talking point
done by the doctor or midwife is more uncomfortable as it is a very invasive and sometimes painful procedure.
labour comes from many sources and not only from the contractions of the uterus. Fear
Q exacerbates pain, as
will hunger, thirst, feeling cold or lack of support and companionship. The position of the baby, as well as the position of the mother, can help or hinder the progression of the labour and influence how much pain she will feel. Rest assured – labour is very manageable. The following can make a difference for you: Be as active as possible and assume positions
that are
comfortable for you and will also assist with the descent of your baby (upright positions). Stay as calm and relaxed as possible – tension (often caused by fear) will put the brakes on labour. Make sure you have peace and quiet around
lights and too many people around you can amplify pain. Coping skills including
breathing and movement can change the perception of pain. Touch or massage, warmth or even cold can all assist in changing how you feel. Having someone to support
you on labour day makes all the difference.
Q
THROUGH LABOUR? Most of labour is actually pain free. But pain shrinks time – it is the painful bits
42 YOUR PREGNANCY
WILL I BE IN PAIN ALL THE WAY
HOW PAINFUL IS LABOUR? The pain of
that fill your consciousness. There are many moments and minutes where there is no pain whatsoever. Celebrate these pauses – this is your body’s way of giving you time out to recover before facing the next one. Don’t focus on the painful episodes – focus on the moments when you will have no pain at all.
AN EPIDURAL? Q you. Noise, bright
WHEN IS THE BEST TIME TO HAVE
An epidural is one of the most powerful, effective and reliable forms of total pain relief. It works by blocking the pain signals that would normally
travel from your
contracting uterus to your brain. Many women get to the final throes of labour without an epidural and as they enter the last, very short, but intense phase they request one. If you are fully dilated, it is too late to have one as it takes about 30 minutes to take full effect and the baby would have been born at that point. The ideal is to have an epidural in the active phase of labour between five or six centimetres dilated. Having one too soon (in the early latent phase of labour) may knock you out of labour, which means further intervention to get labour going again. Every women is different and you can request one
when you’re ready.
Compared to the intensity of labour, the administration of an epidural is almost painless. Most women comment on feeling the burning of the local anaesthetic into the skin where the epidural needle will be placed and that is the last thing they feel. You may feel a
bit of pressure as the epidural needle goes in. What may be more challenging is the need to keep really still during the procedure. This may prove difficult during a contraction and the doctor will wait for the contraction to pass before continuing. When it comes to pain relief, keep an open mind. You don’t know what labour will bring. It may be easier than you anticipate or harder and more overwhelming than you thought. You don’t know how you are going to feel until you are actually there.
Q
WILL I TEAR?
Unless you are lucky, the
chances are you’ll either have a small tear or episiotomy (a small cut to make the vaginal opening larger). The
most
important factor in preventing this is to avoid pushing too soon or to avoid pushing for too long. You should also try pushing with your tummy muscles, and not your full lungs. By adopting an upright position and pushing slowly with your body urges, there is a greater chance that your perineum (area between the anus and vagina) will remain intact. The vagina is a muscle and can stretch tremendously given time and good positioning in labour. Pregnancy itself takes a toll on your pelvic floor so make sure to do your Kegel exercises.
Q WHAT
HAPPENS TO THE PLACENTA?
The delivery of the placenta occurs between five to 20 minutes after the birth of baby. This is more uncomfortable than painful. As baby’s head
is born you will be given an injection in your thigh that causes the uterus to contract down and shears the placenta off the uterine wall. The placenta will be closely examined by your doctor. He will make sure all the bits are there and that nothing has been left inside of you.
Q IS BORN? WHAT
HAPPENS ONCE
MY BABY
In many hospitals, whether you have a vaginal delivery or a caesarean delivery, labour ward
staff are promoting
immediate skin on skin contact between mother and baby. There is much research to show that this has
huge implications for
early attachment, which leads to better breastfeeding and increases the ability of the mother to bond with her baby. Baby also settles quickly and the APGAR score (the scoring that rates the baby’s physiological condition at one minute, five minutes and 10 minutes after birth) can be done with baby lying on the mother. In almost all cases this score is better and baby and mother are happier when placed together.
In the case of an emergency, immediate skin on skin may not be possible, but can be done at a later stage. Within the hour, both mom and baby will have had all vital signs checked, mom will be fed and watered, washed down and changed into clean clothing. Where possible, request that your baby go with you (in your bed) to the maternity ward where you will spend the rest of your stay in hospital. YP
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