Janine Gard: Learning how to cope with pain in labour

Parenting and birth educator Janine Gard

Janine Gard is a diploma qualified birth educator and founder of Bellies to Babies. She has taught more than 2900 parents to feel confident, informed, supported and prepared This week Janine talks about pain in labour and birth.

Today we are going to chat about pain in labour and birth and what you can do to understand, cope, support and work with your contractions.

The topic of pain in labour and birth is a hotly debated subject around the coffee table and while pain in labour can't be entirely avoided (for most people), the fear of pain can be addressed and reduced.

Taking good birth education classes, working with a trusted and supportive midwife, and having good continuous support from a partner, friend, or family member all can help greatly reduce your fear of pain in birth. It also helps to know a few things about labour pain.

It's gradual. Labour is not like stubbing your toe. Going into labour isn't the same as walking into a level 10 pain (which is pretty much what it feels like to catch your pinky toe on the leg of the coffee table). Instead, it builds up slowly and gradually, easing you into the process.

It's intermittent. You get breaks during your labour. When a contraction ends, the pain immediately disappears. Poof! Even if your break only lasts a minute, you will be able to rest and relax.

It's 'pain with a purpose'. You may have heard this saying before. The pain you experience in labour is caused by a process — contracting of the uterine muscle, opening of the cervix, and stretching of the vaginal tissues — that allows for your baby to be born.

Most other day-to-day experiences of pain give you nothing but, well, pain. Look at this a different way, stubbing your toe wasn't intentional — you didn't mean to walk into the coffee table and hurt yourself. Whereas labour and birth has a purpose, to birth your precious baby. So, it's a different type of pain.

Your body makes hormones that both cause and counteract pain. Our body truly is amazing. A labouring person's body creates the hormone called oxytocin, also known as the 'love hormone', which is responsible for keeping contractions going throughout labour.

At the same time, your body also produces endorphins, which are hormones that increase feelings of calm and provide pain relief. The level of endorphins gradually rises throughout labour to match your labour's intensity. Your body makes its own specially formulated pain medication — whoa!

And, it ends. Even if you have a very long labour, your labour will, most definitely, come to an end. Labour pain is one of those experiences filed under, "this too shall pass".

It helps to know this going into labour and at various points during your labour when you may feel like it will never be over. A great tip for partners and support people to remind mum.

Now you understand how labour pain is different, let's look at what you can do to help ease and cope with the pain — preparing yourself and finding a soothing environment. We've chatted about this before, if you want to read more about the importance of creating a safe environment have a look at my past columns.

Choose a place to labour and birth that feels comfortable to you, with space to walk and bathe, as well as a variety of furniture and devices to enhance movement and pain relief — a chair, birth ball, low stool, and soft bed. Somewhere you feel safe and comfortable.

Choose your team carefully. Your LMC, your partner, family members and/or friends can play essential roles on your birth team. Choose people who will treat you with respect and patience. The proper support can help decrease stress and inhibitions, so you can find your best coping mechanisms more easily.

Learn about labour — from books, magazines, websites, videos, antenatal classes, a hospital tour, and discussions with your LMC, family, and friends. Ask questions, gather as much sound and accurate advice as you can, such discussions are best had before labour. More knowledge means fewer surprises.

Express your fears. Are you worried about pain, needles, medicines, or losing control? Voicing your concerns can bring relief as well as allow you to learn more about practical solutions to your concerns. Stating your preferences in a birth plan can also help calm fears.

Practise rhythmic breathing. Breathing techniques can help you manage contractions. Breathe fully in a slow rhythm during contractions. Release tension with each exhalation and try moaning. Continue by breathing in through your nose and out through your mouth, keeping your mouth soft and slightly open.

Use imagery and visualisation. Focus on something that makes you happy (like your partner's face, an inspirational picture or favourite object) to engage your senses and decrease your awareness of pain. Listen to music, a soothing voice or a recording of ocean waves, and picture yourself somewhere that's relaxing to you.

Take a warm shower or bath. A warm shower can soothe you, especially if you can sit on a stool and direct a handheld showerhead onto your abdomen, groin or back. Jump in the pool or bath, bathing in warm water may relax you—and which may speed up your labour!

Keep moving and upright. Move around as much as you can to stay more comfortable. Walk, lean, sway, rock, and squat. Some positions will be more comfortable than others. There's good evidence that staying in upright positions or walking around can help to shorten your labour by over an hour.

Unless you're really tired (listen to your body), try not to lie on your back once you're in active labour. Doing so can make your contractions slower and more painful. Change positions often, changing will help inhibit muscle tiredness and tension.

Seek relief with warm or cool compresses. Applying warmth is a tried-and-tested way of relaxing aching, tense muscles. So, it's no surprise that it's an effective way of providing relief from labour pain.

Place a pregnancy wheat bag around your lower abdomen, groin, lower back, or shoulders during labour. Pregnancy wheat bags can be purchased at www.hbantenatal-classes.co.nz. A cold pack or latex glove filled with ice chips can help soothe painful areas—but avoid using it on your abdomen. Cool cloths relieve a sweaty face, chest, or neck.

Indulge in gentle touch or massage. Touch conveys reassurance, caring and understanding — whether it's someone holding your hand, stroking your cheek or hair, or patting your hand or shoulder. It's the first sense to develop in utero and the last sense to leave us.

A massage that starts slowly is best. Frantic rubbing will make you feel panicky rather than relaxed. Firm pressure will help stimulate your body to release feel-good hormones (endorphins), which help to reduce pain as well as aiding relaxation. You could also place three tennis balls in a long sock and have your partner roll them up and down your back to relieve back pain. Or ask them to rub your back with the heels of their hands.

Trust in your abilities. Believe in yourself and your ability to birth your baby will make an enormous difference in how you cope. When you change the way you see birth, the way you birth will change by about 90 per cent. Here's an A to Z of tips to help you manage pain, increase your comfort levels and feel in control of your labour.

A: ask questions, aromatherapy, acupuncture, acupressure, activity

B: breathe, bouncing, birth pool

C: cuddles, caressing, chanting, chocolate, caring, counter pressure

D: dancing, dim lighting, distraction, diffuser

E: encouraging, essential oils, exercise, eating, exhale

F: focus on object, flannels, foot massage

G: groan, grunt, games

H: holding hands, hydration, hugs, homoeopathy

I: Inhaling, ice chips, in-tune with yourself

J: jokes, journey

K: kisses, keep moving, kneeling

L: laughing, love, listening

M: moving, massage, music, meditation, moaning

N: nourishment, nipple stimulation, needs met

O: open, observation

P: positive, positions,

Q: questions, quietness

R: rocking, rubbing, roaring, relaxation, reassurance

S: stroking, shouting, shower, swaying, self-belief

T: trust, thoughts, TENS machine, touch

U: understand, using your voice, urination, use gravity

V: visualisation, vocalising

W: walking, wheat bags,

X: x-tra: kisses, love, hugs, reassurance

Y: yell, yoga poses

Z: zzzzzzz: zone out, zen

There are going to be times where you may find labour extremely hard and challenging and fatigue may start to take a toll. Be prepared for this, take some time to really think about what you might need to help you through then discuss this with your team. Parenthood is going to be filled with many moments such as these, this is the training ground. You got this.

■ If a baby needed CPR, would you know what to do? Learn this essential tool, every parent needs to know - https://www.hbantenatal-classes.co.nz/baby-first-aid.

For information about antenatal classes near you, check out From Bellies to Babies www.hbantenatal-classes.co.nz or phone 022 637 0624. I'd love you to join me, Sign up today!

Medical disclaimer: This page is for educational and informational purposes only and may not be construed as medical advice. The information is not intended to replace medical advice offered by physicians.