When preparing to give birth for the first time, most women worry about how they will cope with the pain.
In fact, giving birth is the biggest fear women have about starting a family, according to a recent poll conducted by Bounty.
There is no getting away from it, childbirth will hurt to some degree - but it need not be a frightening experience.
One of the most important ways to prepare yourself is to keep an open mind about the birth process - and to be realistic.
“There is significant pain involved with giving birth and everyone deals with it differently – and that is absolutely fine,” says Dr Deirdre Guerin, Director of Obstetric Anaesthesia at The Portland, and a Consultant Obstetric Anaesthetist.
Antenatal classes – available at The Portland Hospital and other organisations such as the National Childbirth Trust - can help by teaching you what to expect and how to recognise the various stages of labour.
These will also inform you about the pain relief options available so that, when the time comes, you know what to ask for.
Here Dr Guerin outlines the most popular alternatives:
During the first stages early labour, having a warm bath can really help. The warm water soothes the spasms of the contractions while, at the same time, the very act of having a bath is relaxing.
This is an electronic device with pads that you stick onto your back which supply small electrical pulses to help block pain. A TENS machine is small enough to be portable so you can still move around while wearing one. The drawback is that it only provides a small amount of pain relief so is generally only suitable for early labour. The device can be hired but you need to do this personally beforehand. (Further information is available from the midwifery booking clinic at The Portland Hospital).
Gas and air
Nitrous oxide (NO2) mixed with oxygen reduces rather than takes away the pain. It works immediately and has no effect on the baby as you inhale it into your lungs. Within five minutes you have exhaled it out of your system. Some women find it makes them feel light headed and confused. Also if you don’t take a big enough breath (as many women don’t), then you may not get enough of the pain-numbing effects. So, if you plan to use this, have a run though with your midwife while in the early stages of labour so that you can perfect how to use it.
This is simple to administer. It is given as an injection into the buttock and lasts about four hours. The advantage is that it takes maximum effect within 20 minutes and can bring about a feeling of euphoria. It is especially suitable for women who have a long latent stage of labour before the active birth stage begins. The disadvantage is that it cannot be used in late labour as there is a risk of causing respiratory difficulties in the baby when it is born (although if given at the right stage there is no risk of this).
This is now the most popular form of pain control during labour and is really the gold standard because, at its best, it can totally block out the pain. The anaesthetist inserts a tube into the epidural space by the spine and inserts analgesia (low dose anaesthetic) which helps block the pain messages going to the brain. An epidural takes 20 minutes to work so, if you need something sooner, the anaesthetist can administer a spinal injection (via the same tube) which involves inserting a needle into the spinal fluid and giving a low dose of anaesthesia which works within one minute. There is no risk to the baby with this method of pain relief and, after giving birth, you are able to move around as normal within an hour or so. The other advantage is that if you do need a surgical procedure such as an emergency caesarean, then the amount of anaesthesia can be simply and quickly topped up through the tube already in your back. The downside is that for one in ten women, the pain block won’t be total because the anaesthesia does not spread adequately – so they may still be sensitive in some areas or on one side. This can be remedied by increasing the dose or re-siting the epidural. One in 100 women may get a postural headache when they sit up. This can be alleviated with an IV drip to replace fluid but in some circumstances may require further treatment.
For classes contact 020 7390 6068
The National Childbirth Trust
Tips on how to have a successful birth
Attending antenatal classes gives you an idea of what to expect and when. This can help cut anxiety during labour.
Make sure your partner also knows what to expect.
Ideally, they should attend antenatal classes with you but otherwise talk them through the stages of labour so that they are prepared too.
Have your bag ready.Being organised helps keep you calm. Remember the essentials such as a nightie that you don’t mind getting messy and small luxuries like music and lip balm to keep your lips moist during labour.
Have a supportive person with you.
That can be whoever you think will best do the job. It does not have to be your partner. Some women prefer to have their mother or best friend with them.
Consider pain relief options ahead of time.
Even if you want a natural birth, take time to consider different types of pain relief in case you change your mind. Making a decision in the middle of labour
is much harder.
Write a wish list.
Having a fully scripted birth plan can lead to disappointment and panic if things don’t go exactly as you wanted. A wish list of things you would like to happen, allows for more flexibility and has a greater chance of being realised.
By Lucy Elkins