For pain relief while labouring I used entonox (gas). It made me feel quite floaty and my face felt numb after a while. I hardly said 5 or 6 sentences during labour, but do remember saying how weird the gas made me feel. Mostly it just helped me focus on breathing during contractions. It must've done enough for pain since I remember that I didn't even think of requesting further pain relief (eg. epidural).
Aside from the pain of contractions I had terribly sore hips, but only when trying to move about/change positions. I got into the tub fine, but almost couldn't get out as it really hurt me to lift my leg high enough to get it over the edge. I also found it incredibly painful whenever I had to change positions or roll over. I'd heard of people having contraction pain all through their hips but not when trying to move about between contractions.
My labour ended in an emergency c-section after 2 hours of pushing, and it took them two goes to get the epidural in. I only felt the needle when the local anaesthetic was being administered (both times).
I've heard from several moms that the pushing actually felt kind of good, because they felt like they were actually doing something and because they knew that by then the end was in sight. The amount of time spent pushing can vary a lot from person-to-person, and I'd imagine how long it took and whether or not you felt like you were making progress would make a difference.
Originally Posted by dantea
Again, you can talk to your doctor about episiotomy. I think for the most part, there has been a decrease in routine episiotomies. You can request that it only be done if necessary and that they ask you first, provided it's not a true get-the-baby-out-asap emergency. If the baby's coming fast, they may ask you to ease up on pushing a little to allow for stretching instead of barreling through.
Dantea, so happy to have helped.
Kungfualex is quite correct-- episiotomies are no longer routine. It was hypothesized in the past that a controlled cut which could be quickly repaired after labor would be better than uncontrolled, unpredictable tearing. Makes sense, but turned out not to be true. As long as your lacerations are properly identified and immediately repaired, there is no benefit to having an episiotomy. However, if you need one: as long as your episiotomy is cut correctly (i.e. a 'mediolateral' episiotomy), there is almost no risk of damage to adjacent structures or any other problems.
Soft tissue is NOT the problem in obstructed childbirth. Soft tissue will simply tear, with enough force. If the baby is obstructed and not getting out, that's entirely due to your bones and ligaments. Therefore cutting an episiotomy is rarely going to help speed things along significantly. [In the past, before c-sections, the mother's pubic bones were broken as a last-ditch effort to save her life in the case of true cephalopelvic disproportion. Very rarely worked, and in the pre-antibiotic era you didn't live long with a broken pelvis].
IVs: the best IVs are farther up in your arm, generally in the antecubital vein (the vein in the crook of your elbow-- not the bony side of the elbow, the inner surface contiguous with the palms of your hands). The vein is bigger and it hurts less; the IV is less likely to be dislodged or infiltrate or need to be replaced. The need for the IV is two-fold: 1) you might be receiving medications, like penicillin for Group B Strep or pitocin to augment your labor and 2) epidurals can induce low blood pressure, by causing the veins to dilate and blood to pool. IV fluids support the blood pressure to an adequate level. I admit, I rather hated this (I have very low BP, roughly 90/60, and knew I would get a few liters of fluid once I had an epidural and the resultant hypotension). It makes you puffy but you pee off the extra fluid within a few days. I considered it an extremely miniscule price to pay for adequate analgesia and the ability to concentrate on the work at hand.
The catheter: a urinary catheter is also required as a) you're not going to be up and walking, as I mentioned, for fear of falling and b) the sensation of needing to empty your bladder, like all other sensations, will be dull to absent with the epidural in place and infusing. You don't want a huge distended bladder both because of the risk of urinary tract infection, as well as the problem of the massive bladder smooshing the uterus and preventing the uterus from shrinking down once the baby is delivered. A boggy, distended uterus leads to a postpartum hemorrhage since the uterine muscle can't clamp down to control the bleeding. The placenta has thousands of 'spiral arteries' which take blood from the mother into the baby via the umbilical vein. Those arteries need to close off as soon as the placenta detaches, otherwise the mother's blood will continue to pour through them. This is by far the most common cause of postpartum hemorrhage (happens in 10% of vaginal births). To be clear-- the strongest risk factors for a boggy, atonic uterus are multiple gestations and a multiparous woman, not a distended bladder. But since the problem is completely fixed via insertion of a catheter, it is absolutely required, not up for negotiation, once the epidural is placed. It doesn't hurt much at all, it's lubricated, and you can get it *after* the epidural when you have dramatically decreased sensation.
Re: eating and drinking in labor: the only reason not to eat/drink in labor is if you need to be intubated (have a breathing tube inserted to place you on a ventilator) in order to receive general anesthesia for an emergency c-section or emergency hysterectomy. Pregnant women have very bad airways and are very prone, more so than the average bear, to aspiration (throwing up when unconscious and sucking the vomit into their lungs). This is an extremely serious problem that would require an ICU stay and close monitoring if it should occur. **However,** if you have an epidural, you will NOT need to be intubated under any circumstances, no matter how dire. Therefore it is completely safe, and encouraged, to eat and drink. It keeps your energy up, etc.
Pushing feels good in one sense, but the final descent and actual birth of the baby are by far the most painful parts of childbirth. Unmedicated contractions feel somewhat like charley horses across your entire abdomen (at the end), but the actual exit of the baby from the pelvis and the descent through the vagina are intensely painful.
Lastly, pushing while laying on your back: in most hospitals, you can push however you want (though many obstetricians and midwives will want the actual delivery of the baby to be supine, so as to allow them to monitor & control descent to protect your soft tissue, check for a nuchal cord, manage malpresentation, etc). Hospitals have positional aids like birth balls and squat bars. Any position besides standing upright is an option after you receive an epidural. However, think of this:childbirth is an intensely physical workout. You burn nearly 500 calories an hour during the second stage of labor. It's physically quite exhausting. Every position, except lying supine on your back, requires some effort and energy expenditure to maintain. When you are working that hard, the position which requires the minimal effort often feels best!
Thanks again Blade!
I always wanted a water birth, but that's not available to me here. Instead, I'd like to labor squatting or sitting up depending on what available at my hospital. It's the best positions from what I understand as it allows gravity to help you. In the book published by my doctor that he gave me at my visit, it says that if I need a labor chair or squat bar to tell someone, so I assume I'll be allowed to do that.
Of course, but personally I found it very tiring to squat, even using the bar. I can't squat now, un-pregnant and not doing something intensely physical, for much more than 5 minutes. In labor I grew to hate it very quickly. ;)
Gravity is actually less important-- by far-- than the strength of your uterine contractions. It certainly helps-- far better than standing on your head :)-- but the baby's head is engaged in the pelvis already, usually a couple of weeks before you're full-term. It's already in -3 position, maybe even -2. Only your cervix opening and the propulsive force of your uterus can really help him come out.
Hmm. Good to know ^_^ We'll see what works best for me when it happens. I do appreciate all this insight though. It makes me feel so much less anxious about it all.
I gave birth at a hospital in the US & I was given an IV...not sure if that's standard procedure everywhere but even if I opted for no drugs I still would've been stuck at least that once! It wasn't bad because in the heat of everything else happening I wasn't scared.
I had an epidural & was scared about keeping still if I had a contraction while they were inserting it but I was on a monitor so they were tracking the frequency/likeliness of that & I did fine. It was such a relief for me! I was perfectly able to feel the contractions & push & change positions during my epidural and it didn't hinder me...it was a flexible tube & honestly the catheter was more difficult to maneuver!
I picked the epidural cause it was the only option presented to me that doesn't cross over to the baby.
I didn't end up doing any of the breathing exercises that I practiced! For me, I wanted quiet & calm not repetitive coaching or enthusiasm!
I have a question about the catheter part. Was it supposed to hurt that much? I found it was one of the most painful parts of the whole process. Also are they supposed to keep taking it out and putting it back in? One of the reasons I hated it so much is because I really had to go pee, told the nurse, and she wouldn't put it back in told me that I had to wait several more hours. My bladder was killing me.
I also wanted to add-
Educating yourself about birth is important but I think in the moment you will know what you want & sometimes it will go against the plans you make while pregnant so it's good to remain open to all of these options. I thought I might go natural but wouldn't beat myself up if I wanted an epidural once the pain started. I had my epidural & couldn't be happier with my experience! And like I said I wanted nothing to do with breathing exercises or coaching cause it just didn't feel productive to me. Communication with the people in the room is key. I am so glad I was able to express that I wanted quiet & calm! And I got really lucky with my nurse! I was surprised that my doctor was only there for the grand finale! If I had the money I would hire a doula so I could have some say on who was in the room in a more professional sense in case I don't get a great nurse next time.
Sorry for the rant!
Mine only went in once. It didn't hurt because the put the catheter in post epidural. I also didn't get pitocen until after the epidural so it wasn't so bad.
Originally Posted by scarlettrobin
The in & out thing sounds strange to me.