Welcome to pain free labour comrades

A big здравствуйте to all the Russian people who have started looking at my pain free labour blog. Я надеюсь, что погода там не также холодна. That was just a little secret message to our Russian friends.
It seems that the message is getting through regarding midwives calling contractions PAINS. More and more are recanting their ways and, at least while I am present, they are making a very concerted effort to not use the P word. It will take time. For our Russian friends, you need to call uterine activity сокращения and not боли.
The social construct that we have created and woven into our belief systems regarding painful labours is very strong, it will be difficult to erase. Midwives who are independent enough to fight against this acceptance of painful labours, and at least try to address the balance, will help women to achieve the best labour possible for them as an individual. Once we teach them how to behave in labour, and what elements are causing any discomfort, then we will be truly 'with woman'. Cos at the end of the day, that is what 'midwife' means.
See earlier posts in this blog for relaxation techniques and staying upright to achieve a pain free first stage of labour. Goodnight. Доброй ночи, я надеюсь, что Вы наслаждались этим постом.
And, for our Aussie friends - Sling another Wombat on the barbie will ya Shiela. Thankyou.

Birthing in the pool

I have just spent the weekend having two of the most amazing gentle pool births that you could ever imagine. I love it. Working on the birth centre at North Manchester General Hospital is just the perfect job for any midwife.
Both the women that I have cared for over the weekend said they coped so much better after entering our lovely birthing pools and are going to recommend them to their friends. Giving birth in nice warm water is a more natural way to birth for baby, she is already used to an aquatic environment. Heat is a universal source of comfort for all ages and being surrounded by warm water whilst giving birth seems to cocoon women in a security blanket that most do not want to leave after the birth.
Birth centres cater for low risk women, ask your community midwife if you are low risk and if so ask her to book you in at your local birth centre. Normal labour wards can still have birthing pools, though they do not get used as much. Even if you have risk factors, ask the labour ward where you are booked if you can use the pool. Always remember that you are the boss. All maternity care is offered as a service, with you as the client. When you go to the hairdressers and ask for a certain style, you would not be happy if they said that style was not available and you could only have a crew cut instead. Well, not unless you like that sort of thing. Write your birth plan before you are in labour. Have someone calm and confident with you so they can fight your corner if necessary, leaving you to focus on your relaxing. Stay upright untill you are in the pool, the water will then negate the pull of gravity and you can adopt whatever position is comfortable for you at the time. Floating has been the mode of choice this weekend. Love it.

Is this unethical practice by British midwives?

At the dentist last week I was thinking of all the things I would rather be doing instead of having my face compressed and my mouth stretched and my pain threshold tested to extreams by my dentist's torture equipment. The receptionist was very nice and calm and friendly, which helped a little to put me at ease. While I was waiting to be seen I asked the receptionist if she would ever mention the word PAIN when greeting a patient due for treatment. She looked at me horrified. "That would be highly unethical behaviour" she replied. "We try to make people feel welcome and at ease, any mention of the P word would just make them anxious, don't you think?" I readily agreed and explained that the only reason that I asked was that I was researching how other care professionals approach the tricky subject of language when talking to clients who may face a potentially painful procedure.
So, are midwives acting unethically when they call uterine contractions PAINS? Is this an issue for the Nursing and Midwifery Council? Let me know what you think. Are midwives adding to the propaganda spread by society that smooth muscle is designed to cause the sensation of pain when contracting under normal conditions?
Oh dear. Having just eaten I can feel the smooth muscle in my stomach contracting. I think I need an epidural, good job it was only a vegan sausage.

Birth Centres

Having just worked for 3 months at a wonderful birth centre, I am more awestruck that ever at how wonderful women are. They have been taught that childbirth will be very painful, by the society that they live in, and yet they still get pregnant and they still come back for more. Awesome. While working on the birth centre I have met some lovely people and have helped them to have a pain free first stage of labour for most. It is very difficult to teach women relaxation techniques in the middle of their labours. Relaxation really must be practised during the pregnancy as outlined in other posts on this blog. However, I have found that some women are capable of taking a step back from their pain and discomfort and trying the methods that I teach. Once they are upright on a chair or ball and in a more relaxed and controlled state of mind they look up at me and say "Why has no one ever told me it can be this way before?" That is a very good question. I have now been told that I have to leave the birth centre and move to another ward. They knock me down, but I get up again. I have an article to be published in Midwifery Matters in the Spring issue that aims to teach midwives how to help women labour. Please help spread the word. Thank you.

Remember, how to approach labour.

REMEMBER

• Stay upright, this can be on a chair, leaning against a partner, sat on a birthing ball or leaning forward on a beenbag. As long as your uterus is not working against the pull of gravity. You do the math, I'm not your mum.
• Practice the relaxing techniques in pregnancy outlined in this blog.
• When you start contracting in labour, DON'T PANIC, even being a little anxious will produce a rise in your adrenalin levels. Start doing the relaxing till you have it under control and the contractions stop causing the sensation of pain.
• Contact your midwife if you have any concerns. If having a hospital birth then come in when the contractions are every 3 min and lasting for 50-60 seconds if this is your first vaginal birth. If you have had a vaginal birth before then come in when the contractions are every 5 min.
• Have calm relaxing people with you in labour. I have seen otherwise calm people sent up the wall with fussing mother in laws who panic and should never be allowed within 50 miles of a labour room.
• Eat small regular carb meals in labour cos it is a big muscle and must be kept well fed. Lets face it, its the only time you feel good about feeding your face lots of yummy carbos.

One born every minute - USA

After reading the inspiring book by Ina May Gaskin (Guide to Childbirth) I thought I would check out the TV Programme One born every minute - USA. Oh my goodness! It really was a pregnant woman's worse nightmare. There were no midwives at all present in the hospital, only obstetric nurses and doctors. The women did not stand a chance of anything like a normal delivery as we understand it in England. As soon as they were in the delivery room they were made to lie down on a bed and strapped to a CTG machine to observe the fetal heartbeat, and these were low risk primips. See the post 'Staying Upright' and 'Why Labour Hurts 4' and 'Hazards to a pain free labour 4' for why this is a bad idea. Next they were cannulated and an IV started and then when the nurses had made sure that they were in as much pain as possible, they were offered an epidural. A doctor came in for the birth, only 10% of women in America are delivered by midwives. They had to deliver with their legs up in stirrups in the lithotomy position, which as we all know is not a good position for an easy natural birth. The doctor then performed an episiotomy and applied forceps to deliver the baby. Oh my goodness, if this is what American women have to put up with then no wonder Ida May is so popular. I think she should be put up for election as President of the USA. I would vote for her. Maybe then you could see normal midwifery back in the US of A. Seriously, you cannot put up with this treatment, you would give more respect to a pregnant animal than they gave to the women in their care. The really sad part was that the women were so compliant and never questioned their treatment. Tell us how it really is, leave a message. Ann x.

Ina May, now thats what I call midwifery

Have been on anual leave this week and have just read Ina May Gaskin's Guide to childbirth - wow. Just finished drying my eyes and my make up isn't even waterproof, there should be a warning on the front of the book. It was lovely, the first half of the book is birthing stories. Ina May lives in a village in the USA called The Farm. All her women either give birth at home or in a birthing centre. Her CS rate is less than 2% and instrumental rate is 0.05%. Wow. Ina May recognises that adrenalin is bad in labour but she does not state why. I think women today want to know why and how something happens and that is why I have revealed why labour hurts in this blog. She refers to contractions as rushes, that is so sweet. As least she doesn't call them "pains" like the majority of midwives I know do.
One thing in the book that did shock me is the way American women are expected to give birth within the usual health structure there. OMG times 10. They have to book with an obstetrician who they will see throughout their pregnancy and birth. In England only high risk women have care throughout with a doctor. At the birth the American women are expected to have continuous CTG monitorin, IV access and an episiotomy as standard, even if they are low risk. They are looked after by obstetric nurses and the doctor is called at the end to deliver the baby.
No wonder women are afraid to give birth, there is nothing even remotely natural about these births. I always look at America as pioneers who show us the way but in midwifery they are way behind. I can see why Ina May is so popular. There is no way anyone could have a pain free labour under the American way, how on earth do you put up with it? Leave a message and let us know.