Photo above by Danica Donnelly: Holly Palkowitsch of Eagan gave birth to her daughter, Wilhelmina, with her partner, Chris, by her...
Labor of love
In many ways, our notion of pain during labor comes from cultural expectation, including basically every birth depicted in scripted TV. Mothers scream and sometimes become cartoonishly violent toward their spouses.
It’s high drama.
But for a growing number of women, even in the U.S., childbirth is viewed as an intense, but not necessarily painful experience. In fact, some women do describe labor as — honestly — orgasmic.
“In the U.S., women have a skewed view of birth,” said Minneapolis-based certified doula and evidence-based birth instructor Anne Ferguson. “We primarily hear about births that are long, difficult and fraught with drama. One of the main reasons women experience pain in childbirth is that they expect to. The fear-tension-pain cycle is very real.”
Consider the word: labor. This is work! While the experience of birthing is multi-faceted, it almost always comes with certain discomforts, challenges, worries, fears and — most certainly — hard work.
How will I cope?
As women move through gestation, they at least consider — and often sporadically panic about — the pain associated with labor. This is particularly true for first-time pregnancies.
Questions loom: How will it feel? What can I handle? What’s best for my baby?
ALL women — both those who birth in the woods under the stars and those who order the epidural from the car on the way to the hospital — call on different comfort measures to cope with the sensations of labor.
“There are so many different options,” said Allanna Skoogman, a labor and delivery nurse at Regions Hospital in St. Paul. “Often during a labor, you’ll get involved with many — pharmacologic or not. It’s the same process for everyone, essentially, but every woman does it differently.”
It’s important to at least familiarize yourself with the options — all of them! Read up. Explore. Ask around.
Talk to your partner. Dig deeper into the options you instinctively favor, but have an open mind about the alternatives.
Remember that there are no right or wrong choices.
St. Louis Park mom Daisy Simpson used Hypnobabies techniques during the birth of her son, Isaac.
Delivered by IV, the opioids Demerol or Stadol claim to “take the edge off” during labor. However, the drugs often leave women feeling nauseated, dizzy and drowsy.
Another concern is that they do cross into the baby’s bloodstream. Baby, too, can become drowsy and therefore less of a participant in labor. The drowsiness can also affect post-birth bonding and breastfeeding success.
The use of narcotics during pregnancy is becoming less common, thanks to improvements in the way epidurals can be administered, including situations in which women can still get up and walk around.
Learn more at tinyurl.com/labor-narcotics.
Laughing gas is back and better than ever! Long ago, use of laughing gas for labor pain diminished because the then-recommended high doses were rendering women unconscious.
In the last year or two, the use of nitrous oxide has made a significant comeback in America — with women controlling how much and how often to dose. Most Twin Cities hospitals and birth centers now offer this option. But be sure to ask beforehand if you’re interested in the option.
“The biggest benefit is that it is safe for mothers and babies,” said Kerry Dixon, clinical director of the Minnesota Birth Center.
Nitrous offers quick onset and quick offset if Mom doesn’t like the way it makes her feel, Dixon said, adding that another big plus of nitrous is that it reduces anxiety.
“That’s right: It’s the only anti-anxiety medication we offer to women in labor,” Dixon said. “For many mothers it is not the actual pain or discomfort causing problems, it’s worrying about what MIGHT be coming next.”
Learn more about nitrous in labor at tinyurl.com/health-foundations-nitrous.
General: This means completely asleep and pain free.
It’s rarely used during labor these days, because it completely inhibits the mother’s involvement both throughout labor and immediately after, during the first few moments of the baby’s life.
Spinal: With this form of anesthesia, the
medication is injected into the spinal cord fluid.
It’s chosen for its quick effectiveness. The flip side is that it wears off quickly as well.
Because it’s administered in a single shot, the laboring woman doesn’t need a catheter. If given during labor, it’s usually given in conjunction with an epidural.
Epidural: It’s the most common form of pain management in the U.S. today.
Rather than being injected into the spinal cord fluid, the medicine is injected into the epidural space, or the fluid-filled area just outside the spinal cord.
An epidural numbs the woman’s pelvic region and is considered a highly effective form of pain relief. Risks include headache, allergic reaction, bleeding or injury around the spinal column, a drop in blood pressure, infection and, rarely, seizure.
“Epidurals are getting better all the time,” Ferguson said.“Though my leanings as a doula and hypnobabies teacher tend to be natural, I’ve attended some great births where an epidural saved a vaginal birth. I’ve seen ‘light’ epidurals where the mom could still push in a variety of positions.”
Some believe that a loss of sensation can lead to a longer pushing phase, which can lead to forceps or vacuum extraction, if not to C-section.
The statistics are improving, however, as control over the release of medication, which is delivered by a catheter in the mother’s back, is improving. Women can now control their own epidural flow, reducing or discontinuing the medication when it’s time to push.
Either in hopes of full water birth or for momentary relief, women are increasingly interested in the availability of birth and labor tubs.
It’s no secret that warm water soothes achy muscles and a tired body.
Learn more about water birthing at tinyurl.com/water-birth-mn.
St. Louis Park mom Daisy Simpson used Hypnobabies techniques during the birth of her son, Isaac — as well as hydrotherapy, massage, a supportive partner (her husband, Kyle) and, finally, an epidural — to manage labor pains.
The idea with hypnobirthing is to train beforehand to acquire the ability to move into a different state of consciousness during the painful stages of labor. Hypnobabies, a six-week childbirth class, is the most common program for this tool.
Several local doulas are trained in the practice and can serve as facilitators during labor.
According to the Hynobabies website, the process involves retraining the subconscious mind so that contractions in labor will be perceived by the body “as pressure or a squeezing-type sensations and/or pushing, pulling and normal baby-movement sensations.”
See hypnobabies.com for more information.
Even women who are wary of hypnosis class can benefit from the powerful idea of altering one’s mindset with some basic visualization. I’m at the beach; I’m in the mountains, at a Parisian cafe. You get the idea.
This local mom coped with labor pains with help from a doula, counter-pressure on her back and Hypnobabies techniques. Hypnobabies methods — taught in special childbirth education classes — involve moving into a different state of consciousness during the painful stages of labor. Because her baby was preterm, she delivered her baby in the operating room to ensure easy access to neonatal care at The Mother Baby Center at Abbott Northwestern Hospital in Minneapolis.
Gone are the days of laboring flat on your back in a stiff hospital bed.
Some women walk MILES during labor. Some lightly bounce or sway while perched on a balance ball. Some women find relief on their hands and knees, while others like to dance!
Even women using medical methods of pain management are usually allowed at least some movement while going through labor.
Particularly nasty contraction? Change positions or walk through the next one. Learn more at lamaze.org/movementinlabor.
The oxytocin rush we receive while kissing boosts happy, feel-good hormones while minimizing pain and anxiety.
An extra bonus is a relaxing of the entire sphincter system, which in turn actually helps soften the cervix and progress labor. At any rate, it can’t hurt! Unless, of course, you’ve crossed over into the “touch me and die” stage of labor.
The risk in kissing during that phase falls on your partner. Listen to your instincts.
“Often overlooked is a good support team — doula, partner, family. A third party to help you remember what your vision is can be really helpful,” Skoogman said.
A team of supporters can also offer TLC, breathing coaching, light massage or counter-pressure applied to the back, plus many other forms of emotional support.
While the laboring mother works and copes, her support team can help her remember her pain-management options as well as suggestions for what to try next.
Learn more about doula support in Minnesota at childbirthcollective.org.
Jen Wittes is a freelance writer and mother of two who lives in St. Paul. She’s helped many Twin Cities families in her work as a postpartum doula.
Megan Crown specializes in birth photography. Learn more at megancrown.com.
Lead photo: Minneapolis mom Annie Goldbaum worked with doulas and also relied on special positioning and counter-pressure on her back (including help from her husband, Jeffrey Goldman) to handle labor pains while giving birth to their daughter, Rosalie, at Methodist Hospital in St. Louis Park.
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