Here I am about 4 weeks from my due, so it’s the perfect time to publish part two of my “pain management in labor” series. In part one, I shared the facts about epidurals (which I’ve had twice). Today’s post, part two, is about natural/unmedicated birth. The final installment will talk about labor pain itself and what the purpose is.
Birth without drugs is painful, or at the very least uncomfortable. I’ve heard of truly painless births but they must be very rare exceptions. What this all means is, that without medication, it helps to have a good idea of what you might expect so you can have coping techniques on tap. Without drugs, you’ll need a few more tricks up your sleeve.
THE UNMEDICATED BIRTH
Here are some of the most common things that mothers experience during a normal delivery (via the birth canal) without medication of any kind.
It can be noisy. Your husband might especially benefit from knowing this beforehand, or he might go into “panic mode” when you cry or yell. Making all kinds of noise is normal and expected during labor. Doctors, nurses, midwives (and even those annoying med students who come in to peek at you) expect it. Just try not to scream; you’ll scare yourself and everyone else in the room!
It can change your behavior. Perhaps you’re just a bit snippier than usual. Or maybe you completely morph into that angry, green Marvel comics hero. I can’t say how you’ll act, but I do know that the pain, stress and hormones of natural labor can make you do or say some things that are not “typical” for you. Once again, the staff has seen it all, so don’t worry on that account.
You can decline the constant checks. Does the doctor realize just exactly how much those constant cervix checks hurt, and does he deliberately time it during a horrible contraction?? Checking for progress not only adds to your discomfort, but each intrusion introduces the slight possibility of contamination. I know doctors are terribly curious about when you might deliver (and release them from duty!), but you CAN decline the routine probing. My midwife always asks if she can do a check, the understanding being that I can say yes or no.
It can get intense at the end. God designed most labors to progress gradually so you have time to adjust and cope. Contractions become more frequent and painful, but you muster your resources and manage as best you can. You might even feel that, despite the intense pain, you’re “in the zone” and doing whatever it takes to bring your child into the world. And then transition comes. Forget everything you’ve been doing until this point, because (for most women) transition can be quite overwhelming. Sometimes we cry. Sometimes we beg for drugs. Sometimes we fear it’s never going to end. I told my midwife once “I’m going to split in two with the next contraction!!” (Amazingly, I didn’t.) Everyone’s level of pain or discomfort will be different, but things definitely ramp up and get more intense during and after transition. Just knowing that it’s coming can help psychologically with coping. Knowing that what has been working may suddenly not bring any relief at all is good to know (as opposed to panicking and thinking something is wrong).
It can burn during crowning. Thanks to veteran mothers (and not Johnny Cash) there’s a very description nickname for this sensation: “The ring of fire.” You’re stretched to the widest point just before delivery to accommodate your baby’s cute (but huge) head. One of my friends has a personal vendetta against the ring of fire. She can’t say enough nasty things about it. For me, it’s not so bad. It stings like the dickens, but it’s so different from the painful contractions I’ve been feeling for hours, and it’s so brief, that I actually welcome the feeling, in a morose sort of way. For me it means the baby is just about to come out and that’s a HUGE morale boost. I grit my teeth and endure this milestone with a sense of relief. Interestingly, a few women don’t even experience this sensation at all, but it bears mentioning.
It can help to curl up. Being in pain makes you naturally want to arch your back. Don’t. Especially in the pushing phase. Although everything in me fights against it, curling inward and tucking in my bottom while pushing works amazingly well to move a baby down and out. My midwife has to repeat this to me over and over while I’m pushing, because I’ll tense and straighten with the contractions.
It isn’t over when the baby comes. All the pain seems to momentarily vanish as your gloriously squalling newborn is held aloft for all to see. But there just a few more unpleasantries you need to be aware of. Delivery of the placenta (or “after birth”) can also be quite painful, though not as much as active labor. Getting stitched up (if you tore) can also be mighty uncomfortable. If you nurse right away after an unmedicated birth, the afterpains feel like menstrual cramps. The more babies I’ve had, the more afterpains hurt. For me, though, having the baby I’ve waited 9 months to see cradled in my arms is like a balm that helps to lessen the pain of these after-birth inconveniences.
It might not be what you expect. Some women prepare like champs for their natural delivery and are completely shocked at how difficult it was despite positive imagery, prenatal conditioning, and breathing techniques that would put a Tai Chi master to shame. Still others walk (waddle?) into labor with plenty of horror stories from friends and family members, and are later able to say “I don’t know what the big deal is. It wasn’t that bad.” Natural childbirth is truly the most unpredictable type of birth because there are so many variables that result from a mother’s unique response to pain, pressure and hormones.
Have you experienced natural childbirth, or do you hope to? What advice would you give to an expectant mother?