Take a deep breath...and read on for ways to have a delivery that will let you be calm and comfortable.
They don't call it labor for nothing, but there are more ways than ever to manage that pain. "The trick is to have as many tools in your bag as possible," says Kim Hildebrand Cardoso, a certified nurse-midwife in Berkeley, California. "You don't know what's going to work until you're in it, and what helps a woman at one point can change five minutes later." Know your options -- and keep an open mind.
RELIEF WITHOUT MEDICATION
Relaxation "The most important thing you can relax during labor is your mind," says Stacey Rees, a certified nurse-midwife in Brooklyn, New York. When you fear pain, you tense up, which makes the pain worse, and causes you to tense up more. Cardoso, who had back labor for 21 hours with her first baby, says, "I tried to not spend pain-free minutes stressing about what was to come."
Moving Around Walking, swaying, changing positions, and rolling on a birthing ball can ease the pain and help labor progress by putting the force of gravity to work on your behalf and encouraging Baby to move down the pelvic canal. "It really helped to be on my hands and knees, leaning onto my husband's chest," says Andrea Vander Pluym, of Oakland, California.
Breathing Whether you're hee-ing or haa-ing, panting or inhaling deeply, as long as you focus, you'll find relief.
Massage Even if gentle counterpressure on your back doesn't reduce your pain, having your partner rub your swollen feet or give your temples a gentle massage can help distract you.
RELIEF WITH MEDICATION
Epidural It's given via a slow continuous drip, and takes 10 to 25 minutes to work. Most hospitals use patient-controlled epidural anesthesia, which allows you to press a button for more. You should still feel enough pressure to be able to push. Contrary to what you might have heard, getting an epi doesn't put you at a higher risk for C-section, but it does add about an hour to labor. You also don't need to worry about missing the window of opportunity to get one, says Benito Alvarez, M.D., codirector of obstetrics and gynecology at the Cleveland Clinic: "It's really only too late if the head is coming out." It's not given to women with certain blood-clotting disorders, scoliosis, or past back surgery. But for the vast majority, an epi is A-OK.
Spinal and Combined Spinal-Epidural A spinal is an injection into the lower back that works in seconds and lasts about 45 minutes. It's standard protocol for most elective cesarean births. Sometimes docs do a spinal-epidural combo for women far along in labor.
Opioids When epidurals aren't possible, some women opt for painkillers such as Demerol, delivered via IV. Unlike spinals and epidurals, these medications can make you drowsy and nauseated. "IV meds can make the baby groggy," Dr. Alvarez notes. "So if we think the delivery will happen within an hour, we try not to use them."
Originally published in the October 2011 issue of American Baby magazine.
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