Yes - It will Hurt! How to Cope with Labor Pain
How can anyone possibly decide what and when they will choose for pain management before actually experiencing the pain? It has always puzzled me that women somehow think that pain management options need to be decided on in advance. For instance, some will say, “I KNOW that I am having an epidural!” To that, I would respond that it’s good to know that you are an epidural candidate and you should definitely communicate that to your nurse upon arriving at the hospital.
The important word when it comes to tackling labor pain is “coping.” It is important to understand the distinction between coping and suffering. Coping means you may still be experiencing the pain, but you are dealing with it, and it is manageable. When someone is no longer coping in labor, and now suffering, a change needs to be made. That change can often include the decision to utilize medication or an epidural. Questions to ask yourselves: Are you and your partner in sync and in a rhythm with the process? Are you making actual progress in labor? If you are able to release and let go in between contractions than you are coping. On the other hand, if you feel like you are being totally overtaken by the pain and are emotionally undone, than this is suffering.
I think it is a great goal to picture yourself moving through labor on your own steam. I also think it is unrealistic and unnecessary to be rigid as you anticipate labor. Remaining open and flexible to make decisions along the way gives you room to choose as your needs become known during labor.
Here are some tools to assist you in coping with pain throughout the labor experience:
Vocalizing: The human response to pain is noisy. The Best Birth utilizes productive sounds and moaning – either soft and chest-centered, or deep and guttural. Think about it: they call it labor for a reason! This is not a tea party; this is a gritty, primitive day out of your life. When you have the picture of yourself digging in and getting the job done, responding to the pain forcefully, moving it up and out – it helps you cope with the peak of the contraction, which can feel like a knife going in and turning. Not a pretty picture, but true.
The rhythm becomes:
1) as you feel the contraction beginning, take a deep breath;
2) breathe slowly as the contraction builds;
3) moaning through the peak where it is the toughest; and,
4) breathing slowly as the contraction subsides.
Resting: In between contractions, women in labor must be reminded and encouraged to release and let go, to utilize the break. This time is essential for building up energy to ride the next contraction. Labor is not a tsunami that knocks you flat in one big wave; the contraction comes, builds, peaks, and subsides and goes away for three, five, 15 minutes, depending on what point of labor you are in. During the rest period, partners can really move in and make a big difference with touching, holding, massaging, hydrating, and giving words of encouragement and reassurance.
Medication: Labor narcotics are often overrated, giving the impression that they will provide complete pain relief or send the woman floating on a billowy cloud. Neither one is accurate. The medications used for pain relief in labor are fast-acting, short-lasting narcotics that take the edge off the contraction’s peak. Some women will respond to these narcotics by being able to release and let go in between contractions and simply be able to cope more efficiently through the contraction, or nod off in between them. Others report feeling no relief at all and opt to move straight to an epidural. Note – contrary to what you may think, it is not always possible to receive an epidural immediately upon request. Based on the anesthesiologist’s schedule and the number of people requesting epidurals, you may need to wait. A dose of medication may assist you through this waiting period, knowing that relief is on the way.
Epidurals: Epidurals often get a bad rap – they get blamed for the inability to push, slowing labor down or creating back pain. By and large, a labor epidural is a viable option to replace pain with a sense of pressure. It is an intervention, and the decision to have one needs to be made carefully. The Best Birth recommends you make as much progress in labor as possible before choosing an epidural. Once you have an epidural, you will be in bed for the duration of labor and will often end up being “wired for sound” – meaning that the cascade of interventions – including intravenous (IV) fluids and a foley catheter – will begin to unfold.
One point not often included in discussing epidurals: they can be the mechanism that assists someone in achieving a vaginal birth! When the body can be pain-free, in a total state of relaxation, void of the tension created by pain, the uterus can then really do its job.
The decision to choose an epidural should not be made lightly. However, if labor is marching on hour after hour and progress is not being made, or if someone is not coping and is now suffering, an epidural can be a very appropriate pain management option.
About the Author
Sarah McMoyler, RN, BSN and mother, is the founder of McMoyler Method (www.mcmoylermethod.com). An acclaimed childbirth, perinatal and newborn care educator and author, McMoyler has been a labor and delivery nurse for more than 20 years, assisting in the delivery of more than 5,000 babies. Combining the best of last century’s Lamaze and Bradley methods, along with Sarah’s medical know-how and highly engaging, realistic approach, McMoyler Method is this century’s essential guide to labor and delivery. With more than 12,000 San Francisco Bay Area graduates who rave about their birth experience thanks to McMoyler’s approach, the same class content is now also presented for an international audience through The Best Birth DVD (www.thebestbirth.com) and her book The Best Birth: Your Guide to the Safest, Healthiest, Most Satisfying Labor and Delivery.
