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The truth about pain relief in labor: My honest account.

Before I had my first baby, I literally spent the whole pregnancy reading and preparing myself for what was to come.

What I found was a lot of science of how each pain relief option would work, what I didn’t find was a true and honest account of what moms had gone through unless I spent hours on message boards looking for answers.

Some of the most common questions I get asked as a mom of five kids is ‘which type pain relief did you use?’. ‘how effective was the pain relief’ and ‘did the pain relief slow down your labor?’

Although I will be going through the science, I will also go through the pain relief options offered to me and give you an honest account of how it worked or didn’t work for me. Please bear in mind that this is an account of my personal experience and what didn’t agree with me may be absolutely fine for you.

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TENS MACHINE

Transcutaneous electrical nerve stimulation (TENS) is a method of pain relief involving the use of a mild electrical current.

A TENS machine is a small battery-operated device that has leads connected to sticky pads called electrodes.

The pads are then attached directly to your skin, small electrical impulses will give you a tingly sensation on your skin. These electrical impulses are thought to reduce pain signals going to the spinal cord and the brain, which can reduce pain and make you feel more relaxed. TENS is also meant to stimulate endorphins which are the body’s natural pain killer.

MY EXPERIENCE OF TENS

I found that TENS was a great help in the early stages of labor and it did feel as though it took the edge off the early contractions. I would however seriously recommend that you and your birthing partner open the box and look through the instructions before hand.

We didn’t do this and decided on the day I went to hospital was a good time to look at it. It just so happened that the sticky pads didn’t stick onto me, so when we got to the hospital the midwife found some super strong tape to attach it to me.

The problem was that as I progressed the TENS machine wasn’t doing much, and it was really starting to piss me off all I wanted was it gone so I could be more comfortable without all these leads attached to me.

It was just my luck we couldn’t get the damn tape off, can you imagine; I’m there in the midst of a contraction with my husband and midwife trying to yank off the tape and I’m screaming at the top of my lungs to ‘get the f***ing thing off me!’ When they did manage to get it off and I had somewhat calmed down and was able to concentrate on my breathing.  

OPIOIDS

Pethidine also known as Demerol is a morphine like opioid used primarily for women in labour. other types used include Fentanyl and morphine. The medications can be given either intramuscularly or intravenously. It normally takes effect within 20 minutes and can last between 2 and 4 hours. When given via IV it can take effect within a few minutes and can last an hour or two. In general, the medication makes you feel calm and relaxed.

However, there are side effects; opioids can make you and baby both relaxed, given too close to the baby being born it can affect some baby’s ability to breastfeed.  It can also make some women feel drowsy, dizzy and nauseous. Narcotics are often given in the first phase of labor so that it can wear off before baby is born.

MY EXPERIENCE WITH OPIOIDS

It has been said that 1 woman in 3 finds opioid drugs such as pethidine unpleasant as it can make you feel really spaced out. Pethidine can make you feel drowsy and slow your breathing. Pethidine can also cross the placenta and make the baby drowsy affecting breastfeeding.  My eldest child was born in the UK, so I was offered pethidine a drug that is commonly used.

I must have been one of the women that pethidine didn’t suit at all, I felt drowsy and completely out of control and I could barely understand anything the midwives were asking or saying, my husband was advocating for me. I was so drowsy that I couldn’t even push at the final stages and the whole experience was just a blur.

According to my husband I was awake but not able to talk properly and kept falling in and out of sleep. I believe that the pethidine shot was the main reason my baby was born via an assisted delivery and a ventouse was used.

My baby also suffered from the effects of the opioid injection and he struggled to wake up to feed in the first few days making breastfeeding him incredibly difficult.

I wish someone had told me the side effects of this drug before I had agreed to it, thankfully I have never needed to have it again in any of my other labors as I have vehemently apposed it in subsequent labors.  

EPIDURAL

An epidural is an injection inserted into a part of the spine called the epidural space. it will numb the nerves that surround the lower abdomen.  Epidurals are the most popular form of pain relief and account for 50% of the method of choice used by moms in the US.

Epidurals are an excellent method of pain relief for 90% of birthing women. It is a relatively quick procedure once you manage to get hold of an anaesthetist who is normally involved in an emergency C section. It takes around 15 mins to set it up and can work instantly or it could take up to 20 mins for it to take full effect.

Once it is in the Midwife can normally top it up,so you aren’t waiting around for the anaesthetist to come back! If you are rushed to have an emergency C section, you can be topped up with a local anaesthetic that is stronger in the same catheter.

Unfortunately, not all epidurals work. If after half an hour the epidural still hasn’t kicked in then you can get a top up. There is a 1 in 100 chance you may develop a severe headache and the monitoring equipment will mean that you won’t be able to have what is known as an active labour. The epidural can cause the pushing stage of your labour to last longer.

Epidurals are also known to increase the need for an assisted delivery using forceps or ventouse as the drugs could hinder the baby’s ability to move into the correct position. Something to also bear in mind is that you will not be able to have an epidural if you are hoping to have a home birth.

MY EXPERIENCE WITH AN EPIDURAL

My third child was overdue and when I got the hospital it was evident that I had been leaking amniotic fluid for days if not weeks, I was told that the risk of infection was high and that I would need a course of IV antibiotics and I would have to be induced if I didn’t spontaneously go into labor myself within 24 hours. Let’s just say I spent the whole night walking around the hospital grounds that I can probably still recall where all the canteens and restaurants are even today!

I was bouncing on a birthing ball and trying hard to do some squats desperately trying to get the baby to make her way out. Unfortunately for me I needed the Pitocin drip to get my contractions going; the midwife did suggest I have an epidural, but I didn’t want it thinking that I had a few hours at least before I could make the decision, oh my gosh how wrong was I.

Within the space of what felt like 30 seconds I was screaming for the midwife to remove the drip I had gone from 0-6 cm in the space of minutes it was the most horrible and painful experience of my life and didn’t feel at all natural.My previous two labours had progressed slowly and intensified over the course of a few hours, so this wasn’t what I was expecting at all.

I was at this point screaming for an epidural luckily, I didn’t have to wait too long for the anaesthetist the problem was I was part of that 10% that it didn’t work for, it literally had no effect on me at all.

The baby was however born within 2 hours of having the drip put on and it was an extremely fast and intense labor.

Even though I was part of a small minority that the epidural didn’t suit I would recommend to any mom who is due to have the Pitocin to seriously consider having the epidural from the outset as like me you may not have time to make that decision later.

SELF HYPNOSIS

Hypnosis for labor is being in a state of deep mental and physical relaxation that enables the hypnotised person to focus entirely without anything distracting them.

Hypnosis for labor doesn’t involve any swinging pocket watches or sinister utterances of ‘you are feeling very sleepy’. In fact its been around far longer then one would think, women are able to hypnotise themselves with positive affirmations, deep breathing, visualisations and a way of deep relaxation blocking out anything that may distract them. 

Recently there has been a growing trend for using courses such as hypnobirthing and hypnobabies. This excellent course gives you an amazing understanding of how it works and is an excellent resource to have. The course seeks to empower women in their birthing experience, no matter what form that takes. Read my honest review here.

MY EXPERIENCE OF SELF HYPNOSIS

When I got pregnant with baby number 4 I decided to take this course.

I went into hospital with my fourth baby and had the pessary to try and get things going, the midwife told me that the pessary doesn’t really work but it helps soften the cervix a little so I wasn’t expecting it to do anything.

I was actually shocked that once the contractions started the labor progressed very quickly, when I felt a surge (contraction) I would visualise blowing a large sky-blue balloon away. Some parts in the book such as the rainbow relaxation and the glove method were irrelevant to me, so I didn’t use them.

I kept telling myself that not all pain is bad pain and with each surge I was getting closer to meeting my baby, I also found that telling myself to stay calm through each contraction would mean less pain these positive affirmations really kept me going.

The methods for relaxing worked for me the only issue was that I didn’t realise how far I was gone, in fact the midwives didn’t believe I was in labour one rudely commented that she had ’18 years’ experience and she could see I wasn’t in labor’ how wrong was she! I was 10 cm and baby was literally born as soon as I got on the delivery suite bed.

Nitrous oxide (ENTONOX)

Nitrous oxide known as laughing gas is 50% laughing gas and 50% oxygen is a commonly used analgesic in labor. it is known to take the edge of pain rather then blocking it out. 80% of birthing women opt to use this method either on its own or alongside other pain relief.

Essentially Entonox is self-administered so you are in control of how much you take and when. It takes about 20 seconds to give you the full effect so it’s a good idea to take it at the beginning of a contraction so it can take effect when it peaks.

What does Entonox feel like? Entonox makes most moms feel a bit tipsy, it can take the edge of the pain and make you feel relaxed. It can also make some feel dizzy, sick or give you a dry mouth. The good thing for those whom it doesn’t suit is that it leaves the system quite quickly.

If you are planning a home birth do let your home birth team know in advance so they can make sure it is available for you.

MY EXPERIENCE OF ENTONOX

I have used Entonox for all 5 of my labors and I love it. It made me feel a bit buzzy rather than tipsy and it genuinely helped me control my breathing. It didn’t make me at all sick considering I would throw up at the drop of a hat during the whole of my pregnancy.

I would describe Entonox as something that doesn’t take the pain away but it does stop you caring as much about it!

I also like biting on the Entonox tube in the last phase when I am bearing down. As you can probably imagine the tube is literally in tatters by the end of the birth!

WATER FOR PAIN RELIEF

Water can soothe pain and used in a large pool can help support your weight enabling you to move into any position you would like. The great thing about having a water birth is that you can combine it with other types of pain relief such as Entonox, breathing, hypnobirthing and massage. It is noted that women who choose to have a water birth need less interventions or drugs.

However, if you get into the pool to early then it could potentially slow down your labour. The TENS machine would also be out of the question as would any injectable drugs such as opioids or epidurals. If you do need these interventions then you can get out of the pool.

HOW I USED WATER FOR PAIN RELIEF

Although a water birth is something that has never appealed to me, I have successfully used water as a way of pain relief. With my first and second child I have laboured for as long as possible.

I used a birthing pool at home as a type of relaxation technique which helped take the edge off the pain and helped me feel calm and in control. The warmth of the water helped me breathe and calmed me down especially with my second child where I suffered from severe
Symphysis pubis dysfunction (SPD).

The buoyancy of the water meant I could get into any position without feeling pain.I eventually gave birth to him laying on my side and on dry land but the water definitely helped.

Unfortunately for my 3rd, 4th and 5th children I had to be induced so water wasn’t an option for me as I needed to be closely monitored.

BREATHING

There is a reason why everyone talks about breathing techniques in labor and that’s because it really does work. It would seem that it is such an obvious thing to do and its hard to imagine that it would help you when you are enduring the worst pain in your life.

Breathing is your body’s way of controlling pain. Slow breathing enables both you and your baby to get the maximum amount of oxygen, the more oxygen the smoother the labor.

Slow breathing is also a way of keeping calm and stopping you from tensing up, the more you can relax through a contraction the easier it will feel letting the pain go over you.

As you feel a contraction coming take a large breath inhaling through your nose and exhale the contraction out through your mouth allowing all the air to come out like a long sigh.

You can count the contraction out if it makes it easier for you. At the final stage when the baby crowns the midwife may ask you to pant so you will need to change your technique just for a moment while she makes sure the cord isn’t around the baby’s neck.

HOW I USED BREATHING TECHNIQUES

I found that breathing really helped me get through each contraction, I breathed and counted through them and getting to 30 meant I had been through the worst. I know its not much comfort knowing you have another one in less than a minute but I believed in dealing with one contraction at a time.

I also felt that breathing evenly and deeply meant that I was able to appreciate and use the Entonox properly. I would advise that you speak to your birthing partner about your technique before Labor Day so they can support you when the time comes.

Breathing is also an excellent way to deal with those horrible internal examinations, stretch and sweeps, prodding at scans and later when dealing with that same baby when he becomes a teenager!

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