Past pain free labours 3

During the 1970s and 1980s, there was a social shift to accepting hospital births as a norm, local doctors in the comunity offered a intermediate service which allowed women to be cared for and birth in a GP Birthing Centre. A wonderful midwife who I have worked with for many years, was working at a GP birthing centre during this time. These centres were very popular for low risk women who could attend and give birth with a community midwife they knew well. This was a homely setting which added to the women feeling at ease. During the 18 months Margaret worked there, none of the women she cared for needed any pain relief. They were calm and relaxed and able to move around freely in the company of someone they trusted. Moving around freely and staying upright is an inportant factor with pain free labours as discussed in the post - Staying upright.
Politics have taken natural childbirth away from women today and the GP Birththing Centres have been closed down. We have taught women to fear childbirth by expecting them to attend large medical institutions that can only see childbirth from a medical point of view.
OK, for a small percentage of women who undergo a home birth, transfer into hospital may be required but that should not mean that all births should take place there. Having said that, as a hospital midwife, I have had some lovely births in hospital after teaching mums how to relax in labour discussed in the post - Relax with progressing muscle relaxation. And it has worked a treat. So hospital is not a bad place to have your baby if you have the right support. There should be access to a birthing pool where relaxation is enhanced by the warm water. However, you have to be confident and in control of your labour and insist on staying upright and on having some peace and quiet in order to run through your chosen relaxation method. I always darken the room and make as little noise as possible during a normal low risk labour. You can labour safely in hospital but you will be more relaxed and in control at home. See the post - Home birth - for help in the Manchester England area for help and support in booking a home birth.

Past pain free labours 2

In her book 'Safer Childbirth?' Marjorie Tew outlines the move from mainly home births in the UK to mainly hospital based care and the effects this move had on childbirth. By the 1080s it was generally accepted that a "medical institution" was the place to give birth. Tew explains how this move led to women feeling less self-confident about birth, feeling that control of their bodies had been taken away. In her book Tew describes how women coped who underwent home births before the nationwide move to hospitals - "Having no fear, her body like her mind was relaxed and allowed the automatic processes to be completed with the ease with which other animals reproduce". Tew was obviously aware of the effects of adrenalin on the cervix discussed in Why labour hurts 3, when she stated "The body's response to the stimulus of fear is tension, affecting in particular the circular muscles of the cervix and causing them to resist dilatation. This causes pain and reinforces the vicious circle of fear-tension-pain." 
Reading her book is a little depressing but it is becoming clear why women simply do not believe in a pain free labour. In 1892, doctors were taking over the birth process which in their opinion could no longer be regarded as natural. "Throughout the 20th century, the incessant stream of propaganda has continued to capture public opinion, to make everyone believe that childbirth is fraught with dangers against which only care by obstetricians can protect."
In other words, we have been brain washed for generations. Well, now is the time to WAKE UP and take back control. Childbirth is a big industry, lots and lots of money is invested in keeping women pliant and keeping them in pain so that hospital medical interventions can be justified. If the majority of women suddenly started having low intervention pain free labours, hospitals would be thrown into disaray. Jobs would be lost and the system would have to change big time. People do not like change.
I am not saying that we will never need the services of obstetricians, there are always high risk women who will continue to need their specialised help. I am saying that for the majority of low risk women, there has always been a chance to choose. I chose to go pain free, what will your choice be?

Past pain free labours

Pain free labour is not a new concept. People for generations have been aware of the fact that labour contractions are not meant to cause pain.
Doctor Grantly Dick-Read was born in Britain in 1890, he studied at Cambridge University and practiced at the London Hospital. He noticed during his work that labouring women, who were not afraid of childbirth, did not require any pain relief. In his book, Childbirth Without Fear, he outlines why women feel labour contractions as painful. "Pain in an otherwise uncomplicated labour arises from the activation of the sympathetic nervous system by the emotion of fear." That is the actions of the hormone adrenalin outlined in my post: Why labour hurts 2. "A labour without disproportion or malpresentation of the baby is long because it is painful, not painful because it is long." In this statement he is referring to the cervix being held shut by adrenalin causing the contractions to become stronger and making the labour much longer as discussed in the post: Why labour hurts 3.
As you can see, during the 1940s when Dr. Dick-Read's book was first published, a pain free labour was often had at home by women who were not afraid to labour. I don't know if the good doctor recommended any relaxation techniques in order to have the best chance of experiencing a pain free labour, he does however outline hypnobirthing which must have been in its infancy during that time.
Dr. Dick-Read's book is an interesting read as a historical text book. It is however not relevant to today's women who don't want to plough through a lengthy book just to extrapolate the information you can glean just from reading my blog. Sorry Dick.

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.

A pain free labour for Maisy, sorted.

Last night I looked after a young lady who I shall call Maisy. She arrived at our labour ward in the early hours of the morning in labour. She was very distressed and in pain, so much so that she could hardly walk. After assessing her cervix to see if she was in labour I managed to calm her down by explaining why her contractions were causing pain. I then taught her the progressive muscle relaxation technique and sat her on a birthing ball.
When someone has entered the stress/pain cycle it can be very difficult to pull them out of it by getting them to listen to you and understand what you are trying to tell them. To her credit, Maisy listened to everything I said and very quickly began to reap the benefits. To her amazement the contractions stopped causing her pain. She was able to breath through the contractions sat on her ball with wonderful support from her partner who remained calm all the way through. When offered analgesia she declined saying that she was no longer in any pain.
Maisy went on to have a lovely normal delivery in a kneeling position on the bed. I am not going to tell you that the second stage was pain free cos that would be silly. As that head is crowning the perineum gets stretched and stings a lot. But Maisy was wonderful, she listened to me - when to push and when to pant - and we had an intact perineum. Her baby was alert and awake and fed at the breast within an hour of the birth.
Looking after Maisy was a delight. It makes the midwives job so much easier when mum takes control and breaks out of the stress/pain barrier. If Maisy can do it then why are you still telling yourself that a pain free labour is not possible, all it takes is to believe.

Hypno Birthing in Manchester, England

According to my local news station last night, Hypno birthing is being offered at Tameside hospital in Manchester, England. Hooray, at last a mainstream hospital is beginning to see the advantages of a pain free labour. They must be a lot cheaper to offer than epidurals. They call it Hypno Birthing but that may put a lot of people off. You are at no stage hypnotised so the name is misleading to say the least. All that is being offered is what I am offering in this blog. That is, using relaxation techniques learned in pregnancy and used during labour so as not to enter the stress/pain cycle that I see with most labours. Well done Tameside, the revolution has begun.

Relax with progressive muscle relaxation

For my two pain free labours I used progressive muscle relaxation as a technique to ensure that I did not secrete adrenalin. I was sat up on a comfortable padded chair with my eyes closed to begin relaxing. I focused on my feet, making them feel heavy and imagining the tension in them drifting away like a mist. When my feet felt very relaxed I then moved on to my legs then chest then arms and hands. The shoulders and neck should be given extra time to relax as most of our tension is found there. Just take a few extra minutes to feel them relax and imagine all that tension and stress drifting away. The head is next followed by the face. There are a lot of little muscles in the face so it is best to do the muscle relaxing there in stages. First the forehead, then the area around the eyes, and finally the jaw and mouth area.
Once you are fully relaxed, you have to keep going back to check that no tension has crept back into bits of your body, especially the shoulders. If a contraction occurs while relaxing it should be ignored with the mind focusing on relaxing the neck and shoulders. Your chosen method of relaxing should be practiced in pregnancy so that when labour day arrives you can start to relax easily and quickly before each contraction.
Of course, there are people who are incapable of relaxing. Coffee drinkers are adrenalin junkies and find it difficult to sit still for 5 minutes let alone relax and become tension free for a whole labour. Any caffeinated drinks are therefore not desirable as refreshments in labour.
Having a good social support system in place is beneficial as it will stop you stressing about other children or dependants. Being organised by having your bags packed and ready will reduce stress levels, you would be amazed at the amount of women who turn up in labour with a half packed bag. You've had nine months for goodness sake.
And finally, it is essential that your birth attendants are calm capable people who know exactly what your birth plan is so that they can negotiate with hospital staff instead of you risking getting stressed. Better still, stay at home and organise a home water birth. What better way to relax than to be in your own home, eating your own food and watching your own TV programmes. ZZZZZZZZZZZZZZZZZZ This technique is also fabulous for getting to sleep at night.