Friday, 9 June 2017

How I achieved a DRUGFREE LABOUR - 8 tips to help with pain during labour!!


Today I want to take a minute to talk to you about labour...



I'm a firm believer in doing labour your own way. If you want every medication under the sun, I hear you. If you want to try and do it "drug-free", good for you. I don't preach anything to anybody. I'm not here to tell you what to do, I'm simply here to give my advice and share you story. Labour and giving birth is a very personal experience that can not only be different for every person, but can be different every time.

I have had to opportunity (with four labours under my belt) to experience many different sides and forms of labour. I've done it with all sorts of drugs and I've done it naturally. The only way I haven't done it is through a cesarean (well, not yet!!!).

It is something that I'm asked about a lot, and I love to share what I have learnt along the way, and what helps me in hopes that it may help someone else.



First of all, labour is bloody painful. Let's not sugarcoat it here. It doesn't matter how you do it, it's going to hurt. You may think some people may have a higher threshold for pain, but don't let that fool you into believing it doesn't hurt for them. And don't underestimate yourself. I went into labour with my first with very low expectations about my threshold for pain, and I feel like that held me back. I didn't think I would deal very well with the pain ... and I didn't.

First I want to tell you about my first labour, as I believe that I learnt the most in this labour.

With my first baby I noticed on my due date that I was 'leaking' and went into the hospital to be checked out. I was sent home and told to "see how it goes". The next day I went back into hospital with the same issues. I was told that my waters were in fact leaking and I was sent home again with an appointment to be induced the next morning if I didn't go into labour overnight .... I didn't. As we headed into the hospital the next morning, I had started to have some cramping pains. As my waters were already technically ruptured they went straight in with the syntocinon (this is a hormone that is put through an IV in your arm. It mimics labour to start contractions).

Here's some things I wish I had know about. If you are given syntocinon...
... your contractions will start immediately. And not the "early labour" pains that you may have read about in the baby books. It pretty much takes you from no pain to mid range pain in a very short amount of time. BE PREPARED!!!



... they like to closely monitor the baby to ensure that it doesn't get too stressed out with all the new contractions, so they will hook you up to a little contraction monitoring machine via two elastic straps around your stomach. One will measure the contraction, the other measures the babies heart rate. This means that there is no wondering around the labour room to help you ease the pain of contractions. You have to stay in one spot.



... they count how many contractions you are having over a period of ten minutes. If there are too few they may up the dose of the syntocinon. If, like in my case, there are too many, they tell you that there isn't a whole lot they can do about it because if they turn down the syntocinon it may stop the labour completely.

So there I was. My first experience into labour. I had gone in with the dread that I wasn't going to be able to handle it, I was put on a drip that put me BAM into labour, and my body was contracting 10 times in 10 minutes. It didn't take me long before I was at my peak. I wanted out. I started to panic about the pain. I tried the gas ... I didn't like it at all. I wasn't breathing it in properly and the taste it left in my mouth made me gag. I had an internal check and the midwife told me that I was only at 3cm dilated and there was still a long way to go ... PANIC ...

I WANTED DRUGS .... I NEEDED DRUGS ... I NEEDED ALL THE DRUGS!!!!

The lovely calm midwife told me that we should start with pethidine and see how I felt after that. Pethidine is a synthetically made drug similar to morphine. I agreed and in went a needle into my thigh. I expected some relief, but nothing came. I asked the question that I should have perhaps asked beforehand, "how long does it take to start working?" .... The dreaded answer ... "about 20 - 30 minutes". I almost fell off the bed. At the rate that my contractions were going, I was still going to have another 30 contractions before this 'might' take the edge off the pain.

NO WAY!!!

PANIC ... PANIC ... PANIC

As I said before I went into this with low expectation of my abilities and I had completely lost control of the situation. I was in so much pain and I all I wanted was it to stop. I told the midwife I wanted an epidural. She tried to talk me around to waiting a little longer, but I wouldn't have a bar of it. I didn't need to be some sort of labouring hero here, I just didn't want to be in pain anymore. The midwife agreed and in came the anaesthesiologist who started rattling on about side effect and such, which to be honest I have no idea what they even said. So if you are interested in knowing the side effect I suggest you read up on them well before you are in the middle of labour.

This is where it gets a bit interesting, and this was something I realised later on. As I sat there on the edge of the bed, getting the epidural needle inserted into my back, I was very still. Actually to be honest, I was in and out of sleep. At one point I think my husband was sort of holding me up. Now, I have seen a lot of episodes of One Born Every Minute (a UK based reality TV show that has cameras set up in a busy labour ward), and not many people sit still while the epidural is being put in. From the contractions to the fact that they are literally inserting a giant needle into your back, there is a lot a pain involved, which makes it a little tricky to sit still.

As I said before, it wasn't until I looked back later, that I realised that in the time that it took the midwife to get the doctor and the doctor to get the anaesthesiologist and the anaesthesiologist to get the drugs and needles organised, the pethidine had started to kick in. This was my turning point. As I reflected on my birth, as I sat cuddling my new little baby in the less painful days following my labour, I came to the decision that if I had given the pethidine time to come into affect, I may have been able to continue with just that. It gave me the power to believe that maybe I could have done it without the epidural. Maybe I was stronger than I thought.



Why???? I hear you asking. Would you bother going without the epidural. If you don't have to have the pain of labour why bother?

Let me explain the rest of my story...

What I knew about the epidural before that first labour, I have to admit was not a lot. It was a needle in your spine that took away the pain. That's all I knew.

Again here are some things I wish I had know about ...
... once the epidural is inserted into your spine, a small tube comes up over your shoulder and you are give a little button to push to give you another boost. This button is capped. From memory it was something like 7 times in 15 minutes. It didn't matter how much you pushed it, it wouldn't give you any more than 7 boosts in 15 minutes.
... they will come at you occasionally with a small ice pack, which they will hold on different parts of your body to test the whether you are numb.
... you are lulled into a false sense of security. I sat there, finally free from the crippling pains of the contractions. I chatted with my husband and mum, I ate grapes and drunk lemonade, and we all waited for something to happen. I'm not really sure what we were waiting for to be honest, but several hours later I was given another internal check and we were told I was at 10cm and we were ready to go!



... they take the booster button away from you and calmly tell you that we will now let the epidural wear off (WEAR OFF!!!!) and wait until I have the all encompassing feeling to push!!! Well first of all I was shocked that the epidural didn't cover the pushing part. I felt like someone who had gone to the movies only to be told that my ticket was only good for a seat in the theatre and not the movie itself. Secondly the feeling never came. And as time ticked on I noticed that the midwife had started to constantly check the clock, watching me as if I was about to explode at any moment.

So we sat and we waited a little longer, and the 'push' feeling never came, and the epidural was not wearing off.

The decision was made that I should start pushing even though the epidural hadn't wore off and see how we went. Well ... it didn't go great. I pushed for near 2 hours with no success. We would watch the monitor to see when I was having a contraction and I would try and push. I had absolutely no feeling and no idea how to get this baby out of me. And with every push the midwife would try and tell me to 'push into my bottom!' a nice way, I feel, of telling me that I wasn't pushing properly. 

Nothing was happening. The baby was moving forward a little with the contraction and backwards as soon as it stopped. I was exhausted and defeated. My baby was getting distressed and I couldn't do anything to get it out. It was truly upsetting and I felt like a failure. A doctor came in, I was cut, a ventouse (which is a small vacuum with a plastic cup that attaches to a babies head) was inserted and as I had my next contraction my baby was sucked out of me.

Here's photo of me ... looking like absolute shit!!!

So this was my story. I decided afterwards that the epidural had completely slowed down my labour, and had made pushing my baby out need impossible.

Of course it doesn't happen like that for everyone, but that's how it happened for me.

My next three labours I did drug-free. Not really intentionally, I never go into a labour believing I know how it's going to go. And I have never gone through the birthing centre (which is a program at my hospital, devoted to those who want to have a natural birth, with water births and such), for the pure reason that I tend to beg for the epidural at the very last second ... hahaha



So after all of that, if you are even still here reading this, here are my actual tips and advice on how to give birth naturally.

One...
Understand that a 'pain threshold' is nothing but a state of mind. If you go into labour believing you have a low pain threshold, chances are you will. And it may take you a labour or two to really understand what your actual pain threshold is, once you take away all the preconceived ideas of it.

Two...
Labour will not last forever. The pain will not last forever. There will be an end, and the prize you get for the hard work will all be worth it. Always keep that in mind. An hour will pass, the night will give way to the morning, and before you know it, it will be nothing but a (painful!) memory. If you don't believe me, ask yourself why people go back and do it a second or third or however many times. You completely forget almost instantly, and you are left with a feeling of accomplishment. It doesn't matter how you do it, whether it be naturally or via a cesarean, you still did it, just like thousands of women before you.



Three...
The pain of labour comes from the contractions. And contractions ebb and flow. Whether these contractions have started naturally or have been induced (which mine have been EVERY TIME!!!) they have a start and end. You just have to feel for it. Here is my most asked question of those who have seen photos or video of me during labour ... "how do you look like that when you are in labour?" I believe that I go into a bit of a mediation like state. It is how I deal with the pain.
So here is my first actual tip ... count your contract length. When you feel the contraction starting take a deep breath in and then count each breath it takes until the contraction is over. This is why I lay so still during labour. I put all my concentration into counting my breaths and it really does help me. I know from past experiences with any pain that it doesn't help to cry and scream, sometimes it actually makes it hurt more. If I know that my last contraction lasted for 35 breathes, all I have to do the next time is breath 35 times. I close my eyes and I count ... 10 breathes, 25 to go .... 20 breathes,15 to go .... 30 breathes, 5 to go. Of course they won't all be exactly the same length but it will give you something to do, and something to take your mind off the pain.

Four...
Clary sage oil. My midwife told me about this during the 41st week(!!!) of my second pregnancy. I can't say I knew much about burning oils, nor did I really believe in such things but this changed my mind. The midwife told me to get some Clary Sage oil, and also some Raspberry Leaf Tea tablets to help bring on my labour naturally. At the time I was ready to try anything. So I went straight from my appointment to a health shop. *Note... Clary sage oil does not smell particularly lovely, however it is not all that bad, and now every time I smell it, it takes me right back to being pregnant. I burnt it, I bathed in it, I massaged it into my body, I put some on my pillow, I even put it on a tissue and walked around with it in my bra.
Well, let me tell you that neither the clary sage oil or the raspberry leaf tea helped to bring on labour. Not with my second ... or my third ... or my fourth. Even though I was using them from 34weeks with my third and fourth pregnancy. I have since done more research into clary sage oil. First of all, if your body is not ready to go into labour, no old wives tales or oils will work. However, clary sage oil does help relax the mind and body and soften the cervix, which in turn helps you have more effective contractions once you are actually in labour.
I truly believe now that it helped me during my labours, they were so much quicker than my first, and I felt so much more relaxed and in control.
Which brings me to...

Five
Control ... Stay in control of yourself. Pain is all a mind game. Don't let it take over.
There is a quote by A.A. Milne that says...
"You are braver than you believe, stronger than you seem, smarter than you think, and loved more than you know." and it couldn't be more true in this sense. You have no idea what you are capable of until you do it.



Six
Listen to your body. Forget what the midwives are telling you and truly listen to your own body. Since I'm not one to be throwing myself around and screaming I am able to feel what is happening inside my body and I can actually feel as I move into different stages of labour. 
I discovered this during my second birth when I finally felt that 'urge to push' they kept talking about during my first labour. My body was telling me that this baby was coming. As it was my second labour I had started to panic again as the pain increased. I told the midwife what I was feeling, she did a internally check and told me I was only 6cm and I wasn't ready yet. Suddenly I couldn't help myself. I was pushing. I was yelling for the epidural. And I was doing everything in my power to stop my body with no luck. My baby was born within a few minutes. I tore, only slightly this time, which I later realised was because I had pushed so quickly and so hard. Turns out that you can go from 6cm to 10cm in the matter of a minute.
Now I have discovered that I can tell when my labour transitions, I can prepare for it. If I can feel when the contractions intensify I know that my cervix has dilated more and that my labour is progressing. There comes a time when it is more painful to hold back from pushing then it is to let your body do what it wants to do. Your body generally knows what it needs to do.



A little bit of TMI, during my last pregnancy I was actually induced 2 weeks early due to the fact that I was measuring at 48cms instead of 38cms. I had been having some digestion problems and it turned out that my bowel was severely enlarged and there was a risk of it rupturing. I hadn't been able to go to the toilet for weeks and I was terrified that I was going to have to go in the middle of my labour. And that is exactly what happened. During the labour I knew that I needed to go to the toilet, but I also knew that a lot of people mistaken that feeling for the urge to push so I knew the midwife wasn't going to let me get up and go to the toilet. I had been labouring for a few hours and knew that I had gone into the final stages of labour before I needed to push, but I knew there was something 'blocking the way'. Well I will spare you the gross details but in short once the blockage was out of the way my baby came right on out.

Seven
Listen to the midwife. I know, I know I just said forget what the midwives say. But this bit is important. When your babies head is crowning it is an art form to get the rest of it out without tearing. But the trick is to listen to the midwife. They will most likely tell you to stop pushing when the baby's forehead is out and they will carefully guide the face out. This bit is very hard to do. I think I heard somewhere it described as a "burning ring of fire", and that pretty much sums it up. But if there is any advice you take, let it be this. Try with all your might to stop pushing and breath for a couple of seconds. It is for the best. It is so much nicer to spend the moments after birth bonding with your baby, instead of being stitched back up again ... sorry ... TMI again!



Eight
Just remember that it isn't a competition. The 'prize' is the same for everyone no matter how you do it.

I hope this is helpful to you. Whether you are an expecting Mum, or you've already had your children.

I love reflecting on my labours. It is such a special day that I will always hold close to my heart. It is the first day you will meet a person you will love unconditionally for the rest of your life. It is magically and nothing can top it.