Labor and birth are thought of as painful, and rightfully so with all the ‘advertising’ as such it has been getting over the years. According to the bible, women bear children in pain because of Eve’s sins, the media and the film industry expose us to the horrors of childbirth pains and other women’s stories about their experience can sound horrific when you are expecting (usually the first time around) and already terrified.  In reality, every woman has her own level of tolerance for pain and will have her own unique birthing experience which includes personal and situational factors.

Some see this pain as a rite of passage into motherhood, while others prefer to avoid it at all cost. Regardless of your view, it is always a good idea to be armed with knowledge, in this case pain management tools, in order to make the best choices, for you, when the time comes.

If you prefer to avoid medication, it does not mean you have to suffer without relief. There are breathing and relaxation techniques you can use to manage your pain, which are taught at most birth preparation classes, offered at hospitals and birthing centers. Walking and moving around can also be helpful, as well as water therapy and massage.

Relaxation techniques start in your mind. When in pain, the body tends to tense up. This leads to even greater pain, which makes the body tense up even more. Start by enjoying the pain free moments between contractions to help your body relax.

Breathing can help you stay calm. There are different breathing techniques, and whichever one you use, just remember to stay focused. Do not worry about what sounds you are making or what you may look like, just stay focused on inhaling and exhaling.

Walking and moving around, changing positions and sitting on a birthing ball are all good ways to manage your labor pains, as well as speed things along. You can use gravity to your advantage and encouraging the movement and rotation of the baby down through the pelvic canal.

Warm water can work miracles on labor pains. A warm bath or shower can really help relieve pain and the steam of a hot shower will also massage you. Some healthcare providers, however, advise to avoid warm water during labor because it can slow things down.

Massage to help with labor pains can help, but try a harder, more pressure intensive one. Have your partner rub your feet or put pressure on your lower back.

Pain relief medications are available to you at the hospital and if you are interested in them, you should say so right away. You may not be able to receive the epidural after a certain point during labor and if you miss that window, you will have to go without it.  Another option is a spinal. If you prefer to avoid these two, you can receive Demerol and Stadol, which are also delivered via IV.

The epidural is given via a slow continuous drip in your back, so the medication does not leave you numb, but the pain relief is continuous. While very effective, it can take 10-25 minutes to start working.

If you do not want to wait, you can get the spinal, which goes into a slightly lower spot on your back and starts alleviating pain immediately.  Different from the epidural, which is continuous, the spinal is given by an injection that lasts for about 45 minutes.

Another option is opioids, like Demerol and Stadol, which are delivered via IV. Unlike spinals and epidurals, IV pain medicine can make you drowsy and nauseated and it does enter the baby’s bloodstream.

No matter which pain management tool you choose, pain will not be eliminated completely, so do not expect that. Remember that at the end of the day you will be holding your newborn in your arms and all this will be behind you. That is a great motivator to always keep in mind, especially during the real tough moments of childbirth.

For some woman, there is no question regarding what type of birthing experience they want. Others, however, may need more information, in order to choose the most suitable experience for them. There is no guaranty that after you choose your method of childbirth, that it will be the one that will actually take place.

Depending on the development of your pregnancy, you will know if you are indeed free to choose the birthing experience you prefer. If your pregnancy is healthy and there are no health risks, to you or your baby, you will most likely be able to pick and choose.

The first two things to choose are: who will care for you during your pregnancy, a midwife or OBGY, and where do you want to deliver, at a hospital, birth center or at home. Once you answer these two questions, you will learn what other options you have and make more specific decisions about the nature of your care and delivery method.

Traditional options at the hospital:

• A normal delivery at a hospital is one that starts spontaneously after the 37^th week of pregnancy. The labor and birth is monitored by the medical staff to make sure everything progresses on track and with no complications. If there are any complications, the staff will intervene.
• An assisted delivery occurs when complications arise. The two methods of assisted delivery include: the (1) vacuum – a suction cap that is attached to the baby’s head, which enables medical staff to pull him out and the (2) forceps, which is positioned on either side of the baby’s head to gently pull him out.

Assisted delivery shortens the time of distress to the baby. In certain situations it can save the baby’s life, too. The suction cap or forceps may leave the baby’s head a little bruised and misshapen, but the head will go back to its normal shape with time.

• Cesarean section. Unless surgery is needed as intervention, because of a medical emergency, an elective cesarean section is another option. It allows you to choose your delivery date, avoid long hours of labor, the pain of pushing etc.

At the same time, a cesarean section is an operation and the recovery time is longer than that of a vaginal delivery. There is also a risk of infection and in future deliveries you may have to have a cesarean section as well.

Alternative childbirth options:

• Home birth is a normal delivery conducted at home by a nurse or midwife. This option is available to you only if you have a normal, healthy pregnancy with no complications. Many women who choose home birth prefer to deliver in their familiar environment. The midwife or nurse comes to you, rather than you going to their territory. If complications arise, however, you will have to be transferred to a hospital in a rush.
• Water Birth is a normal delivery conducted under water. It is said that laboring in water can be soothing and relaxing for mom, allowing for more freedom of movement, which in turn can reduce pain. A water birth can take place at home, in a hospital or birthing center.
• Silent Birth is a method of delivery done with no words around the birthing mom, usually at the hospital. The idea behind it is to bring the baby into a peaceful environment with no hospital staff chatter.
• Hypnobirth is a method of pain control based in self-hypnosis and has made firm believers out of some. If you plan on trying it, make sure to start learning the techniques weeks or even months before your due date. It takes time to master the techniques and discover if it’s really right for you.

To make the best choice for you, research your options and ask friends and family who have been through the different methods. Knowledge is power.

The process of labor and birth is divided into three stages.

Stage one includes early labor and active labor. It is the longest stage of the three and it is when the cervix opens (dilates) and thins out (effaces) to allow the baby to descend into the birth canal and start the journey out into the world.

Early labor is the stage when contractions start and your cervix begin to dilate. Contractions may last 30 to 60 seconds and come every 5-20 minutes. As your cervix begins to open you may notice your mucus plug has passed (also known as bloody snow.) This stage is unpredictable and may last for hours or even days. The level of discomfort varies between one woman to another and even between one pregnancy and another, for the same woman.

Active labor starts when your cervix dilates to 10 centimeters. At this point contractions will become stronger and progressively longer. If you haven’t already, get yourself to the hospital now. This stage may last up to several hours. On average it lasts up to eight hours. This is the time to use the breathing techniques you have learned in your birth preparation classes and to get encouragement from your partner and the healthcare team.

Stage two includes the birth! This is the time to start pushing with each contraction. This stage could take, from a few minutes to several hours, or more. It usually takes longer for first time moms. The best birthing position is the one that works best for you; if you are uncomfortable lying down, try squatting or sitting. When pushing, be sure not to hold tension in your face. Bear down and concentrate on pushing when it counts. You will feel a great sense of relief after your baby is born, so Push! Push! Push!

Stage three includes the delivery of the placenta, after your baby is born. At this point you may already be holding your newborn and thinking it is all over, while in actuality your obstetrician is still delivery the placenta and ensuring your bleeding is normal and under control. This stage usually takes about 5-10 minutes, but can take up to 30 minutes, in some cases.

Your health care provider will massage your lower abdomen to help your uterus contract and expel the placenta. You may be asked to push one more time to deliver the placenta, which usually comes out with a small gush of blood. You will be asked if you want to see the placenta. If you tore or had an episiotomy and need to be stitched, your doctor will do so now.

Congratulations!

If you are 37 weeks pregnant and do not have a hospital bag ready for the big day, it is time to get one ready, just in case you go into labor and need to go to the hospital in a rush. Even if you do not need to hurry, when the time comes, you may not be thinking as clearly with all the excitement. Why not put a bag together and be ready.

What will you need:

• Comfortable PJ’s, preferably ones with boob access if you are planning to nurse. Do not pack your favorite PJ’s, unless you are OK with blood stains.
• Your hospital may provide disposable underwear, but in case they do not, pack some from home. Not your sexy ones, but granny ones you do not care too much about, as you may have to throw them away.
• Most hospitals also provide sanitary pads, but just in case, bring some for postpartum bleeding.
• Socks! If it is winter bring slippers as well! You will be walking around on your hospital room floor before you are released.
• If you are the robe type, bring one!
• Clothes to wear when you are released from the hospital. You will most likely NOT fit into your pre pregnancy jeans. Maternity clothes will do just fine at this point.
• An outfit or two to take your baby home in. Consider bringing two different sizes – new born and 0-3 – you never know exactly how much your baby will weigh.
• Receiving blankets, burp clothes.
• Toiletries: body soap, shampoo, conditioner, tooth brush, tooth paste, deodorant, etc.
• Toiletries and a change of clothes for hubby (he may be spending the night in the hospital with you.)
• Snacks for hubby – chips, energy bar, etc. While you will not be allowed to eat during labor, hubby does not need to suffer with you.
• Your body pillow if you use one or any pillow from home. If you are at the hospital for a while, why not be comfortable.
• Cell phone and charger.
• Books and magazines. You cannot anticipate how long you will be in labor. Have something to help you pass the time.
• Camera!
• Cash for the vending machines.
• Car seat for the baby, already installed.
• Hospital registration forms, completed. You do not want to deal with paperwork when you get there.
• Birth plan, if you have one.
• Insurance cards.
• Your ID or driver license, for admission.

Happy delivery experience!

There are different ways in which a woman can give birth. Some are chosen while others are as a result of an emergency. A silent birth is a birth that takes place in complete silence. There are no words spoken, no doctors or nurses chatting or even giving directions to push etc. This type of labor and delivery allows the birthing mother to bring her child into a calm and loving environment.

The assisting staff has to learn to say nothing during the labor and delivery. There can be no loud comments, laughing remarks or even words of encouragement. Absolute silence must be maintained. No words can be spoken, but that does not mean the mother is silent.

The idea behind a silent birth, as explained by L. Ron Hubbard, is that “the hidden source of nightmares, unreasonable fears, upsets, insecurity and psychosomatic illness—the reactive mind. This part of the mind records all perceptions during times of pain and unconsciousness—which childbirth is for both mother and child. And words, in particular, spoken during these moments, can have an adverse effect on one later in life.”

A silent birth is not medically different, but is instead a spiritual approach, based on L. Ron Hubbard’s research into the mind and spirit.

Many women, near the end of their pregnancy, start wandering how they will know if labor has started and what contractions will feel like. Do they really hurt and how will they handle the pain of contractions and childbirth.

Labor contractions are the periodic tightening and relaxing of the uterine muscle. They are often described as a cramping or a tightening sensation that starts in the back and moves around to the front in a wave-like manner. Some women report that contractions feel like pressure in the back. During a contraction, the abdomen becomes hard to the touch.

Many expecting mothers describe early labor contractions as similar to menstrual cramps or as severe gas pains, which may be confused with flu symptoms or intestinal disorders. Imagine your contractions as a wave. Each contraction will gradually increase in intensity until the contraction peaks, then slowly subside and disappear. As your body does the work, during labor, the time between contractions will decrease.

As the strength of each contraction increases, the peaks will happen sooner and last longer. There should be some regularity or pattern when you time your contractions. Persistent contractions that have no rhythm, but are five-to-seven minutes apart or less should be reported to your physician or midwife.

A typical labor for a first time mother is eight-to-fourteen hours, and is usually shorter for a second or subsequent birth. For many women, rocking in a chair or swaying back and forth, during a contraction, assists them with this relaxation.

You can check for contractions by feeling your uterus tightening and softening. Lie down and use your fingertips to feel the uterus. During a contraction your abdomen harden, then become soft again.

In this day and age, with medicine taking over the miracle of childbirth, a woman giving birth may feel secondary in the process. After all, the doctors know better, so do the nurses, they are all more experienced. And the expecting mother finds herself following directions rather than listening to her instincts.

The process of childbirth is a natural one and until the 1900’s it was done with midwives at home. It has only been in the last century that childbirth has found its way into the hospitals. Even now, many women around the world still choose a natural childbirth, even in the western world. After all, hospitals are for the sick and they are healthy.

Before you decide to dive into this amazing experience of natural birth, it is important to ask yourself why you want a natural birth and how far you are willing to go for it. It is not for everyone and you need to consider whether it is the right thing, for you. Childbirth may not go as you planned, at home or the hospital. While in the past everyone gave birth at home, you cannot ignore the fact that some women died giving birth. Sometimes the wonders of modern technology and advanced medicine should not be overlooked. There is no guarantee that one way is better than the other, therefore your own intuition is important – listen to it!

If you choose to pursue a natural birth, take the time to learn the process and make sure you understand it and that it is indeed right for you. Listen to yourself, your beliefs, and your inner wishes. Do not hesitate to ask questions and consult everyone you can. Knowledge is power and will help you to prepare for the experience.

First and foremost you should embrace the fact that this experience is the realization of something that is natural to your body. The birth does not have to take place at home, it can be anywhere you feel comfortable. The birthing process is natural, with no foreign intervention.

In a natural birth, you choose who will be present and where you will give birth, as opposed to a hospital birth, where the staff cannot be handpicked. A natural birth should revolve around the desires of the expecting mother, who can choose what environment her baby will be born into. What will be the first sights, smells and sounds her baby will be exposed to at birth.

While pregnancy is a time of excitement and anticipation, it can sometimes also be filled with unknowns, worries and concerns. While pregnant, you are more aware of your body as you follow the changes it is going through.  If this is your first pregnancy, you may be wondering how you will know when labor has begun. You may also wonder what, of all the new symptoms you are experiencing, is normal. You may wonder how your baby is developing, is he doing well or is there a reason to be concerned.

A healthy, low risk pregnancy lasts about 40 weeks. If you go into labor after the 37^th week, it is considered a full term pregnancy and there is no reason to be alarmed. However, if you go into labor before the 37 week mark, it is considered a preterm labor.  A baby born before 37 weeks of pregnancy is considered premature and can be at risk with regard to health problems.

Preterm labor is usually common in pregnancies with multiples, women with previous premature birth experience and women with certain uterine or cervical abnormalities.

Warning signs that you may be experiencing premature labor include 6 or more contractions an hour, leakage from your vagina indicating your water broke, cramps in your lower abdomen, back pain that comes and goes, pelvic pressure and/or an increase in vaginal discharge.

If you think you may be experiencing preterm labor call your healthcare provider immediately. To help prevent preterm labor, take these precautionary actions – lie on your left side, avoid lying on your back (it can cause contractions to increase), empty your bladder, drink plenty of water (dehydration can cause contractions) and count your contractions per hour.

If symptoms continue or worsen, go to triage. At the hospital you will be checked for the frequency of the contractions and your cervix will be examined to see if it is dilated. If your cervix is opening premature labor could be starting.

To stop or prevent premature labor, magnesium sulfate is given, via IV, at the hospital. If birth is unavoidable or seems to be near, corticosteroid is given to help mature the baby’s lungs and brain. While it is usually better for the baby to stay in the womb longer, birth is sometimes unavoidable. In these cases the baby may be admitted to the NICU (neonatal intensive care unit) for special care.

You may think it is a waste of your precious time, going to those hospital-sponsored prenatal classes. After all, childbirth is natural and you do not need anyone to teach you what women have been doing naturally since the dawn of time.

But what if you were to learn something that would make this experience a bit less scary or a tad more comfortable? Would you consider prenatal classes then?

Prenatal classes do not mean someone is telling you how it is all done, but instead is informing you of the birthing options you may have at your hospital. You will learn about different types of birthing and may, in turn, be more inclined to write up your own birth plan, in which you will give to the obstetrician when you go into the hospital to deliver.

Knowledge is power. Prenatal classes will give you the power to make a more educated decision about your desires for the big day. Your instructor will help you put together your birth plan, which tells your obstetrician what you would like your birth experience to be. This is not to say that you will get what you wish for necessarily, as emergencies and the well being of both, yourself and your baby, supersede your comfort and/or wishes. If you write down, however, that you would prefer to avoid an episiotomy, have a preference regarding an epidural or any other wish that can be honored, your doctor will now be aware of it, and most likely will respect it.

You may even make some new mommy friends at these classes, ones who have a due date close to yours. It is always nice to have someone there who really knows what you are going through, and Hubby, as much as he will try, will never know what it is really like. You may make friends for the long run – women, whom you will be raising your kids with, getting advice from, etc.

With your first pregnancy, everything is new and exciting. Nevertheless, it can also be scary!  Worrying about what you do not know or what to expect ahead is common. It is normal to fear the unknown and that is why there are birth preparation classes. Knowledge is power, as they say, rightfully so.

When you start your third trimester, your healthcare provider will explain some signs of early / preterm labor and when you should call, or go to triage. It is important to know these signs because it will help you recognize when you need to go to the hospital. Some labor signs (a few weeks or even days away), include:

It is said that Nesting is a good sign that your baby is on its way, but it is not a clinical sign.  Those who experience nesting have sudden bursts of energy toward the end of their pregnancy.  After a long period of fighting the fatigue that can take over with pregnancy, you will find yourself full of energy and excited to start cleaning, organizing and getting ready for your newborn.

After long weeks of feeling heavy, and rightfully so, you can suddenly breathe again. Lightening is an indication that baby has dropped, settling deeper into your pelvis. While the pressure is off your diaphragm, your bladder is the next victim in line, which means frequent visits to the restroom. All in all, it is a sign that your baby is getting ready to start its way out, which is cause for celebration in itself, even if it is spent going to the bathroom every five minutes.

It is said that the loss of mucus plug is often the first sign that labor is approaching. This thick plug of mucus protects your cervical opening from bacteria enters the uterus during your pregnancy. When your cervix begins to thin and relax, this plug is expelled. The mucus plug may be clear, pink or blood tinged and can appear minutes, hours or even days before labor begins.

Possibly the most famous sign of labor is the rupture of membranes, or more commonly referred to as your water breaking. You should know that only 1 in 10 women experience this dramatic gush of amniotic fluid and can break before labor begins. If you experience rupture of membranes, first you need to determine if it is urine or amniotic fluid. The difference is in the odor. The amniotic fluid is odorless. Once you know it is not urine, contact your healthcare provider for future instructions.

When you begin to experience regular uterine contractions, you are in labor. This is a good time to start timing your contractions and see how long they are and how far apart. Contractions may feel like menstrual cramps or a lower backache that comes and goes, and during early labor, they may be as far apart as 20 to 30 minutes. Over the course of several hours,your contractions will begin to occur at shorter intervals; and you may notice themto start happening every 10-15 minutes or less. When your contractions are consistently 5 minutes apart, it is time to call your health care provider.

Contractions are:

• Regular
• They follow a predictable pattern
• They become progressively closer
• They last progressively longer
• They become progressively stronger
• Each contraction is felt first in the lower back and then radiates around to the front or visa versa
• A change in activity or position will not slow down or stop contractions
• Blood may appear
• Membranes may rupture
• Your health care provider will notice cervical changes, ie. effacement (thinning) or dilation

Keep calm and remember, knowledge is power!