Just Relax...

"Just relax? Yeah, that's a whole lot easier said than done! I'm having a baby here!"

So in the first post in this series, Is Birth Painful, we talked about where we get our ideas about pain in childbirth and the fact that, yes, birth can be 'painful'. In the second post, Let's Talk About the 'Pain' of Labor, we talked about the difference between pain and the intensity of labor as well as what is happening inside our bodies hormonally during labor. 

Today I want to wrap up this conversation with what I think is the most effective form of pain relief in labor... relaxation.

Wait! Don't roll your eyes and leave just yet!

If you've been with me throughout this blog series you already understand the roll fear plays in increasing pain, or at least your perception of pain, in labor. So the inverse is also true- the lack of fear can lead you to the ability to relax in labor and decrease or even eliminate pain during birth!

"Ok Robin, I can believe that relaxation might make birth less painful but it's not the most effective form of pain relief... Come on, an epidural takes away all pain doesn't it?"

Well... 


(First I think I need to say that I am in no way opposed to pharmaceutical pain relief! I do have a tendency to look to a natural alternative first but when I've exhausted those resources bring on the drugs! I've had surgery before and you had better believe I was super grateful for anesthesia! I say this because I don't want you to get the impression that I think unmedicated labor is the holy grail of birth! Every birth has it's own story, it's own pattern and it's own needs. And every birth needs it's own plan.

I am opposed to moms not having clear and accurate information about their choices in birth though! And moms, the information is out there for you if you want to be informed about birth! There are resources, support systems and practitioners out there to support you! Your doctor or midwife, Lord bless them, are not able to discuss every possible option or method out there. Take charge of your birth and become a well informed woman in regard to your body and your birth! By the way, this is an area where a doula really shines! A doula can help you to find accurate information and weed through all of the junk you'll find on the internet when you're up way too late at night stressing about birth.)

 
 

So where were we before I digressed?

Oh yes, does an epidural take away all feeling, all pain, all sensation that accompanies labor?

Yeah, no, it doesn't.

Although an epidural definitely shines when it comes to pain relief it, ideally, does not take away all sensation and sometimes not even all pain. I have accompanied women both with epidural pain relief, IV pain relief and non-medicated comfort measures and at times you might have a hard time by just observing the moms who was using which method.

Let me tell you about a few different labors-

Mom A planned to labor to a certain point and then receive an epidural. She was unsure of what to expect and fearful of the process. Laboring to her goal was difficult and painful but she was able to cope well. All went according to plan- she had the epidural but it wasn't working the way mom had anticipated. Being unable to walk or change positions with ease now made it much more difficult to handle labor. Although she had much less pain she now felt trapped in bed and labor became harder for her to manage. 

Mom B labored with apparent ease, so much so that it was difficult for her to decide if it was time to go to the hospital. Once admitted, she was found to be 6cm and continued to manage her labor with very little sign of even discomfort- walking, bathing and frequent position changes we're all she needed until the last hour. She then added massage and light counter pressure to her pain management plan. 

Mom C had planned an unmedicated birth but found herself in need of an epidural once she had reached 10cm- up until then she says she hadn't experienced any thing she would call pain during the whole labor. What was interesting about this mom was that once she had made the decision to have the epidural almost all signs of pain disappeared and she was even able to take a nap while waiting for the anesthesiologist! In my mind, this was a very clear picture of what relaxation can do to your pain level! Once she knew relief was on the way she totally relaxed and labor went back to being manageable.

Mom D had a planned induction. She was well informed about the birth process as well as her birth options. Her birth plan was to receive an epidural as soon as her doctor would allow it so at about 3cm she very happily received her medication. Labor proceeded very well and she dilated to 10cm while playing cards with her husband. Although unable to feel much of an urge to push her birth team guided her in 30 minutes of pushing and about 7 hours after the induction began her baby arrived.

Just one more-

Mom E was hoping for an unmedicated labor but was not opposed to pain relief if she felt that it became necessary. She labored at home beautifully, a little too well though because labor was so 'easy' for her to tolerate that she underestimated how far into it she was. While at home she used gentle counter pressure, breathing and position changes to keep her mind distracted and labor manageable. Once she decided to head to the hospital baby made a different decision and arrived on the way! When I asked mom at what point the intensity of labor turned to pain she said that it never really became painful! She said that maybe, when she realized in the car that baby was coming that she became fearful and it may have been painful then but mostly just intense... Yeah, she is now my birthing superwoman and has also decided that future labors will take place in the hospital to prevent another exciting, high speed delivery;)

Ok, so back to relaxation.

Although each of these births had lots of different things going on, from my perspective, there was one major difference and that was a basic trust in the birth process which led mom to be able to more fully relax. I am NOT saying any of theses moms 'failed' or should have 'just trusted her body more'! They each had thier own life and birth journey that unfolded beautifully for them! They each did the best they could with the information they had at the time and they are all happy with their births and over the moon in love with their little ones! 

What I want you to see from these birth stories is that you could not necessarily tell by the way mom was responding to labor whether she'd had pain medication or not! From looking at mom B, C and E during different parts of their labor you might have assumed that they had whatever mom D had! Mom A is different though. (Mom A is a composition of many different moms who labor in our culture by the way, not one particular person.) Mom A went into birth fearful. She had a fear-heightened experience of every single physical sensation of birth. Her fear kept her so alert to everything that she was never able to relax, even with the epidural, and so she experienced more pain than any of the other moms. 

 
Muscles send messages to each other. Clenched fists, a tight mouth, a furrowed brow, all send signals to the birth-passage muscles, the very ones that need to be loosened. Opening up to relax these upper-body parts relaxes the lower ones.
— William and Martha Sears
 

When you are afraid it is much more difficult to relax and to allow your body to do the work of opening that it needs to do.

I think that relaxation is the key to any labor- medicated or unmedicated. (For that matter, it's a discipline that will serve you incredibly well for parenthood too!)

Relaxation in labor

“Birth is an opportunity to transcend. To rise above what we are accustomed to, reach deeper inside ourselves than we are familiar with, and to see not only what we are truly made of, but the strength we can access in and through birth.”

Marcie Macari

"Ok, so how do I relax while pushing a human out of my vagina?"

That's a great question and I'm so glad you asked it!

First is to become educated about birth and how your body works.

Have a basic understanding of the stages of labor and what to expect during birth and make sure your partner has this basic understanding too! Learn about the journey your baby will be making and what is happening in your body to accommodate that journey. When you can understand what is happening to you it is much easier to trust your body to do it's work- to relax and get out of your body's way.

Next is to have a birth plan.

Briefly, let me say that a birth plan is not a list of your demands for the hospital staff! It is not you saying "I WILL be allowed to do XYZ and you WILL NOT do LMNOP!" A birth plan is where you learn about your options and choices for birth and decide what your options and choices will, ideally, be. I have had moms who honestly didn't know that they were able to get out of bed during labor- working through a birth plan opens your eyes to possibilities that you may not know exist! In my opinion, the second reason to have a birth plan, or birth preferences, is so that you and your parter can get on the same page. You might have some expectations that your partner has no idea even exist! And how could he if you've never told him?! Take the opportunity to work on your preferences together so that you both have the same playbook to work from! Once you have become well informed about your choices, been able to decide what your preferences are, decided how you might like to handle changes to your plan and talked those things through with you partner, doula and doctor/midwife you will have a greater capacity to relax. 

If I don’t know my options, I don’t have any.
— Diana Korte

(By the way, I go over these two things extensively with my first time clients during our 3-4 private prenatal sessions)

 

Last but possibly the most important element to relaxation is to put together a trusted birth team.

You will not be able to learn every little thing there is to know about birth. Your partner won't be able to either. Your doula, as wonderful as she is, doesn't know it all. Your midwife, doctor and hospital staff won't even have all of the answers, all of the time. Oh, but something amazing happens when you put together a team of support people, who each excels in their given area. You will realize that, although you have become well informed about your birth and your body, you don't have to know it all. You'll know that you are among people you trust, who have your best interest in mind and who have the common goal of supporting you in your birth. You will be free to remain in your birth mind and let those around you take care of the details, knowing that they are in sync with your desires. You will be able to relax and let your body and your baby do the work of birth because you are surrounded by your trusted birth team. This is a huge part of creating an environment that you can relax in!


Let me leave you with a few favorite quotes about relaxation.

 
Sometimes the most productive thing you can do is relax.
— Mark Black
Relaxation means releasing all concern and tension and letting the natural order of life flow through one’s being.
— Donald Curtis
When was the last time you spent a quiet moment just doing nothing - just sitting and looking at the sea, or watching the wind blowing the tree limbs, or waves rippling on a pond, a flickering candle or children playing in the park?
— Ralph Marston
You have enough. You do enough. You are enough. Relax.
— ANONYMOUS
 

Until next time,

Robin