Know Your Options: Pain Management - Part 2

Welcome to the third post of the Know Your Options series! This is the second part of three on Pain Management. They're better read in order so check out the first one here and the next one linked at the bottom of the page. Happy reading!

So now that we understand what pain is and dived a little deeper in how the body works during labor and birth, it's time to get into how to cope with the discomfort and, yes, pain that comes with having a baby. There are different kinds of methods and medications out there for you to consider. So much so, in fact, that I broke what was going to be one long article on pain management into three separate articles.

​I'm choosing to start with non-medicated pain options. The reason for this is because I feel strongly that everyone needs to be familiar with these methods, even if you're planning a medicated birth. While the following tools and skills can certainly be used all on their own, they can be used during a medicated birth either along side medication or in the even that medication does not end up working well for you.

Non-Medicated Pain Management Options

Our bodies natural response to discomfort and pain are to release pleasure hormones (endorphines) in order to counterbalance the unpleasant sensations. When we become afraid and tense we trigger adrenaline and nonadrenolin, otherwise known as our "fight or flight" hormones. These trigger a response that increase our pain perception. Our work, then, becomes to work with our body's endorphines instead of against them. It is work! For most of us, relaxation does not come easy. It takes a certain amount of mental, emotional, and physical effort to achieve and maintain. This is why we need to both learn and practice skills before labor that will help us relax, focus and allow our endorphines to do their work.
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Breathing

​Almost all relaxation methods start with learning and practicing how to breath through stress, discomfort, or pain. Conscious breathing can be very effective in and of itself. It works by reducing your heart rate, anxiety, and pain perception. The increase in oxygen provides your working muscles and uterus with what it needs to work. Holding your breath or breathing too quickly which limits your oxygen intake will cause your muscles more cramping and pain than if you breathing steadily. The more you practice, the more calm breathing becomes a response to pain. This helps you remain in a more relaxed state and respond more positively to the onset of pain. A steady rhythm to your breathing is calming during labor; it provides a sense of well being and control. I encourage you to practice and use breathing during any everyday stressor you encounter: from 5:00 traffic to slow wi-fi. 

The Power of Breath

Visualization

This is the use of mental images to influence bodily processes, control pain, or prepare for top performance. This is where we begin to practice our mental focus. The first step is to clear your mind, much like in meditation (our next topic). Use deep breathing to help you achieve this. Visualizing the birth itself can help you prepare emotionally for birth as a normal, healthy event. Practice breathing and relaxation first, then add in visualization once you are calm and receptive to suggestion. If you're unsure, try a guided birth visualization, with a script for your partner to read aloud in a soothing voice.

You can also visualize a "happy place" real or imaged. The ocean is a common image used as a many find it soothing. The important thing is that it's a place you feel calm, relaxed, safe, and secure. It can be as unique as you are! If you find it even more soothing for your partner to describe it to you, write your own guided meditation script to practice. 

Focal Point - If you struggle to keep your eyes closed, or find that closing your eyes causes you more stress. Try using a focal point to help you remain focused on your breathing, relaxation, visualization, meditation or other coping mechanisms. ​It can be something your brought, such as a picture of your "happy place" or a special baby item. Or you can improvize and use anything you've found in the room, as mundane as the light switch or a speck on the wall. You can use a focal point with any of these methods.
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Additional Notes: 

Meditation is different than visualization in that, meditation is largely about letting your thoughts come and go without hanging onto or following a particular thought through to it's conclusion. It's focusing on how your breath feels and being present in the moment. 

Self-hypnotism is often begun using the tenets of medication and scripted visualization to achieve a relaxed, suggestive state. If this interests you, there are classes and books out there just for self-hypnosis during childbirth. Check out Hypnobabies or HypnoBirthing for more information. 

Visualization

Touch

One of the best relaxation tools available is that of touch. One of the great things about touch relaxation is the involvement of the birth partner as a key roll in helping the mother relax. Not only does it help the mother through birth, but it helps both people feel connected and the partner feel useful and needed. Touch can be as simple as gentle pressure on the parts of the body the birthing person needs to relax, such as the forehead or jaw. It can be as complex as reflexology, which requires knowing which part of the feet to apply pressure in order to relieve the mother. 

The best time to practice touch relaxation is just before bed. Really take the time to focus on the areas of your body where you hold tension. Practice relaxing your entire body with the help of gentle touch or massage from your partner. 
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Pro-tip: Return the favor! So you partner can better understand the nuances and changes you may experience during labor, takes turns helping each other relax in this manner.  They will discover how what feels good or bad changes day to day (or moment to moment during labor!) and you will better understand the power of effective communication. ​

The mind and body are interacting, on helping or hindering the other. It is probably impossible to relax the body completely if the mind is under tension. Likewise, it is impossible to relax the mind completely if the body is under tension.

-Robert A. Bradly, M.D. "The Husband-Coached Childbirth"

Touch Relaxation

Hydrotherapy

This is arguably a form of "touch" as the water provides relief in much the same way. Hydrotherapy, or the use of water for relaxation, is an increasingly popular method of easing labor pains. The pressure, pulse and warmth of a shower during the first stage of labor can be quite satisfying. During the later stages and into the second stage, the buoyant, weightless freedom of a tub can be very helpful. 

This is not necessarily a form of relaxation you need to practice as much as it's something you need to prepare for. Not all birthing spaces will allow you to utilize water as much as you may like. If you choose to birth in a hospital setting, for example, you may not have access to water all the time, or at all. Or you may have free access, but limitations when it comes to the second stage (pushing stage) of labor. These are things you need to know before hand so that you can be better prepared and make the best choices for you. 

Laboring in Water

​In the end, if you only take one thing away from this I hope that it's that you should practice and prepare for childbirth, no matter what kind of birth you are planning on having. These are fantastic tools to have at your disposal throughout your life, not just childbirth. Learning how to deal with stress, discomfort and even pain will help you feel more confident to take on the momentous event that is childbirth. If these are your go-to coping mechanisms, be sure to practice and really educate yourself further on what works well for you.

My final pro-tip is this, practice several different kinds of breathing and relaxation methods. They will most likely change somewhat as you progress through labor. You may surprise yourself!
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Remember this, for it is as true as true gets: Your body is not a lemon. You are not a machine. The Creator is not a careless mechanic. Human female bodies have the same potential to give birth well as aardvarks, lions, rhinoceri, elephants, moose, and water buffalo. Even if it has not been your habit throughout your life so far, I recommend that you learn to think positively about your body.

- Ina May Gaskin, "Ina May's Guide to Childbirth"

For more info, I highly recommend Evidence Based Birth's Pain Management Series. 

Know Your Options continues in Pain Management Part 3!