why we feel pain in labor and pain relief methods

Hey everyone

I have noticed that there are lots of questions about pain relief and what labor 'feels' like

if anyone is interested i would be more than happy to write up a blurb about why we feel pain in labor and pain relief methods

I will be able to post a blurb this arvo if anyone is keen

xx yogababy

Me! Me! Meeeeeeeeeeeeeeeeeeeeee!!!!! I'd be more than interested ....

Do I need to show more keeness??? :cryinglaugh:

hi yogababy im interested to find out why we feel so much pain in labour

yes please

I think it would be most constructive! I went through it in my posts about hypnobirthing when I was pregnant and even after the birth, but I guess I'm having a credibility crisis ;)
Fear=tension=pain, ladies!!
Go for it, Yogababy :)

Yogababy, that would be great, thank you so much.

thanks guys for your encouragement :D

I may break it up into a couple of posts...and give everyone the opportunity to give feedback and add there experiences and advice

so I'm thinking I'll break it up...please let me know if you want anything in particular...or dont want something ;)
1. how the uterus works
2. hormones in labor and birth
3. outline of the stages of labor and birth
4. why we feel pain in labor
5. pain relief options...natural
6. and only if requested...medical forms of pain relief

xx yogababy

ps Diva I lurve your enthusiasm x

all of the above please!!

Great idea Yogababy..really helpful

Me too!!! I'll have a large dose of whatever you're interested in throwing our
way .... first time PG here .... got ALOT to learn .... ;)

the uterus is the most amazing muscle...yes its a muscle...and is designed to grow with our beautiful babies, keep them snug and also support the placenta

the uterus is made up of the same/similar type of muscle fibres as the muscles is in our arms or legs...that is they are designed to stretch, relax and maintain tone. The uterus has the extra special ability to retract.

The uterus does not have nerve fibres that cause pain...the only time you will feel pain as a direct result of your uterus is if it is forced to work against itself. The uterus requires lots of oxygen to work effectively in labor...so when someone tells you to breathe thru a contraction, it is helping to provide oxygen to your baby and to your uterus (aerobic metabolism). If we dont breathe effectively the uterus begins to tire, and when in established labor contractions do not generally stop, so it starts to use its own stored energy reserves in the muscle (anaerobic)...this causes the beginnings of uterus discomfort. The other way the uterus will cause discomfort is if complications arise (which I wont go into...simply as there is enough scare mongering with childbirth already...but simply these things do not happen all the time :))

The uterus contracts in labor to facilitate the opening of the cervix (all the way up to 10cms :D) , and is composed of 3 layers...
1.the inner layer has muscle fibres that run around the uterus, ...and help the cervix dilate
2.the middle layer is a criss cross of blood vessels that supply the uterus with all the oxygen it needs
3.the outer layer is made up of long muscle fibres that run up and down the length of the uterus this layer draws the muscles of the uterus up to the top, or fundus, and as labor advances the fundus becomes thicker and the lower segment of the uterus gets thinner


the uterus is designed to contract and maintain muscle tone following each contraction, and works rhythmically in response to the work of the muscle layers and hormones in labor

next is hormones :D

xx yogababy

That's great :)
When I learned this last year in my HB classes, what very little apprehension I had about labour vanished into thin air. Then I did the birth centre classes...do you think they went through ANY of what the uterus is about? Like, you know, the most important part about labour and they tell you about what pain relief is or isn't available in the FBC, instead of what your body is doing and what the purpose is :rolleyes:
I think knowing about this removes more than half the fear, so thanks heaps for posting this with your authoritative and experienced perspective!

Great idea Yogababy, we're really fortunate to have this right here at BB.

Aren't our bodies wonderfully made? It's like when you know what it's trying to do, then you want to do all you can to support its job.

I remember reading in Active Birth that the working uterus likes to tilt forwards as it contracts - so when you lean forward during cx, as many (not all) women seem to want to do insticitively, it's working with the uterus, whereas lying back on a bed makes the uterus tilt uphill, so it usually hurts more. Lying on your side would be easier for the working uterus than back-lying.

Looking forward to your next installment!

OMG, I soooo wish that i had come to this post prior to having my baby last year. I was induced and i feel i chickened out and went for the epi. All through my pregnancy i did Yoga and during the first internal exams i really used my breathing and i was amazed at how i sailed through that. Next time i am going to do some Yoga pregnancy based classes and really get into the breathing and not chicken out! Seeing posts like this makes me wish i had tried, you have given me and im certain many others the confidence in themselves and what our bodies can do... Thank you...

ok now its hormones and how they affect the beautiful birthing woman :D

there are 3 main hormones that affect labor, the work of the uterus, and birth

1. oxytocin
known as the love hormone, as it is released in men and women during orgasm and nipple stimulation (yep thats why nipple stimulation can help induce labor).
This amazing hormone is released in large amounts during pregnancy, helping with nutrient absorbtion via the placenta and helping to reduce stress levels, plus also promoting sleep.
Oxytocin levels increase in the late stages of pregnancy, peaking...at the onset of labor...and is the hormone that is the key to stimulating the uterus to contract.
Oxytocin levels are highest between about 2-4am...which is why many women go into labor in the early wee hours (at term).
Oxytocin also facilitates the birth of your baby...immediately prior to birth oxytocin levels increase to stimulate powerful contractions...like is experienced in transition...to help birth the baby quickly and easily...another reason to not push until you have uncontrollable urge :)

2. endorphins
our body's natural opiate, which work by filling up pain receptor sites
endorpin levels rise in pregnancy...causing 'pregnancy' brain...and peak at 38-40 wks, just prior to the body going into labor

endorphins increase oxytocin and oxytocin levels increase endorphins

3. adrenaline
Released when we are fearful, anxious, stressed etc...
When adrenaline is released we 'fight or fly' and all non essential body systems are put on standby...which includes the uterus
If we are fearful in labor...adrenaline is released and blood is divereted away from the uterus...meaning the uterus gets less oxygen...meaning it has to work against itself...and starts causing discomfort :(
Adrenaline also negates endorphins...no natural pain relief hormones...and Adrenaline reduces oxytocin levels...contractions may slow down or stop

so whats this all mean?

we need to remain relaxed and calm to encourage endorphin release and allow our body (and oxytocin) to do the work it was designed to do...working with your body to birth your baby :)

adrenaline is not beneficial in early labor and has its place immediately prior to birth...adrenaline released in labor has a negative impact on the baby (decreases their oxygen supply and makes labor longer for them) and mother (labor longer/or disrupted...hence the term some of you may have heard 'failure to progress'...and contractions more painful as the uterus has to work harder and longer) adrenaline is however, released just prior to the birth of your baby (this is termed Maternal Fetal Ejection Reflex, first talked about my Dr Michel Odent) to increase maternal awareness, and promote an alert baby, which helps stimulate first breath and also first breastfeed

so why do we feel pain in labor?

so far
1. if the uterus has to work without oxygen
2. if we are fearful, which releases adrenaline and decreases endorpins (natural pain relief) and decreases oxytocin...meaning a longer labor and more chance of medical intervention


hope this makes sense :)
next...
brief outline for stages of labor

xx yogababy

Wow this is so helpful, even after having had 2 babies. Thanks so much for this Natalie!

thisis great!!!

stages of labor...I will keep this simple, but please feel free to ask me to add more detail on any area :D

prelabor can be experienced for up to 2 weeks before true onset of labor...

there are 4 stages of labor

1. 1st stage...which is divided into latent and active labor
0-4cms (latent stage) effacement (thinning) and dilation of the cervix
contractions are mild to moderate in intensity, and may even be irregular, perhaps occuring 3-10minutely (this is different for every labor) and lasting anywhere from 30-60seconds
this is the part of your labor where it is best to stay somewhere you feel safe and secure...rest and relax
4-10cms (active stage) this is the stage of labor where the uterus kicks up another notch and the contractions becom more intense and regular, lasting 60-90seconds and occuring 2-5minutely (again just as a guide)
if your waters remain intact...that is no one breaks them 'accidentally'..this cushions the action of your baby's head on your cervix, softening the intensity of the contractions...mother nature giving us a helping hand :)
generally your waters will break sometime in the active stage of labor
towards the end of the 1st stage you enter transition...which for many women is the most challenging part of their labor
remember the work of the hormone oxytocin...which reaches peak levels just prior to your baby being born...with contractions at their most intense, as the uterus works to fully dilate the cervix and birth your baby
transition is often the stage at which you may request your personal method of pain relief

2. the second stage of labor is from fully dilated to the birth of your baby
the body is an amazing thing...as often a laboring woman will reach 10cms dilated and the uterus will actually take a break...contractions will ease off or stop for 5-30minutes of so...giving the mother and her baby a bit of a break before the work of birth...this is normal, and allows the baby to have lots of oxygen and the mother an opportunity to refocus, refresh and revitalise
as the baby moves down into the vagina, its head places pressure on the posterior wall of the vagina, stimulating the overwhelming sensation of pressure (which for some women feels like needing to do a poo) and then an uncontrollable desire to push...which leads to the baby being born :D
some women are so relaxed that they literally just breathe their baby out, and this occurs with optimal levels of all birthing hormones
an uncontrollable desire to push is very different from directed pushing...as some of you may have experienced during birth. Directed pushing is just that, someone telling you how to push "take a breath and now push for 3, hold it then take another breath...". This type of directed pushing decreases O2 to your baby, tires out the mother, increases mother BP and increases medical assistance with birthing. There is no research that indicates the directed pushing improves outcomes for mother or baby

3. the 3rd stage is the delivery of the placenta
which can be physiological, that is no artifical injection to stimulate the release of the placenta from the uterine wall, or managed (which means the jab in the leg)

4. this stage is often not referred to in a lot of hospital based antenatal classes...but is a very important stage
and I love this...its called the babymoon period
this is the first 2hrs after the birth of your baby...for bonding, the first breastfeed and just getting to know each other
a lot of focus is placed on the labor and birth...but this stage is vital for the release of hormones in the mother to help with milk supply, the first breastfeed for the baby (and subsequent breastfeeding success) and also helps to reduce the onset and severity of symptoms associated with PND

next up...why we feel pain in labor

xx yogababy

ok i may be asking a dumb question here, but with the placenta, do you have to have that injection?
or can you just be left alone and it will be birthed onits own?
this is one part that really confuses me and nobody seems to want to talk about it.

also, i haev read where is hospital the midwives and doctors break your waters for you to onset labour into the nect stage... if you leave them intact will labour stall or will it happen on its own with them breaking when the body is ready to progress...

sorry if these are dense questions, i am trying to get info so i can have a drug free birth.... and want to know what the body does NATURALLY when left alone..

Hey Lisa

they are great questions!
you can choose to have your placenta birthed without the injection (which is synthetic oxytocin to help the uterus to contract and push the placenta out)...this method takes anwhere from 5-30 minutes or so for the placenta to naturally peel off the uterus wall and for you to push it out...which isnt like pushing your baby out, more like a feeling of a fullness in your vagina, and with a little push, or sometimes a cough, the placenta plops out :)
many Drs prefer you to have the injection...to decrease the risk of postpartum bleeding...but if you have not had any complications in pregnancy or labor to suggest that you may be at risk for this...then you dont have to have it...but do let your doctor know in advance, and write it in your birth plan so the midwives at the hospital are aware as well

yep its true that breaking your waters van help move labor along, and sometimes this is necessary if your labor has been overly prolonged and you are tired. Generally speaking though the body will move at its own pace...which is the pace which is perfect for you and your baby

once you have anything done at all to you in labor...intervention...it sets off a snowball affect (called the cascade of intervention)...basically one thing gets done...then another...then another

hope this helps...feel free to ask any questions...I LOVE talking all things, belly birth and baby

x

I will be putting up a blurb on why we feel pain in labor tomorrow (Monday)...so let me know if there are any burning questions :D

thanks for that its exactlywhat i needed!!

Natalie, thanks a heap for doing this. It's much appreciated by all :D

ok I know its not Monday...but special treat for me...the inlaws are bathing the kids :)

so why do we feel pain in labor?

first the definition of pain...an individuals interpretation of a sensation (basically)...so everyone feels differently

as a basic rundown...the history of childbirth is not a pretty one, and it is this that has set the seed for fear (and in some cases for good reason...think early christianity and midwives being burnt at the stake) for society

the fear surrounding childbirth helps to initiate and set in place the fear-tension-pain syndrome...which Kelly talks about in detail in one of her articles...but simply put...
if you are frightened...you become tense...and when you are tense adrenaline is released...fight or flight response (remember back to how adrenaline affects labor)...and then we feel pain

we need oxygen so that the uterus can work to its full potential, and also to keep our baby happy :)...if we are fearful, our breathing becomes short and tense, decreasing our oxygen levels leading to an unhappy baby and a oxygen deprived uterus...leading to pain (as the uterus struggles to work...leading to disrupted and prolonged labor) and dips in the babies heart rate with every contraction (fetal distress)

the uterus does not hurt in labor...but the cervix has lots of nerve fibres...and the sensation of the cervix opeing, stretching and being pulled up can be painful for some women at the peak of a contraction and in transition, and for others it is simply 'intense'...again remember that intact waters cushions the impact of the babies head on the cervix decreasing the intensity sensations expereinced by the laboring mother

I'm of course not saying that you will not feel pain...but every experience is different, and everyone interprets the sensations differently...this is why hypnobirthing is effective as it trains the mind to interpret the sensations as a postive experience and calms and relaxes the laboring women to allow the body to work as effectively as it can...

what are everyones experiences of contractions?

for myself...my first labor was pretty difficult...I was fearful and had a very medical expereince, and a good dose of PND. I worked hard to release my fears with my second pregnancy and had the amazing birth I wanted...yes it was intense but it was good intense...it was even enjoyable...I have some great shots of me smiling and looking rather serene (B&W of course :)) in the bath with my support team working around me

I hope that this helps :)...you can do it Gracie...as Kelly said surround yourself with a fearless support team ;)

next post will be on natural pain relief methods...any requests?

xx yogababy

this is so informative and helpful and inspiring to read - thank you :) From someone who is not even pregnant with their 1st yet, it's really helping me to not be afraid of anything....
rather be informed and that will help prevent me from having fears... if we are educated then we are less likely to be fearful hey....

Natalie, you could write your own book!! :)

thanks Renstar...that really means alot...in fact I have been busy writing my own book, on all things yoga for belly, birth & baby...just not quite sure what to do with it :)

Thanks for all the info yogababy! i have a couple of qn's.

I am already waking in the middleof the night with butterflies in my tummy. I know this is the feeling from adrenaline, but it not b/c i am anxious, it is b/c i am SO EXCITED! i can't wait to experience the whole thing. Does what you are saying mean i should try not to get too excited when i finally go into labour? I might start to feel anxious about being too excited and make the whole thing worse! LOL

One other qn, re syntocin for third stage. Someone (an OB) said to me there is a VERY small risk that vessels in the cord may not do what they are supposed to and bub could bleed back into the placenta without anyone knowing. What are your thoughts on that?

With my first labour i was quite fearful and really had no idea how the body worked at all during labour. I ended up having gas for most of it just to knock myself out of it so i wouldn't really feel much and i also had pethadine. For my second though i went in there knowing so much more and i was scared about the birth itself(for other reasons due to having such a bad experience last time) but i wasnt scared of the contractions at all. Yeah it hurt but i went almost 30 hours without pain relief and that was with a posterior labour. I did end up having an epidural in the last 7hrs but only because i was so tired(and labout kept stopping and starting) not because of the pain. For my next one i am planning a homebirth which will hopfully help with the stopping and starting business(labour would start up again soon as i got home after been sent away from hossie)

Having this knowledge you've given us too i think will help me a lot aswell. Thanks again!

great Q's

its great to be excited...all those postive vibes going to your baby, and giving you wonderful anticipation and positive reinforcement...its pretty hard not to get excited, and really normal...a little bit of adrenaline is fine, and excitement quickly settles as you immerse yourself in the work of labor...im talking totally out of control fear

Ob's are great for complicated, difficult pregnancies, labor/births...I guess you could say having an OB is an insurance against an unknown major hiccup...but...they are trained in all the things that could go wrong, when this so infrequently occurs. It is rare that a baby bleeds back into the placenta...and not really a good enough reason to enforce a medical 3rd stage...in fact it is so much more likely that everything will go fab...as long as you avoid the pokes and prods of well meaning professionals trying to 'help' :)

xx

Ummm, sell it to BB members and other doulas???
Seriously, do you have a publisher in mind, or would you self-fund for the first run and see where that takes you? There are loads of independent publishers that you could approach - how about Sarah Buckley's publisher? Or a women's brand like Virago (tend to be more female oriented titles)?
I used to be in publishing, but it was educational and I never got far with it (promises from the higher ups never materialised cos I was too precocious!), so I'm only giving very generalised ideas. My GF published using a UK publisher, and she's here (it's a professional relaxation CD and guide that her a her colleague devised - both psychologists), so it doesn't even have to be a local publisher.
Anyway, thanks for the posts, they have validated and confirmed everything I learned for my own birth experience, and why it was such a good one to have as a first :)

Hey Mayaness

I have self published 2 yoga manuals...so was going to go the same way with the bigger version...its just getting it out there :)

Maybe you could use the manuals and some excerpts of your new book to present to a pub company? That way they do most of the work in getting it out there. Meanwhile you could still do a small print run and sell on BB while someone else sources other markets!
Oooh, you could approach the ABA - they recognise that better birth= better BFing experiences! Between ABA and BB, you'd sell heaps of books!

thanks so much for your encouragement Mayaness...I really love what I do, and it really gives me confidence when I am told that I am doing ok :)

I was just about to post an apology for going way off topic!
The reason your proposed book excites me is that I read widely before even falling pregnant and the only book I read that actually had a description of the uterus' role and a diagram of what it looks like was my Marie Mongan HypnoBirthing book. That's ok, except it's American, and we need Australian perspectives of these things.
Honestly, I'd purchase your book and loan it out to my preggy friends! they were skeptical of my rendition of events until I had Oscar and could report that 'it works' ( :rolleyes: ). The less books by Kaz Cooke (about how awful childbirth really is), the more about empowered birthing, the better :)

I will be posting a blurb about natural pain relief later today...with particular attention to HypnoBirthing...please feel free to request any info :)

xx yogababy

Alrighty ... I'm adoring all this info ... I went away and had a good think, and now I've come up with some wonderfully curly questions for ya ...

I fully appreciate how vital but oh so detrimental adrenaline is ... but what if, (through a lifetime of dealing with two anxiety disorders) you've trained and honed this silly gland like a well oiled machine, strengthened it to be half the size again of a normal adrenal gland and now due to the fact that it's linked to the involuntary system it can now secrete far more cortisol/adrenaline than the average woman wants or needs???

I've spent many, many, MANY years learning to cope with it's after effects, using cognitive behaviour therapy and positive self talk, but due to the involuntary nature of the darn gland the only way you can stop it shooting first and asking questions later is to desensitise yourself to the stimuli, and as this is my first PG I can't do a truckload of labour runs until I teach my body it's all good! :lol: Watching the birth process does diddly squat for me as I'm only seeing it from the outside looking in and my body needs to feel all the twangs and twinges many times over before the darn gland gets used to it.

I've managed to stall the TTC process with all this excess adrenaline, and because we're having a remote homebirth I REALLY don't wanna stall the labour process with all this excess hormone, but how on earth do you stop an involuntary gland????

Hope that makes sense ... sometimes I find it hard to get all my thoughts in a row ... I talk better than I type sometimes ... ;)

From what I understand, Diva, (and this helped me enormously during labour and birth), it *may* not be a problem, because it is (normally!) impossible for endorphins to fire at the same time as adrenaline, it's an either/or. My neuroscience books never mentioned exceptions to the rule, so take heart in that!
That's why breathing is so important - and not shallow TV breathing, either. Nice, big, deep breaths that make you feel nice...cos once you're feeling nice you KNOW that it is the endorphins responsible and you know that the adrenaline is hiding until it is required to come to play right at the very end of the process (essentially, expulsion of that baby).
Anyway, the HB post by Yogababy will elucidate this further, I'm sure.
Rule of thumb - if you feel good/relaxed/'zen', there is no adrenaline, because they don't fire at the same time :)

Mayaness - Thanks for that ... I'm the queen of deep breathing cycles, it's a surefire way to get a panic attack under control ... but I wouldn't hold your breath on me not doing the impossible ... I'm the queen of that too .... ;)

Infact I'm staring at the fridge that has my FS's report saying I have 0% chance of natural conception ... right next to our 9w6d u/s .... :cryinglaugh:

Love it:dance: You'll make it do-able!

Hey Diva

what a wonderful question...I love the curly ones ;)

everyone works at different levels at every stage of life...pregnancy just being one of them...your body adjusts to the level of hormones that is 'average' for you and works from there....this is why so many women find HypnoBirthing a wonderful too, because you personalise it for your needs, and it becomes an unconcious response (with practice of course)...and we do need adrenaline...Ive got loads of it to diva, but have learnt to use it in a positive fashion

when I do post the HypnoBirthing blurb, just so you know that I teach form a practitioners perspective (BirthSkills) and a personal perspective...and having used the BirthSkills I still did suffer AND and PND with my 2nd pregnancy but it was so much easier to work through it all...so I really do understand :)

xx yogababy