Monday, 5 December 2011

Pain Free Labour the book.

Hi everyone, finished the book 10 days ago and am still waiting to hear from the publishers. The more time that goes by the more I worry. What if they don't like it?
The last response I received from Amy at Carroll and Brown was a comment on the tiger in the post: Why Labour Hurts 3 - "Imagine you are a cave woman coming toward the end of your labour when a Sabre toothed tiger appears at the cave door. OMG. The first thing you would do is to release adrenalin into your system so that you have extra energy to run away or stay and fight. But 'Oh No' your cervix is nearly fully dilated, if your baby is born now then the tiger will think its her birthday and celebrate with a very fresh human, covered in a tasty liquour dressing accompanied by a side order of bloody placenta. Yum"
Amy said it was a bit OTT. I think she meant Over The Top. She may have meant One Terrific Tale.Who can tell. If that was Over The Top then the bit about medical men burning midwives at the stake, and calling us witches, just to take over our practise in bygone days, may not have gone down very well. I will let you know if there is any book left to publish after they have finished with it. Wish me luck, Ann x.

Monday, 10 October 2011

Due to another project this blog will close for a while. You now have all the information that you need to enjoy a pain free first stage of 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.
I will let you know how my other project is going, have you ever tried to write 25,000 words. It's not frelling easy I tell you. Good luck, I will be thinking about you. All it takes is to believe. Ann xxx.

Wednesday, 14 September 2011

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.

Sunday, 11 September 2011

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.

Thursday, 1 September 2011

Pain free labour for Tailor, sorted.

I was caring for a young lady having her fourth baby, a girl after 3 boys just like me. On taking over her care from the night staff I found Tailor sat on a birthing ball leaning forward on the bed using entonox. She was very tense and when she had a contraction she was crying with the pain. I knelt down next to her and started talking her through the contractions, teaching her how to relax her shoulders and then the rest of her body. It took her about 15 min to master the relaxing and she was amazed at how the contractions did not cause her any more pain. She was able to remain relaxed and started laughing and joking with her family who were very supportive. We got to 10 cm dilated in no time at all now that her cervix was not being held shut by adrenalin (see why labour hurts 3).
I cannot pretend that the second stage of labour is pain free cos you have a bony head stretching your perineum, have you ever had a Chinese burn? It is something like that! Tailor got onto the bed and adopted a hands and knees position. It is always so much easier to give birth in this way as the pelvic outlet is bigger and there is less pressure on the perineum, an English burn instead of a Chinese one, maybe? Taylor was brilliant throughout and soon gave birth to a beautiful bouncing baby girl delivered by my lovely student Jo. Awwww.

Saturday, 20 August 2011

Questions asked about a pain free labour 3

Isn't lying down on the bed the most comfortable way to labour?
No, lying down in labour is the worst position that you can be in. Whilst labouring with my third I was forced to lie in a semi sitting up position whilst on a CTG machine, lay on a bed, and was in agony with the contractions. See the post - The third. Sitting upright or standing or walking about allows your uterus to work with gravity. If you lie down then the contractions have to become stronger as they are working against gravity. See the post - Staying upright and Why labour hurts 4.
You may think that you will be in labour for hours and hours and staying upright will become a major pain in the bum, literally. If you are calm and doing one of the relaxation methods outlined in this blog then your labour will be a lot quicker as there will be no adrenalin holding your cervix shut. I have noticed that women who are relaxed and in control in labour have much shorter labours. Then you can get back into bed and cuddle your brand new beautiful baby and lie down as much as you want. Till the meconium starts flowing and you have to get up to change the first nappy, EW!





Saturday, 13 August 2011

Questions asked about pain free labour 2

Why is my cervix not dilating when I am having contractions?
This is the question that I get asked the most. Women start having contractions and become stressed cos they think they will be in a lot of pain during their labour. This stress leads to the automatic production of the hormone adrenalin. Adrenalin receptor sites are present on the cervix. The role of these receptor sites is to protect the baby from being born whenever there is a danger present that will cause mum to secrete adrenalin. Modern mums are taught to fear labour for the pain they think they will suffer so the adrenalin produced attaches itself to the cervix and stops it opening. See the post -Why labour hurts 3.
 Labour is not meant to last days and days. Sometimes it is a simple matter of the baby being too big and not fitting in the maternal pelvis, this is often known before labour starts and the labour sill be watched carefully. Other times it is a matter of not giving the uterus enough energy to burn by not eating small regular meals in labour, carbs are the best. Most of the time a long labour is caused by adrenalin holding the cervix closed cos mum is producing abnormal amounts. See the post - Relax with progressive muscle relaxation, for the method I used for my pain free first stage of labour. See the post - The second. Getting to 10 cm dilated has never been so much fun. xx.

Wednesday, 3 August 2011

Questions asked about pain free labour

Questions asked about a pain free labour by women in my care as a midwife.
The first reaction women have when introduced to the concept of a pain free labour is disbelief. This is not surprising when you consider how society as a whole presents childbirth to us as an unavoidable, extreamly painful event. Once a beliefe system of this magnitude is in place it is almost impossible to erode or challenge. If anyone is brave enough, they are usually rewarded with ridicule and scorn. Little wonder women today are reluctant to even envisage the very idea of labouring during the first stage of labour without the sensation of pain.
The only concrete evidence I can give women with questions regarding beliefe is that I personally have experienced two pain free out of four labours - see posts in this blog The Second and The Fourth. Some women in my care in labour have also benefited from learning how to relax and so not produce adrenalin in labour. Adrenalin is bad cos of the negative effects it has on the labouring body - see the posts Why labour hurts 2 and 3.
I tell women that it is always beneficial to practice your relaxation method in the pregnancy so that you are used to it by the time labour day arrives. This way you can stay calm and start relaxing as soon as the contractions begin. So when women ask me if a pain free labour is really possible I say yes if you approach it with a birth plan that includes relaxation techniques.
We need more women to come forward after experiencing a pain free labour using coping strategies outlined in this blog. This will help chip away at the belief system that is painful labours. Feel free to leave messages on this blog to spread the word, my lone voice is just not enough.

The Fourth

When the midwife arrived for my home birth I was found to be 5cm dilated. We made the bedroom ready and then went downstairs for a nice cup of tea. I was able to sit and run through my relaxing technique (see the post - Relax with progressive muscle relaxation) and the contractions caused me no pain at all, bliss. However, I don't think the midwife was convinced that I was in labour as she didn't call the second midwife to attend. In the middle of News at Ten, whilst sipping tea and eating biscuits, I instinctively threw myself off the couch onto the floor shouting "My waters have gone and I want to push". The midwife took one look at my sanitary pad and asked my husband to ring the doctor and ask him to come immediately as I was losing meconium stained liquor. This means that the baby has been stressed at some time in the pregnancy or labour causing their bowels to open and contaminate the amniotic fluid surrounding the baby. If any of this meconium is breathed in by the baby at the birth it can have very serious consequences. "Can you make it upstairs?" my midwife asked me. The contraction was ebbing away and so I composed myself and we both sprinted for the stairs. I had planned an upright or hands and knees birth, my midwife asked if this was still the plan but I just threw myself on the bed saying "Just get it out". The head was out in seconds. My midwife was saying to me "Don't Push" as she struggled to get her pack open and suction my baby's mouth and nose to help prevent inhalation. Research has since shown that this practice is of no benefit with meconium stained liquor and in fact can cause harm. I kept saying, "Can I push yet, can I push yet?" just like an annoying child on a journey asking "Are we there yet?" At last she said I could push and my baby shot out into the safe hands of my lovely midwife. I still have dreams of giving birth where my baby shoots out and falls off the end of the bed and I have to follow the cord to find him, my babies are always boys in my dreams. I was having a home birth due to the cruel and heartless way I was treated with my third in hospital, he was taken away before I had a chance to see him 'for a bath' and put back into the farthest corner of the room leaving me aching to hold him. This time my baby was delivered onto my tummy and I was able to see my poo stained bundle of joy for the first time. My gorgeous girl had arrived. I was complete. The wonderful GP who had taken me on for my pregnancy and home birth gave us both a clean bill of health and then left us to it. My second pain free labour. I should become a midwife and help spread the word that most women don't have to suffer painful labours, and here I am. Sorted.

Monday, 25 July 2011

Empowered Birth Awareness Week

Empowered Birth Awareness Week starts on the first Monday in September and lasts for one week, naturally. It is a way of reaching out to women all over the world and empowering them to gain confidence in their ability to bear and birth their children without fear and in a positive manner. This can mean lots of different things to each and every individual woman. The central message is to take control and question everything that health professionals present to you. Research births on the Internet cos there is sooooo much info out there regarding birthing in a way that suits you. If that means you are posh spice and having your gizilienth c section then so be it. If however, you are not too posh to push, then join the Awareness Week available on facebook to push back against the constant creeping shadow that is medicalisation of the birthing process trying to swallow us whole. Join together during Awareness Week and celebrate just how wonderful we women are, sorted.

Sunday, 10 July 2011

Past pain free labours 3

During the 1970s and 1980s, there was a social shift to accepting hospital births as a norm, local doctors in the comunity offered a intermediate service which allowed women to be cared for and birth in a GP Birthing Centre. A wonderful midwife who I have worked with for many years, was working at a GP birthing centre during this time. These centres were very popular for low risk women who could attend and give birth with a community midwife they knew well. This was a homely setting which added to the women feeling at ease. During the 18 months Margaret worked there, none of the women she cared for needed any pain relief. They were calm and relaxed and able to move around freely in the company of someone they trusted. Moving around freely and staying upright is an inportant factor with pain free labours as discussed in the post - Staying upright.
Politics have taken natural childbirth away from women today and the GP Birththing Centres have been closed down. We have taught women to fear childbirth by expecting them to attend large medical institutions that can only see childbirth from a medical point of view.
OK, for a small percentage of women who undergo a home birth, transfer into hospital may be required but that should not mean that all births should take place there. Having said that, as a hospital midwife, I have had some lovely births in hospital after teaching mums how to relax in labour discussed in the post - Relax with progressing muscle relaxation. And it has worked a treat. So hospital is not a bad place to have your baby if you have the right support. There should be access to a birthing pool where relaxation is enhanced by the warm water. However, you have to be confident and in control of your labour and insist on staying upright and on having some peace and quiet in order to run through your chosen relaxation method. I always darken the room and make as little noise as possible during a normal low risk labour. You can labour safely in hospital but you will be more relaxed and in control at home. See the post - Home birth - for help in the Manchester England area for help and support in booking a home birth.

Wednesday, 6 July 2011

Past pain free labours 2

In her book 'Safer Childbirth?' Marjorie Tew outlines the move from mainly home births in the UK to mainly hospital based care and the effects this move had on childbirth. By the 1080s it was generally accepted that a "medical institution" was the place to give birth. Tew explains how this move led to women feeling less self-confident about birth, feeling that control of their bodies had been taken away. In her book Tew describes how women coped who underwent home births before the nationwide move to hospitals - "Having no fear, her body like her mind was relaxed and allowed the automatic processes to be completed with the ease with which other animals reproduce". Tew was obviously aware of the effects of adrenalin on the cervix discussed in Why labour hurts 3, when she stated "The body's response to the stimulus of fear is tension, affecting in particular the circular muscles of the cervix and causing them to resist dilatation. This causes pain and reinforces the vicious circle of fear-tension-pain." 
Reading her book is a little depressing but it is becoming clear why women simply do not believe in a pain free labour. In 1892, doctors were taking over the birth process which in their opinion could no longer be regarded as natural. "Throughout the 20th century, the incessant stream of propaganda has continued to capture public opinion, to make everyone believe that childbirth is fraught with dangers against which only care by obstetricians can protect."
In other words, we have been brain washed for generations. Well, now is the time to WAKE UP and take back control. Childbirth is a big industry, lots and lots of money is invested in keeping women pliant and keeping them in pain so that hospital medical interventions can be justified. If the majority of women suddenly started having low intervention pain free labours, hospitals would be thrown into disaray. Jobs would be lost and the system would have to change big time. People do not like change.
I am not saying that we will never need the services of obstetricians, there are always high risk women who will continue to need their specialised help. I am saying that for the majority of low risk women, there has always been a chance to choose. I chose to go pain free, what will your choice be?

Wednesday, 29 June 2011

Past pain free labours

Pain free labour is not a new concept. People for generations have been aware of the fact that labour contractions are not meant to cause pain.
Doctor Grantly Dick-Read was born in Britain in 1890, he studied at Cambridge University and practiced at the London Hospital. He noticed during his work that labouring women, who were not afraid of childbirth, did not require any pain relief. In his book, Childbirth Without Fear, he outlines why women feel labour contractions as painful. "Pain in an otherwise uncomplicated labour arises from the activation of the sympathetic nervous system by the emotion of fear." That is the actions of the hormone adrenalin outlined in my post: Why labour hurts 2. "A labour without disproportion or malpresentation of the baby is long because it is painful, not painful because it is long." In this statement he is referring to the cervix being held shut by adrenalin causing the contractions to become stronger and making the labour much longer as discussed in the post: Why labour hurts 3.
As you can see, during the 1940s when Dr. Dick-Read's book was first published, a pain free labour was often had at home by women who were not afraid to labour. I don't know if the good doctor recommended any relaxation techniques in order to have the best chance of experiencing a pain free labour, he does however outline hypnobirthing which must have been in its infancy during that time.
Dr. Dick-Read's book is an interesting read as a historical text book. It is however not relevant to today's women who don't want to plough through a lengthy book just to extrapolate the information you can glean just from reading my blog. Sorry Dick.

Wednesday, 22 June 2011

It was like flipping a switch.

A young woman arrived on labour ward saying that she thought she may be in labour. It was her first baby so she said that she didn't know what to expect, what labour felt like. She almost apologised for her arrival as the contractions were not causing any pain, just a little back ache, so she thought she was wasting my time.
I sat her down on a padded chair and placed my hand on her abdomen to palpate her contractions. They were coming every 3 minutes and felt moderate in strength. After examining her cervix I pronounced that she was not in fact wasting my time and that she was in labour.
It was like flipping a switch. While she thought she wasn't in labour, she was calm and collected and coping well with the contractions. As soon as labour was confirmed the fear set in. I could see it in her eyes. I tried to address her fears by saying that she had been in labour all morning and not felt any pain, so why should it become painful now? I explained about adrenalin starving the uterus of oxygen and attaching to the cervix to prevent it from opening, but it was too late.
The widely held belief that labour contractions are meant to be painful is so deeply embedded that with some women, it is impossible to erase. After she found out she was in labour she was a different person. The family were sent for and she sobbed into her mothers arms. When I explained to her mother how well she had been coping in labour beforehand, and that she could continue with her pain free labour I was told to get the anaesthetist quick for an epidural. "Can't you see that my daughter is in pain?"
Generation after generation the legacy of painful labours is passed down. How can anyone compete with that. All I can do is keep repeating the mantra - Smooth muscle is not designed to cause pain when it contracts under normal circumstances. One day the message will get through. Please help spread the word.

Monday, 30 May 2011

A pain free labour for Maisy, sorted.

Last night I looked after a young lady who I shall call Maisy. She arrived at our labour ward in the early hours of the morning in labour. She was very distressed and in pain, so much so that she could hardly walk. After assessing her cervix to see if she was in labour I managed to calm her down by explaining why her contractions were causing pain. I then taught her the progressive muscle relaxation technique and sat her on a birthing ball.
When someone has entered the stress/pain cycle it can be very difficult to pull them out of it by getting them to listen to you and understand what you are trying to tell them. To her credit, Maisy listened to everything I said and very quickly began to reap the benefits. To her amazement the contractions stopped causing her pain. She was able to breath through the contractions sat on her ball with wonderful support from her partner who remained calm all the way through. When offered analgesia she declined saying that she was no longer in any pain.
Maisy went on to have a lovely normal delivery in a kneeling position on the bed. I am not going to tell you that the second stage was pain free cos that would be silly. As that head is crowning the perineum gets stretched and stings a lot. But Maisy was wonderful, she listened to me - when to push and when to pant - and we had an intact perineum. Her baby was alert and awake and fed at the breast within an hour of the birth.
Looking after Maisy was a delight. It makes the midwives job so much easier when mum takes control and breaks out of the stress/pain barrier. If Maisy can do it then why are you still telling yourself that a pain free labour is not possible, all it takes is to believe.

Friday, 20 May 2011

Hypno Birthing in Manchester, England

According to my local news station last night, Hypno birthing is being offered at Tameside hospital in Manchester, England. Hooray, at last a mainstream hospital is beginning to see the advantages of a pain free labour. They must be a lot cheaper to offer than epidurals. They call it Hypno Birthing but that may put a lot of people off. You are at no stage hypnotised so the name is misleading to say the least. All that is being offered is what I am offering in this blog. That is, using relaxation techniques learned in pregnancy and used during labour so as not to enter the stress/pain cycle that I see with most labours. Well done Tameside, the revolution has begun.

Saturday, 14 May 2011

Relax with progressive muscle relaxation

For my two pain free labours I used progressive muscle relaxation as a technique to ensure that I did not secrete adrenalin. I was sat up on a comfortable padded chair with my eyes closed to begin relaxing. I focused on my feet, making them feel heavy and imagining the tension in them drifting away like a mist. When my feet felt very relaxed I then moved on to my legs then chest then arms and hands. The shoulders and neck should be given extra time to relax as most of our tension is found there. Just take a few extra minutes to feel them relax and imagine all that tension and stress drifting away. The head is next followed by the face. There are a lot of little muscles in the face so it is best to do the muscle relaxing there in stages. First the forehead, then the area around the eyes, and finally the jaw and mouth area.
Once you are fully relaxed, you have to keep going back to check that no tension has crept back into bits of your body, especially the shoulders. If a contraction occurs while relaxing it should be ignored with the mind focusing on relaxing the neck and shoulders. Your chosen method of relaxing should be practiced in pregnancy so that when labour day arrives you can start to relax easily and quickly before each contraction.
Of course, there are people who are incapable of relaxing. Coffee drinkers are adrenalin junkies and find it difficult to sit still for 5 minutes let alone relax and become tension free for a whole labour. Any caffeinated drinks are therefore not desirable as refreshments in labour.
Having a good social support system in place is beneficial as it will stop you stressing about other children or dependants. Being organised by having your bags packed and ready will reduce stress levels, you would be amazed at the amount of women who turn up in labour with a half packed bag. You've had nine months for goodness sake.
And finally, it is essential that your birth attendants are calm capable people who know exactly what your birth plan is so that they can negotiate with hospital staff instead of you risking getting stressed. Better still, stay at home and organise a home water birth. What better way to relax than to be in your own home, eating your own food and watching your own TV programmes. ZZZZZZZZZZZZZZZZZZ This technique is also fabulous for getting to sleep at night.

Monday, 9 May 2011

Why labour hurts 5

The focus with our maternity units today is mainly centred on pain relief. From the moment you enter a labour ward your contractions will be called 'pains' by midwives and doctors alike. The British TV programme 'One Born Every Minute' included recently an interview with a midwife stating that women should expect to be in "agony" during their labour.
With all the social conditioning aimed at convincing us that labour WILL be painful, we are brainwashed into thinking that we cannot possibly even contemplate going into labour without intensive medical help. It is therefore not surprising that women today fear childbirth. If I was told that I had a hospital appointment next week where I would be in acute agony for hours and hours then my adrenalin levels would start rising now and accumulate on a daily basis as the dreaded day drew nearer. With pregnancy you have nine months to hone that fear. Little wonder that women present in labour shouting for an epidural before they have even got through the hospital door.
The fear of labour is so instilled into out society that it will be very difficult to overcome. Until the fear is seen for what it is - a cause of painful labour contractions - then the "agony" will continue.
A self fulfilling prophesy.
Help break the mould by spreading the word of Pain Free Labour by following the simple steps outlined in this blog and posting your outcomes for all to see. Thank you.
Pain Free Labour books now available from Amazon.

Friday, 1 April 2011

Relax with meditation

Meditation is used to focus the mind and combat the negative effects of stress. It brings together mind and body so that they work in unison more easily. There are different ways to meditate, you don't have to be sat still as it also works whilst on the move. A focused calm mind will automatically calm the body, reducing adrenalin output which is vital for a pain free labour.
For best results in labour:
  • Sit upright in a quiet environment making sure you are well supported and comfortable.
  • Focus the mind with a meaningful phrase ('pain free labour' will do) and repeat it in your mind while relaxing.
  • Or focus on an object in the room and work at emptying your mind of all else.
  • If other thoughts intrude, work on fading them away as soon as you realise your mind has drifted. It is quite difficult at first but gets easier with practice.
  • Similar to progressive muscle relaxation, you can conduct a body scan whilst meditating. Focus on parts of your body from the feet up but instead of telling them to relax you just note how they feel and move on.
  • Practice meditation for at least 10 minutes a day to get really good at it.
Any relaxation technique when practiced regularly brings your body and mind into balance whilst increasing energy levels cos you are not wasting resources having unnecessary panic attacks throughout the day. Stress hormones are reduced along with their harmful effects on the body.
Finding a technique that appeals to your lifestyle and preferences is vital. When you find the one that best suits you it can be used throughout the pregnancy so that when labour begins you will not instantly go into panic mode. If you do then you can pull back and start to take control by practicing relaxing in a way that suits you best.
Progressive muscle relaxing worked for me in my two pain free labours. I still use it today more than 20 years after my forth was born and it can work wonders at reliving the stresses of everyday life.

Thursday, 17 March 2011

Home birth

Booking a home birth is not as simple as it should be. When I set out to book my home birth in 1990 I had to go through my GP. Thankfully this is no longer the case and you should be able to book a home birth with your midwife at the booking interview. Useful web sites include www.homebirth-manchester.org/ and www.homebirth.org.uk/ where advice is available on how to go about ensuring your chance to choose. My GP said "No way, it is far too risky". So I went to my local library and looked up GPs in my area. I rang round till I found a GP who would accept me for care in the pregnancy and birth only. When my GP found out that he would not be getting paid for my care I was called into his surgery and given a right old telling off. I would however not change my mind as after my third birth I had vowed never to present at a hospital in labour again. Statistics for home births in the UK remain quite constant at around 2.5%. This figure could change with the current government's love of cuts. There are not enough midwives to cover all the hospital births so home births will be seen as a luxury that the NHS may not be able to support. If you have trouble arranging your home birth you can contact Beverley Beech at AIMS (Association for Improvements in the Maternity Services) who has promised to look into any obstacles. Beverley can be contacted by e-mail at chair@aims.org.uk or by post at 5 Ann's Court, Grove Road, Surbiton, Surrey, KT6 4BE. As a student midwife I was constantly offering women a home birth at booking when they were low risk. This behaviour was not looked upon with glee by my mentor who was not known for supporting women wanting a home birth. You have to be pushy and keep asking. Go to meetings run by homebirth-manchester and gain confidence from other mums with the same quest. You are more likely to have a pain free labour if you are at ease in your own home. If you have been practicing the relaxation techniques in pregnancy then you will feel more comfortable continuing the relaxing in labour in your favourite chair. Hopefully you will know your midwife from visits in the pregnancy and had a good chance to discuss the birth in detail so you know what to expect. Pregnancy and birth is not an illness for most women. Having a baby at home is not as scary as people will lead you to believe. In fact, home births can be wonderful. My forth was born at home and was my second pain free labour. Awesome.

Friday, 11 March 2011

Girl or Boy: your chance to choose?

When my youngest son was 4 years old I had an unsettled feeling that something was missing from my otherwise lovely life. Someone was missing. After three boys I began to long for a daughter. Down to the library again to research choosing the sex of future offspring (there was no Google then OK). I found a wonderful little book entitled Girl or Boy: your chance to choose by Hazel Phillips and Tessa Hilton (available from Amazon for 1p). Apparantly, girl sperm are heavier than male sperm cos they have more genetic material, no surprises there then. This means that they swim slower than the boys and get to the egg three days after ovulation rather than on the day. I took my temperature every morning before getting out of bed and plotted it on a home made graph. To my surprise my temp went up by half a degree once a month, ovulation day! I did this for three months just to test the reliability and it was like clockwork, super. For a boy you have to take precautions for the first half of your cycle and make love on the day of ovulation and for the rest of the month without precautions. For a girl you don't take precautions for the first half of the cycle up to three days before ovulation, after this precautions should be taken. Easy peasy. Phillips and Hilton also advise a special diet, not so easy peasy. For a boy, if I remember right, you eat as normal with salt not restricted. For a girl you need a salt free diet, Euwww! For three months I made my own bread that only me would eat cos it was so yuk. I had to tell my work mates, the school dinner ladies, that I was on a diet and that was why I was eating blocks of concrete for my lunch. That school chocolate pudding with pink custard never looked sooooo good. After three months of trying I found myself pregnant, thank you Paul for all your hard work! Girl or boy, nine months has never gone so slowly.

Monday, 7 March 2011

Relax with deep breathing.

From comments made by friends and family it appears that not everyone can relax with my method of progressive muscle relaxation. I am therefore willing to research other means of getting relaxed for labour for these fuss pots.
Deep breathing is a method of relaxing that is most suited to people who usually find it very difficult to switch off and chill out. As well as having something physical to do, the mind is also occupied. It is a quick way to get stress levels into check before they spiral out of control. Can also be combined with other methods of relaxing such as aromatherapy and mood music.Deep breathing will get more oxygen into your system which will oxygenate your contracting uterus and help produce energy there more easily. This means that the uterus can contract more easily and so not produce the sensation of pain.
  • Sit comfortably upright with your back supported.
  • Breath in deeply through your nose. (Some of you may need to blow it first)
  • Aim the breath at your abdomen rather than your chest, this is diaphramatic breathing.
  • Exhale through your mouth, pushing out as much air as you can.
  • Count slowly as you exhale so you have something simple to focus on.
  • Try and empty your mind while breathing of everything except the movement of air going deep into your abdomen.
You need to practice deep breathing for at least 10 to 20 minutes a day to gain the most benefit. It may be a little difficult with a pregnant uterus pressing against your diaphram but should still be possible. This method of relaxing also massages the large bowel so problems of constipation often experienced in pregnancy can be relieved. And from a midwifery point of view, going into labour with a nice empty bowel is a big bonus, honest!

Tuesday, 1 March 2011

The Third

After a sweep at 39 weeks into my third pregnancy where if felt like the doctor was examining my tonsils while she was in there, I went into labour. I wasn't concerned or at all worried. My last labour had been pain free so this one should be a doddle. I did my relaxing techniques at home till the contractions were regular, there was no pain. I duly arrived at the hospital and explained to the midwife how I just wanted to sit in a chair and relax as I had done with my last labour. Oh no. She wanted to put me on a CTG monitor even though I was low risk, the NICE guidelines have since put an end to unnecessary CTG monitoring in labour. While on the monitor I kept trying to sit up and do my relaxing but the midwife kept pushing me back down. I tried to relax in a semi sitting position but it just did not work and I was in a lot of pain. I explained this to the midwife and she said I had to stay on the monitor, she was becoming a little tired of me moaning and eventually said "Do you want your baby to die?" That shut me up. However, at no time did anyone look worried, no doctor came in the room to look at my CTG. I think she was lying to shut me up. All I wanted to do was sit up and relax. Was that too much to ask? Eventually after a lot of unnecessary huffing and puffing, I gave birth to my third little boy. Before I could look at him he was taken away "for a bath" the midwife said. A support worker came in to clean me up and I asked about my baby, she looked worriedly at the door and said he would be brought back soon. Half an hour later he was pushed into the room in a cot and put into the farthest corner away from me. "The midwife said that he is not to be disturbed" I was told by the support worker and then she left. I stared at the little white bundle for a while. Every fibre in my body was aching to hold him but by this time I felt totally disempowered. With my stress levels at maximum I decided to risk all and ring the buzzer, the support worker came in. I asked to be handed my baby, she quickly gave him to me with a guilty look and then left without a word. I was finally able to look at my beautiful little boy and offer him his first breast feed. I did not skip home the next day. I was a victim of institutionalized torture and would carry the scars for the rest of my life. I decided then that if I ever had a fourth then I would never ever, ever attend a hospital for the birth again. The maternity services had totally lost my trust. It would have to be a home birth. All I had to do was to persuade all the other interested parties that it was a good idea. Game on.

Wednesday, 23 February 2011

The Second

After the trauma of my first birth I have to admit that I lied about the date of my last menstrual period when booking with my second. This was to buy me some time in case they wanted to induce me again - no way. I had researched natural births and had a pretty good idea how to make my second much more natural and hopefully less painful. I woke up with painful contractions at 01.00 Hrs. at term + 7 days. I went downstairs and started doing my relaxing as outlined in a previous post. To my amazement the contractions stopped hurting but still kept coming. I made my way to hospital alone, my husband was minding our first born. The labour ward was very busy with an emergency so I was assessed and left in my room. This suited me well cos I was able to sit in the padded chair and do my relaxing. The contractions did not hurt at all and I have never felt so relieved and happy. The midwife came back and told me that she did not think I was in labour as I was far too comfortable, but she wanted to check my cervix anyway before I went to the AN ward. I was fully dilated. She was amazed. I had no urge to push so she left me on the chair to relax. Half an hour later I wanted to push. It was a struggle as he was bigger than my first. I was put in a position I now know as McRoberts cos he was coming too slowly. The midwife passed a catheter to empty my bladder -OW - that was the most painful event of the whole labour. I eventually pushed out my gorgeous big baby boy and I felt elated, I had achieved exactly what I had set out to. A pain free labour (if you don't count the catheter). I could have skipped home the next day if I hadn't had a new born baby in my arms. I now knew that if I chose to have a third, I could look forward to a fabulous pain free labour. O dear Lord. How wrong can one person be?

Tuesday, 22 February 2011

Hypno Birthing

After just watching last weeks OBEM I had to look into this hypno birthing lark. It seems to be an American thing, You Tube have some very convincing clips. One of the docs in a clip said "They are not pains, they are contractions", music to my ears. However, you don't have to be hypnotised to have a pain free labour, my methods work just as well. Sandy, the young lady on OBEM, who was striving for a hypno birth made one fatal error. She did not remain upright. What, is there a water shortage in Southhampton, the birthing pool was only half full and Sandy had no choice but to lie down as she would have gotten cold otherwise. No wonder she was begging for a dose of Pethidine. When she was more upright I noticed that she coped a lot better. My method of relaxing is perhaps not as deep a state as hypno birthing, but as long as it reduces your adrenalin output, it will give you a pain free labour. As long as you remain upright. Plus, if I had my mum gripping my head, like Sandy had, whispering tosh into my ear as well as having to listen to bad Chinese restaurant music, then there is no way I would have remained relaxed. I would have pulled her into the pool to shut her up and run off screaming just to get some peace. The hypno birthers have nearly got it right. Relaxation is the key but staying upright so that the uterus is not working against gravity is an important factor. Now then, for anyone out there who is related to me - you are feeling very sleepy, you will send me lots of pressys and cards for my birthday next month, OK, you can wake up now. He He He.

Saturday, 19 February 2011

The First

My first pregnancy ended, as many firsts do, with high blood pressure leading to induction of labour (IOL). I did not need a prostin pessary as they were able to break my waters and I was started on an oxytocic drip. From that moment on my whole world changed as I was brutally introduced to extreme and unrelenting pain. As a defensive mechanism I curled up into a fetal ball and escaped into the apparent safety of my own mind, hiding there away from the trauma being inflicted on my pregnant body. At one stage I remember opening my eyes to peep outside my refuge to see my husband eating the packed lunch that he had brought with him. As I watched him munching on his tuna sandwiches I marvelled at how the world was able to carry on turning unperturbed in my hour of need. I decided that it was safer inside as the pain was still there so I closed my eyes and went away. Not long after this I felt a sharper pain in my leg and found the midwife injecting me with something. I never did find out what it was, pethidine perhaps? It was amazing how during the 1980s you could be given any treatment without your consent. My concept of the world became fuzzy after that as I settled into an even deeper catatonic state. I surprised everyone then by proceeding to push my baby out in record time resulting in bi lateral 2nd degree tears that took an hour to suture. But I had done it. I had survived. My reward was a beautiful little boy who I fell instantly in love with. After this trauma I set out to find another way to labour. There was no way I would ever allow myself to be tortured during childbirth again. My findings led me to discovering the hidden truth, labour contractions are not meant to cause pain. I vowed that my second labour would be different, and it was.

Tuesday, 1 February 2011

Staying upright

One of the most important steps toward a pain free labour is to stay upright. Don't worry, it doesn't mean that you have to stand up for hours on end. Sitting in a comfortable chair or firm couch will do. You can also kneel on the floor leaning forward on a chair or bean bag, this helps with an OP position (baby has his back to your back instead of to your front). The reason that you must remain upright is that if you lie down then your uterus is working against gravity and the contractions have to get stronger and so start to cause pain. You will have to lie down for a vaginal examination (VE) by your midwife to find out if you are in labour or not. This position should not be held for long and as soon as the examination is over then you should get upright again. If you have to be put on a CTG machine to obtain a print out of baby's heartbeat then you do NOT have to stay on the bed, you can still sit on a chair or birthing ball to labour, let the midwife worry about the trace. Remember, this is your birth, you are in charge.

Friday, 28 January 2011

One born every minute again

One of my women yesterday told me that she always watches One Born Every Minute and as a result she is terrified of going into labour. As soon as she goes into labour she will become stressed because of this fear and begin to produce adrenalin. This is bad. Adrenalin attaches itself to the cervix and prevents it from opening. The contractions then have to get stronger and stronger to try and open the cervix that is being held shut. I am sure that this is the prime reason for women to contract but not dilate. Programmes like OBEM do a lot of damage by spreading the firmly held myth in our society that uterine contractions are meant to be painful. They are not. My two out of four pain free labours taught me that and I would like to spread the word in order to free women from the fear of childbirth.

Tuesday, 25 January 2011

Birthing pools

This weeks One Born Every Minute was a little better than last weeks in that it showed women who had regained a certain amount of control over their labour. The birthing pool labour was particularly nice as it showed how women should be in labour, relaxed and in control. This attitude helps keep everything normal and instrumental and operative births can be avoided. The women who coped the best kept themselves upright and did not do what most women automatically do when in labour - lie down on the bed. This is the worse thing that you can do as your uterus has to work against gravity and the contractions have to get stronger and so can cause the sensation of pain. It's nice when the guys cry when their baby is born. Awwwwww. If you want a pool birth then a birthing centre is your best bet. Your normal labour ward may have a pool but they are usually so busy that they will say it is unavailable even if it is not. Make sure the unit where you are booked have a good record for pool use and state your interest early in pregnancy, a tour of the unit gives you a chance to become familiar with the environment offered. Good luck.

Monday, 17 January 2011

One born every minute

How can women ever break free of the belief that labour contractions have to be painful when programmes like 'One born every minute' exist. I am sure the producers direct the midwives not to help the women in labour so that it is really good  TV in that it is very dramatic and full of pain and anguish. All the women who showed signs of being in pain were lay much too flat on the beds. In this position the uterus has to work against gravity and so the contractions become stronger and so cause pain. If the women were allowed to sit up on a chair or birthing ball and taught how to use relaxation techniques then they would be calm and pain free. Hey, but then that would not be very interesting would it? Where is the drama in just sitting there and coping really well. Just another example of female exploitation for entertainment purposes. AHHHH. It was however nice when the young guy was bonding with his new baby. There were tears. The revolution is coming when labour will no longer be feared and so will not be painful. Join the crusade here.

Thursday, 6 January 2011

my experience

Women today are programmed to expect a very painful labour. This programming comes mainly from the media who love the drama of childbirth and cannot help but portray labour as an acutely dramatic and painful event. When was the last time you saw a woman in labour on one of the soaps who did not appear to be in agony? A calm, pain free labour would not be exciting enough to pull in the viewers who seem to relish other peoples' pain. Did you not see the tram disaster on Coronation Street? It is drama that pulls in the audience and so the producers can only look at labour as an opportunity to stomp up the volume with tales of woe and anguish.
Little wonder that today's women are afraid to go into labour. That as soon as they think they may be in labour they are frozen with fear and start producing adrenalin by the truck load. It is adrenalin that makes labour contractions painful; without it the contractions would not be as strong and so not as painful.
As a mother of four I personally have had two very painful labours and two pain free. Once you know how to act and mentally react to labour it is a simple step to achieving a pain free labour.
As a midwife I try to pass on my experience to prospective mothers but cannot reach enough to make a difference. This blog is my way of reaching out to women today to try and give them back control of their own bodies during labour. To see quiet confidence instead of stark panic in the eyes of the women I meet every day at work. Let me know if you want to hear more.