Positions

Walking around, leaning against your partner or the wall, and rocking your pelvis will probably feel much more comfortable than lying on your back in bed. There are also certain positions that you will find more comfortable than others, because these will relieve the pressure on your back.

Massage

This is a wonderful way of getting reassurance from your partner while relieving discomfort, whether you’re lying, standing or squatting. It can be particularly relieving if you have backache during labour, which most women do, or if you suffer from a backache labour.

TENS

(Trans-cutaneous Electrical Nerve Stimulation) Pain impulses conducted by nerves are blocked by an electric current, which also stimulates the production of endorphins. A battery-powered stimulator is connected by wires to electrodes that are placed on either side of the spine. You then use a handset to regulate the amount of stimulation and thus pain relief that you receive.

Visualizing

Creating images in your mind can be a very effective way of calming fear and reducing pain. As your contraction begins, imagine something that you find particularly soothing, for example, warm, bright sunshine. Contractions in the first stage are opening the cervix and you may find it helpful to think of the image of a bud of your favorite flower opening slowly, petal by petal. Thoughts of waves are also very comforting, the flow of the waves matching each contraction as it increases in intensity, peaks and dies away.

Water

Lying in warm water can be very relaxing and soothing because the water renders you virtually weightless and this brings relief between contractions. For these reasons, birthing pools are used by some mothers under supervision.

Sounds

You can help to diffuse the pain and anxiety of your labour by vocalizing in the way you feel is most helpful. Sighing, moaning, groaning and grunting are all ways of releasing tension, and you shouldn’t be inhibited, or worry about disturbing others.

Many women find that listening to music is very effective. Your birth assistant can play different pieces on a cassette recorder depending on how you are feeling.

Hypnosis

This isn’t something that you should try on a whim, since you need to respond to hypnosis very easily. Women who can go into a deep trance have been able to have a forceps delivery, stitches or Caesarean without feeling pain. A period of practice sessions is advisable, so that both you and your hypnotist are completely familiar with what you have to do during the birth.

Acupuncture

You should only opt for this method if you have already found that it can relieve pain in other situations. In addition, your acupuncturist must be familiar with labour and delivery. This may not stop you feeling any pain at all, but it will certainly reduce it, and also helps prevent nausea.

The kind of pain you’ll experience during contractions can vary. It may feel like a thick band being squeezed around your abdomen as the uterus hardens and tightens for several seconds before relaxing. Some women compare it to severe menstrual cramps, others experience backache, but there may be a combination of sensations as the contraction peaks and then subsides.

Individual response

You may prefer not to use certain drugs during your labour as they can dim your awareness of what is happening; however, it is very difficult to know the level of pain you can manage without relief, particularly if this is your first baby. Some women are surprised by the overpowering intensity their contractions, others may find their pain worsen through fear and anxiety.

Analgesia, such as epidural anaesthesia can offer complete relief of pain, while gas and oxygen and narcotics help reduce pain to bearable levels. Many opt for no drugs in the early part of the first stage, then have gas and oxygen towards transition. Don`t be self-critical if you do need drugs for pain relief it isn’t a sign of cowardice. Remember, labour isn`t a test, and drugs may even be essential to deliver your baby.

If you wish to have full participation in your baby’s birth without dimming your consciousness of the physical and emotional sensations, there are alternatives to drugs for pain relief.

A clear choice

Find out as much as possible about the types of pain relief that will be available. Have a discussion with your doctor, midwife and hospital attendants, and then outline your choices in your birth plan. Be prepared for your plan to change if any complications arise.

How drugs affect you

Apart from offering pain relief, drugs can affect your experience of childbirth in other ways. Make sure you opt for the type that will help enhance, rather than detract from, the pleasure of your baby’s birth.

Drowsiness

This is a common side-effect of gas and oxygen, tranquillizers and narcotics. Some women enjoy the sensation of drifting, but sometimes this can make mothers feel they lack control A few women have become so lightheaded they were unaware of what was happening around them, and gave birth without realizing it had happened.

Dizziness

Pethidine and other narcotics can sometimes induce a feeling of confusion, or disorientation, and some mothers have even had hallucinations.

Nausea

The sensation of nausea is usually slight with gas and oxygen, but is quite common after using pethidine and other narcotics, and a few mothers may suffer attacks of vomiting.

Your state of mind can have a major effect on the intensity of pain experienced in labour. So if the use of drugs will make you less anxious and more relaxed, there is no point in depriving yourself since excessive tension can affect the uterus, increase your perception of pain, and lengthen labour.

UNDERSTANDING YOUR ROLE

Like many partners, you may be nervous or worry about feeling squeamish, or being inadequate at offering sufficient support. You can help combat this by prepar­ing yourself in advance. It s important that you know as much as possible so that you can effectively help the mother meet the physical and emotional demands of labour. At the antenatal classes there will be demonstra­tions to describe the onset of labour and the effect of contractions, and you will be taught techniques for helping her relax.

If it’s going to be a hospital birth, visit the labour and delivery rooms with her and introduce yourself to her hospital attendants so you wont feel like an outside when the time comes. If the birth is to be at home, find out what will be expected of you.

HOW TO HELP DURING LABOUR

You may have a very active role throughout the labour and birth, but sometimes your presence is all the mother needs. Make sure you are familiar with her birth plan and any alternative version. You need to be aware of her wishes in order to speak on her behalf during labour if necessary.

Use your intuition

You need to judge the situation, observing your partner’s moods and fitting in. Alternatively, she may need a great deal of verbal or physical encour­agement, or to be distracted by music or talking.

Provide emotional support

Stay as intimate as possible using loving words, and keep your movements slow, quiet and steady. Always be positive: offer praise, never criticism. If she wants to hear your voice, constantly tell her how well she is doing (how far dilated), suggest how she can relax herself, tell her what other people such as the midwife are doing to help her, and what will soon happen.

Also, help her to see how much she has achieved already – its easy for her to be overwhelmed by how far she thinks she has to go. Massage and stroke her slowly, but if she just wants to hold your hand, you can offer encouragement by using facial expressions and lots of eye contact.

Combat fatigue

Before labour, remind her to rest as much as possible, particularly if she seems to spend a lot of energy cleaning during the “nesting” period. If she has a long, tiring labour, try to help her relax between contractions to conserve her energy for the second stage. If she’s not feeling nauseous, provide her with as much refreshment as she wants (see also p. 32). She will probably find that having her face wiped is very soothing.

Help her cope with pain

It’s hard to see someone you care about in pain, but try not to reveal your anxiety because she may become discouraged. On the other hand, don’t discredit her suffering. Don’t let her feel embarrassed about expressing her discomfort – encourage her to be as uninhibited as possible. Try not to be upset if she becomes critical or aggressive – this often happens when the pain is very intense.

Assist with breathing

You will probably have practiced this during antenatal classes, but allow her to follow her own rhythm. If she seems to lose control, slowly guide her through the pattern until she can carry on alone. Be prepared to adapt – very few people follow exactly what they practiced at antenatal classes.