Wednesday 22 June 2011

It was like flipping a switch.

A young woman arrived on labour ward saying that she thought she may be in labour. It was her first baby so she said that she didn't know what to expect, what labour felt like. She almost apologised for her arrival as the contractions were not causing any pain, just a little back ache, so she thought she was wasting my time.
I sat her down on a padded chair and placed my hand on her abdomen to palpate her contractions. They were coming every 3 minutes and felt moderate in strength. After examining her cervix I pronounced that she was not in fact wasting my time and that she was in labour.
It was like flipping a switch. While she thought she wasn't in labour, she was calm and collected and coping well with the contractions. As soon as labour was confirmed the fear set in. I could see it in her eyes. I tried to address her fears by saying that she had been in labour all morning and not felt any pain, so why should it become painful now? I explained about adrenalin starving the uterus of oxygen and attaching to the cervix to prevent it from opening, but it was too late.
The widely held belief that labour contractions are meant to be painful is so deeply embedded that with some women, it is impossible to erase. After she found out she was in labour she was a different person. The family were sent for and she sobbed into her mothers arms. When I explained to her mother how well she had been coping in labour beforehand, and that she could continue with her pain free labour I was told to get the anaesthetist quick for an epidural. "Can't you see that my daughter is in pain?"
Generation after generation the legacy of painful labours is passed down. How can anyone compete with that. All I can do is keep repeating the mantra - Smooth muscle is not designed to cause pain when it contracts under normal circumstances. One day the message will get through. Please help spread the word.

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