June 4, 2010

Labor Pains: Don’t Be Caught Unprepared

A main component of the prenatal yoga class is the exploration of pain management and relaxation techniques that can be used during labor and delivery. My favorite (and most effective) exercise is the mock contraction. This is a 60 second wall squat that is meant to simulate the timing of a contraction and is frankly, rather uncomfortable. I know that contractions are not experienced in the thighs, but maintaining this position for a minute will certainly make you figure out how to relax and get through it. In class we typically run through this pose two or three times. After the first time, I ask the students, “So, how was that? What did you do to get through it?” Sometimes I get blank stares, but often women speak up about what techniques and tricks they found helpful: breathing, rubbing the thighs, counting, rolling their shoulders, and the list goes on.

“Good!” I say, “These are all techniques that you can acquaint yourself with now to learn how you best deal with discomfort.” I go on to say “It is very unlikely that you will not experience some sort of discomfort or pain during labor.” This is where it gets interesting, and knowing smiles and smirks emerge from some students. “Unless you have a planned induction and get the epidural immediately, or have a planned cesarean, you will be dealing with contractions on your own for a while. Most care providers do not want you at the hospital too early. And even then, you will likely have to wait in the waiting room, go through triage, get admitted to the Labor and Delivery floor, and then have to wait for the anesthesiologist to arrive.” The smiles and smirks disappear.

Over the weekend, I attended a very long birth. We had intended to use the Birth Center, but as labor hit its 27th hour, the laboring mother opted for rest and relaxation by taking the epidural. After moving out of triage (which took about 45 minutes) and into a room, we ended up waiting almost 2 hours for the anesthesiologist to be available. There was a cesarean that was just getting started, and then an emergency arose which bumped us to third on the list. To withstand this two hour wait, we breathed, rocked, moaned, visualized, and created counter pressure with a hot water bottle.

My reason for telling this story is in no way meant to scare people, but instead to give a clearer idea of what may happen. Realistically, those wanting an epidural will still have to employ some pain management techniques for a period of time. It is much better to have a variety of techniques learned and readily available than be surprised by the power of labor.

Think of learning these relaxation and pain management techniques as homework for you and your partner! You can either do the mock contraction or the One Minute Ice Cube test (I got this from my Lamaze training). This exercise requires you to put your hands in a big bowl of ice water for one minute. Again, it is very uncomfortable and requires concentration and support to get through it. On a side note- if you are practicing these at home with your partner- have the partner try a round of two- the exercises can provide some perspective and empathy.

There are so many ways to find some relief during labor. I have written blogs on several techniques and ideas that I would like to share as well as my top 3 favorite techniques.

Paging Dr Feel Good
Breathing for Labor, A Yogic Point of View

The Gate Control Theory of Pain Management in Childbirth and the Epidural
7 Tricks of the Trade to Help You Have a Better Labor!

My top three favorite pain management techniques:

Breathing and Progressive Relaxation
I find that deep breathing and systematically relaxing the body from the top down can be very effective in creating concentration and relaxing the body. Deep breathing helps shift the body into the parasympathetic nervous system which is the “rest and relax” state as opposed to the “fight or flight” response to pain.

Hot water bottle with counter-pressure and massage
The heat from the hot water bottle applied to the lower back or lower abdomen can create immediate relief as well as applying pressure or massage to the sacrum area .

Movement
Next time you stub your toe, notice the immediate desire to move around to relieve the pain. Movement decreases tension and relaxes the muscles which will lessen the perception of pain.

Hopefully your labor will unfold as desired. If there is a bit of a snag in the plan and you have to deal with unexpected turns, you will have the tools to get you to the other side.

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