in The Daily Telegraph.  One article discussed that scientists have found that young women are sensitive to babies physical appearance whereas post-menopausal women and men were less able to distinguish between babies.  The researchers believe that the difference could be a hormonal one and plan further research in relation to postnatal depression. www.telegraph.co.uk/scienceandtechnology/science/sciencenews/4306406/Women-can-distinguish-cute-babies.html

In the same newspaper there is an item discussing that early terminations of pregnancy (up to 9 weeks gestation) are to be provided in some GP surgeries www.telegraph.co.uk/health/healthnews/4306534/Abortions-in-GP-surgeries-to-be-extended..html

On a happier note, today I have been to a first birthday party – the baby was born at home a year ago.  Her mother had previously had a caesarean with her first baby but really wanted a natural birth second time around.  She laboured in a birthpool and had a relatively short and easy labour and birth second time around – wonderful!  It was lovely to visit and catch up with the family.

VBAC or vaginal birth after previous caesarean section has previously been controversial, but with better surgical procedures even doctors are keen that the majority of women attempt a vaginal birth next time as this is a safer option for both mother and baby.  Obviously it is important to review what happened during the last labour, and for some women a repeat caesarean may be the best option, but for many a vaginal birth will be possible.  Doctors and many midwives will recommend that a woman planning a VBAC give birth in hospital and that she be closely monitored, for example by having continuous external monitoring of the baby’s heart, and by having intravenous access in case of  uterine scar rupture which is a rare but very serious possibility.  Scar rupture rates are quoted at between 1:200 and 1:2000 depending upon which research you read, there is an excellent booklet discussing the subject “Birth after Caesarean” published by AIMS www.aims.org.uk/pubs3.htm However there are some who believe that by labouring at home, in a calm and relaxed environment, with no monitors or drips, will give the woman the best chance of giving birth normally.  Indeed some hospitals are now comfortable with “allowing” VBAC clients into the birthing pool for labour.  Most midwives and doctors agree that women attempting a VBAC should not have their labour “interfered” with; it can be dangerous to induce or augment a labour when a woman has a scar on her uterus.  If you are considering a VBAC I recommend that you discuss the matter carefully with your midwife or doctor and give yourself the very best chance of having a normal birth next time – many, many women are now achieving VBACs, and indeed I know of several women who achieved vaginal births after several previous caesareans so it is possible!

When the big day comes you will have learnt lots of things that can help you, for example you might like to have a bath or shower which can really help you to relax. Early labour will probably feel a bit like period “cramps” and bathing or a hot water bottle may well help as can taking a couple of paracetamol if you wish.

Moving around and adopting different positions is also another useful thing to do – you might find that walking, marching or crawling around on all-fours might help. It is fine to go out for a walk in early labour if you feel up to it, and it is a good idea to find something constructive to do – perhaps watching a film. If you possibly can you should also try to have a nap – you will probably be working very hard for the next 24 hours, another tip is to have something light to eat and drink plenty as you will need the energy later!

TENS which is a small, battery operated machine can help; the idea is that you put the electrodes (or sticky pads) into four specific places on your back and the machine sends an electric impulse to the pads which are placed over nerve endings. TENS works in several ways, it boosts the body’s endorphin production (endorphins are our natural pain killers), it also blocks pain messages to your brain and lastly it is a distraction! Many women find TENS helpful – the trick is to put in on fairly early in your labour – TENS machines can be hired fairly inexpensively from some supermarkets, pharmacies and even some hospitals.

Soft lighting, music and massage can be relaxing – especially massage to the lower back as many women experience backache in labour. Either using hands, a nice oil or even rolling a tennis ball around on your lower back will probably feel really helpful. This might be something that you can practice with a birth partner prior to labour.

Most women find that staying active, listening to what their body tells them, is helpful. If your body is telling you to rest, then rest, if you feel better pacing around then pace. Having a supportive birth partner (or partners) is also invaluable – having a woman who has successfully given birth before is really helpful and can allow your partner time to eat, rest or even pop to the toilet! Speaking of toilet – remember to pass urine frequently yourself, ask your partner to remind you to wee every couple of hours at least as a full bladder can hamper descent of the baby’s head.

During the labour, use any breathing/relaxation techniques you have learnt, sit on a birthing ball, practice hypnotherapy, use your TENS machine, be active, sing, chant, make a noise, use massage, visualise your baby, your cervix opening – ask your partner to encourage you and to look deep into your eyes and breathe with you or use any complementary therapies that you have prepared (homoeopathy, oils, acupuncture etc).

I would encourage you to consider not using the birthing pool until the “going gets tough” and then you have somewhere else to go, somewhere that may be blissfully relaxing.

So you can see there really is quite a lot that you can do to help yourself in labour!

If you have tried all these techniques but still need more help there are drugs that the midwife can give you, for example entonox (known as gas and air) – this is not thought to harm either mother or baby and if you don’t like it you can just stop using it at any time. Most women think entonox is really helpful – it is just a mixture of oxygen and nitrous oxide which you breathe in through a mask or mouth-piece. It can occasionally make women nauseous and may make you feel a bit drunk!

The next level of pain relief available is an injection (usually given into your leg or bottom); the type of drug varies in different areas, but is usually meptid, pethidine or diamorphine. These drugs can make you feel drunk and a bit “spaced out” – some women really find them helpful, but other women don’t like them – I guess if you are needing help at this stage the answer is to try them and see what you think. The disadvantages are that they can make you sick (they are usually given with an anti-sickness drug for this reason) and may make you feel “out of control” and the effects of the drug will last for some time. The baby will also get a dose of the drug and this may make the baby sleepy at birth and make feeding slightly harder to establish.

If you require something stronger an epidural may be the answer, this is when a local anaesthetic is injected into your back. The advantages are that this usually offers good pain relief, especially when labour is long – you can usually sleep and rest once you have an epidural. However there are also disadvantages in that you have to stay very still whilst the epidural is sited and you will need a drip and probably a catheter to help you to pass urine. Your movement will be restricted and your baby will need to be continually monitored as very occasionally the baby can become distressed. Other disadvantages are that the epidural may not be 100% effective, some women experience “break-through” pain and occasionally further complications, also because there is a lack of sensation to “push” the baby out you might be more likely to need additional help with the birth.

In summary, you can see that there are lots of things you can do to help yourself during the labour, but if you need additional help there are drugs onoffer to help you.

 


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