Goshen News, Goshen, IN

November 18, 2012

WHOLE FAMILY: Keep on moving to help manage childbirth pain


— I ended last week with this: “So next week I’ll go a little further and write about how to manage childbirth pain without Pharmacia. You might be surprised how simple — normal, natural — it is.”

Well, someone’s baby could not wait for this week, and my phone jangled with a call from a woman in early labor. Not her first baby, but she’d still be interested in hearing more about managing pain. I gave her my three if-we-don’t-have-time-to-go-over-everything best tips and bid her blessings as she birthed.

Did I mention I love my job?

You want those three best tips. Right. Well, they were nothing earth-shattering, but they’re as good a place to start as any. I told her this:

One — Keep moving as long as you can and want to. Despite many TV images and the sad state of many real-life births these days, women largely don’t like to be lying down in labor. So “movement” would be the one-word pain-management technique here.

Movement, means, of course, actually moving, but it can mean more.

If you watch a woman laboring unhindered, you might get dizzy. She sways, she squats, she paces. She’s often up one minute, down the next.  I even had a doula client once who walked on a treadmill and one who escaped to a vast outdoor porch for some walking and fresh air. (It took me a few panicked minutes to find her. How would I explain to the midwife I lost her client in those inky dark outdoors?)

The point is to move however your body wants to move or move at the advice of someone — a coach, midwife or anyone else in the know — who knows what movements might be advantageous.

Additionally, I think of “movement” in labor in at least two other ways: Changing positions fairly often and staying ahead of any tendency to fall into a rut.

Sometimes people ask about the BEST position for laboring. My answer, usually, is there IS NO ONE best position; it’s the fact you CHANGE positions that matters. A general rule of thumb is to change positions every half hour or so. Even the action of walking to the toilet, having a contraction there and walking back to a rocking chair counts as position change.

And the no-rut thing. Most labors have a “flow” of their own, and good birth attendants can “feel” it and adjust as necessary. It’s easy to get “stuck” somewhere in the middle, between the signposts, “Crud, I have to do this” and “$!*!$*! I cannot do this!” Frankly, I think I’d rather be at either end than the long middle.

Avoiding ruts is simple: Change it up. That sort of “movement” means try a new technique, fluff the pillows, change birth attendants for a while, open the blinds or shut them, get a new mantra, on and on. Just MOVE by doing something different.

Rhetorically: How do you get anything out of a tight spot? You either move the object itself or move what’s around it. When a laboring mother moves, she does both.

TWO —  Water, water, water, water, water. The use of aquatherapy in childbirthing simply must be the most obvious, easy but often missed solution to pain. Too many sources to cite, so I’ll just assert it myself: Hot water helps with pain. Think about it. When you’re sore after a vigorous workout of some kind? You soak in a hot bath.

Heat, particularly, helps blood flow and relaxes muscles. A hot soaker can take that sharp and awful edge off of painful labor contractions. Sometimes we half-joking call the labor tub the “aquadural.” (It’s not anesthesia, though. You’re going to feel pain still.)

Don’t forget, either, there are lots of other ways to use water than just getting into a tub. The shower is my personal favorite, as I’ve seen it advance a labor quickly while the woman barely struggled. In the shower, you’re upright, so we have a cardinal labor key: gravity. Also, in the shower, a woman has some control over where the water goes, so she can direct it at that achey lower back or let it pound on her shoulders — whatever she wants. You can put an exercise ball in most showers, too, to the delight of your hospital staff, I’m sure.

Along with the bath or shower, you can use water in hot-water bottles, on towels or washcloths or — and don’t underestimate this — in some sort of ongoing running way, like leaving a faucet on for the calming sound effect. I’ve been to more than one birth where an ocean-waves CD took us all — well, sorta — to the warm and breezy beach.

THREE — Here’s the pain-management technique you want if you can do no other. Relax. Sounds like I’m contradicting myself, I know. I tell you to move — squat, pace, bounce — and then I tell you to relax. Actually, you can do both.

The key pain reliever here is allowing your body to work efficiently by not taxing it with tension anywhere tension doesn’t need to be. See, in labor, you’re going to have some serious, wow-that’s-strong tension in your abdomen. Let that be the only place you’re contracting.

That means that during labor your goal is to be soft and limp everywhere else — at least during a uterine contraction. Let the blood and thus oxygen intended for that large muscle group working go only there and not to your shoulders, hands or tightly clenched jaw.

One of the best phrases I remember hearing — and I’ve totally commandeered it — came from a now-retired midwife with a sharp mind and a gentle voice: “Be soft all around it,” she’d say. I find myself picturing a ball of fire, really, in a woman’s belly and encourage her to sink into it. Sounds weird right now, but I hope you get the idea.

Look at that! My word count is startlingly high. No room for the two dozen more pain-management techniques I have in my toolbox. But I simply must point out that your birth helpers are so crucial to these ideas being successful. If they’re behind you and offer ideas, encouragement and support along these lines, great. If they do not, dare I say you’ll have a very hard time.

So just a plug there: Hire a doula or a midwife who offers similar services. I know a few … And start with these three techniques — movement, water, relaxation — and let me know how it goes.

Goshen News columnist Stephanie Price is a wife, mother, teacher, childbirth educator, midwife’s assistant and nursing student from Elkhart. Contact her at wholefamily@goshennews.com, 269-641-7249 or on Facebook at the page “Whole Family Column by Steph Price.”