Pain Relief

Contrary to popular opinion, women don’t “choose” to be induced.It’s not something you can request so your baby will be born on the right date.There are several reasons why a birth might be induced, pre eclampsia/high blood pressure, very overdue, diabetes,previous fetal death, previous still born,bleed during pregnancy and other ante natal problems that warrant watching during delivery.It ensures that the Medical and nursing staff are all on board during the labour and the delivery is controlled.

There are several ways to induce delivery depending on how far advanced the pregnancy is,the reasons for the induction and the “ripeness” of the cervix.

Stretch and Sweep, this is for a cervix that is “ripe” and is a little uncomfortable as the membrane is separated from the cervix and the the cervix slightly dilated with the Dr or midwifes finger. Labour usually starts in about 48hrs and proceeds normally.

Prostin gel and pessaries are used to soften the cervix and encourage contractions to begin,usually used on overdue women it can be uncomfortable as it starts to work.

Rupturing membranes,or breaking the water using a long plastic spatula, is done when the cervix is “ripe” and the baby’s head is in the pelvis.Usually within a few hours labour starts, if not an oxytocin drip is then started,as now that the membrane is broken,the baby should be born within 24hrs,to avoid the risk of infection.

Oxytocin is administered via an IV, after your water has broken either naturally or artificially and labour hasn’t started.It is also almost always used to kick start a failing labour that has already begun.The dose is steadily increased and you are usually on the drip until delivery.It makes for a short sharp delivery as the contractions often come one on top of the other as the dose becomes higher.

I had 2 induced deliveries, one due to overdue baby by 2 weeks and hypertension and the other due to hemorrhage at 20 weeks.

The first was my first child, and I was well overdue and had been in hospital for 3 weeks with high blood pressure. I was desperate to deliver and each day the doctor would say”tomorrow” cervix isn’t soft.Even on the day I delivered there was doubt about my cervix and I was told the induction may fail,which sometimes happens if your body is just not ready.

The drip was applied and I waited. My water was broken once I got severe period pain. Labour was short but sharp lasting 6 and half hours.I had pain relief of gas and pethidine.The pethidine seemed to put me into transition and I delivered very quickly but this meant baby needed narcan on delivery as he was sluggish from the meds.

My 3rd child was induced as the doctor was worried about my placenta after I had had a hemorrhage at 20 weeks and intermittent bleeding on exertion.

My water was broken,and then a drip started and withing 3 and a half hours the baby was born.I used gas for pain relief,having no time for anything else.The contractions were so strong that it affected the baby and I was given oxygen for about half an hour before he was born. He was also placed on a fetal monitor with a scalp electrode during delivery.

During both deliveries I felt as if I was in safe hands and that the whole thing was carefully watched and controlled and everything and everyone was in place in case of any complications.

If you do need an induction for any reason, do a bit of research, to see what is involved,what is happening to your body and why and ask other mums who have been through the experience.Once labour starts,the experience is not a lot different,though it is harder and faster.There is one downside and that is that you will be in a labour room and not the nice new birthing suite.

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Health and safety in the workplace has never been so stringent, as companies strive to minimise the risks that are inherent in any work space. From the employers point of view, not only do they want a healthy and happy environment for their staff, but should an employee fall victim to any of the countless hazards they may face on a daily basis, the employer will ultimately be held responsible.

One of the most common work-related injuries is back pain. And despite all the precautions and procedures that are taken, 8 out of 10 people still experience some kind of back problem during their working lives. Although technology has helped alleviate much of the manual labour that has traditionally lead to back injuries, it may surprise some people to discover that one of the chief reasons for back pain is actually desk-based, with poor ergonomics the root cause.

Anybody who has ever suffered from any kind of back injury will verify how debilitating it really is, rendering many people completely immobile. So its worth having a work-station assessment done to pre-empt any underlying issues. Most employers will be more than happy to arrange for such an assessment, and any proposed changes are likely to be no more than adjusting the height of a seat or investing in an ergonomic keyboard or riser for the computer monitor.

Furthermore, its estimated that some 7 million adults in the UK have long-term health problems due to arthritis and other related conditions, and is the second most common reason for being absent from work in both men and women. Again, workers in certain occupations seem to have a higher risk of developing arthritis, particularly those who are in high-demand jobs such as assembly line workers or heavy construction.

Fortunately, with advances in medical science, such ailments are becoming increasingly more treatable without the need to resort to drugs. TENS pain relief unit, for example, is an affordable, portable stimulating device that can help alleviate pain caused by arthritis, sports injuries, backache and a variety of other conditions. TENS stands for Transcutaneous Electrical Nerve Stimulation, and is a drug free method of pain relief. One of the most appealing aspects of the TENS machine is its portability, as it can be carried with ease and used anywhere and is operated by the user rather than a health professional.

The TENS stimulator aids the production of endorphins, which are natural pain-relieving hormones and furthermore, unlike many pain-relieving drugs, the TENS pain relief system isnt addictive. And with Christmas on the way, it would seem this would be the perfect present for those loved ones who suffer from such crippling ailments, ensuring a happy festive period for the whole family.

So, even with improved attitudes towards health and safety in the workplace, many people still suffer from back and joint injuries, often through work-related activity. But with the advancement of affordable, non-drug pain-relief treatment such as TENS, many people are still able to live relatively normal lives.

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More and more people are turning to small compact electronic devices like TENs machines to bring them pain relief without having to depend on drugs that can often have unwanted side effects. These small digital machines can be worn unobtrusively while carrying out normal day to day activities.

What is TENs, how does it work and what sort of pain relief can it be used for?

TENs stands for Transcutaneous Electrical Nerve Stimulation where transcutaneous means through the skin. A TENs machine produces small electrical impulses which are transmitted from the machine through the skin by means of a wire connected to a small conductive patch which is placed on the skin.

TENs machines are believed to work in a two ways. The small electrical signal they transmit blocks pain signals from the body’s sensory nerves to the brain resulting in pain relief. The signals generated by the TENs machines can also encourage your body to release endorphins, natures own pain relieving feel good hormone.

A study in Sweden showed that backache is one type of pain which was best treated with the use of TENS machines. It also showed that TENS machines were the only painkillers required by 70 per cent of women in labour.

More recently some TENs machines are available with an electrical probe which can be used to stimulate acupuncture points to bring pain relief. While almost all TENs machines have cautions about placing the electrode pads on the head and neck these accu TENs machines will permit users to stimulate the accu points or channels elsewhere on the body to bring relief to head or neck pain.

Placement of electrode pads is all important for effective pain relief. Usually the pads are placed close to the source of the pain particularly with muscle pain or joint pain. In the case of sciatic nerve pain the electrode pads are likely to be placed either side of the spinal column and the top part of the affected leg. Your health care provider should advise on the best point to place the pads for optimum pain relief. Correct placement is very important and sometimes may take a little trial and error with careful reference to the manufactures guidelines. Pads should never be placed near the eyes or over the nerves from the neck to the throat or brain.

Most TENs machines have three main program modes, Conventional (some machines may refer to this as Normal or Constant}, Burst and Modulation. Each mode has subtle differences in the effect they have. Usually a combination of these modes will work best to provide maximum short and long term pain relief. With the TENs machine set to the Conventional mode (frequency between 90 and 120Hz and pulse width between 80uS and 200uS) the pain relief tends to be short lasting after the machine is switched off. To obtain longer lasting pain relief you should choose a Burst mode, or select a lo-rate TENs program (usually between 2Hz to 5Hz with a pulse width close to 200uS). The burst or lo TENs mode encourages the release of endorphins and gives longer lasting pain relief.

All TENs machine will allow you to control the level of electrical signal and once again it is import to set the machine to the optimum setting. If you set the level too high your muscles may start to twitch. You should adjust the TENs machine to a level where you can just feel a slight tingling sensation.

TENS machines should only be used on the advice of a doctor or other health professionals. They may not be suitable for all types of pain or all conditions. Always follow the manufactures instructions supplied with the machine. TENS machines should never be used by people who have a pacemaker or have heart problems. Pregnant women should avoid using TENs machines as the affects on the unborn baby are not known. Never place TENs electrodes on your head or neck.

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I have had two pregnancies and chose to have my first in the delivery suite of the hospital, and the second in a midwife led birthing unit. Both experiences were different in quite a few ways.

My midwife throughout my pregnancy encouraged me to have my baby in the birthing center as it was my second pregnancy and I was low risk from the first time around, so please remember a birthing unit may not suit every pregnant woman, especially if there are other factors involved.

The main differences I was to expect from the birthing unit was that the atmosphere would apparently be more relaxed, there would only be midwives on duty to deliver my baby (however a link with the hospital delivery suite is there should anything go wrong and it’s needed), there is limited pain relief available (no epidural), and there is always the option of having a birthing pool should you wish to.

I was also told that if my midwife happened to be on duty when I went into labour then there would be a chance she would deliver my baby for me. I wasn’t sure how I felt about this particular piece of information, but I wasn’t going to worry about that until it happened.

Once I went into labour, I arrived at the birthing unit which in my case was attached to the hospital, and next door to the main delivery suite anyway. The midwife that greeted me almost seemed vague and let me do most of the talking. This wasn’t something I was used to, especially being in the amount of pain I was in, I wanted someone to take control and tell me what was happening.

This really wasn’t the case here as the staff very much had the attitude of “it’s your body you tell me what’s happening and how you want this to be”.

I was immediately made tea and toast as it was breakfast time. The staff were very attentive in this way, and made sure I didn’t want the birthing pool before assigning me my room etc.

This aspect of the unit was very nice and I was immediately pleased I had chose this option to have my baby in.

Throughout labour I was encouraged to wander about the unit, and had use of a communal lounge, where there was also facilities to make tea etc. I thought this was especially nice for partners who often have nothing to do but be moaned at and stand on their feet for hours on end. (I know ladies it’s us who go through the immense pain etc, but you have to feel a teensy bit sorry for them when all the pain has gone and you have your bundle).

The staff in the unit were very attentive when they

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“LABOUR” “CHILDBIRTH” two words that will strike fear into the bravest of hearts.Labour is unfortunately hard slog but like the fruits of all labour, the end result is amazing.(men have the easiest role in reproduction).

Becoming a mother for the first time was the most joyous moment of my life, the labour of actually getting him here was not! Since then I have had two more children and each time the experience was better,I was calmer and felt emotionally well equipped. Anybody who brags about having a “natural” birth is more often than not trying to convince herself that the un necessary pain was indeed warranted. Some first time mothers are no doubt under pressure to give birth painfully with no pain relief but I believe that no woman should be mislead or pressured into doing something that she is not prepared for.

Each birth is different because each child is different, therefore each woman should make an individual choice as to how she is going to go through labour, although more often than not the courage that is inbuilt during labour may surprise the weakest of the weak.A supportive birthing partner is essential!

Pain relief only works effectively if your mental attitude is in tune with your physical being.For example: My first labour was full of pain relief, I had the T.E.N.S machine,gas and air more commonly known as “laughing gas”,(I do not remember laughing much)I had pethidine! I stopped short of an epidural as the thought of not feeling my legs was more frightening than the actual labour but if the midwife could have given birth for me I would not have refused!

My third birthing experience was a much more exhilarating experience and my tools of pain relief were controlled breathing, gas and air and alot of tears. Obviously there is going to be pain maybe at times unbearable but each woman has to deal with it in her own way not in some-one else’s way.Advice should be received graciously but should not become law. Your childbirth is yours and when you experience it in the way you want only then will you achieve the most ecstatic feeling in the world….!

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Pain can be traumatizing both emotionally and physically, preventing you from enjoying life at its fullest. To deal with such situations all you need is an effective pain relief medication. German developed medication Tramadol might be an apt solution to help you out in such painful situations.

It can be simply understood as a pain relief medication. Dosages of this narcotic pain relief medication may vary in accordance to the requirement of an individual.

Tramadol is available in both injectable and oral preparations, which is ought to be used in compliance with medical advice.

Tramadol is usually employed in the treatment of moderate and severe pain as well as most varieties of neuralgia, counting trigeminal neuralgia. It is marketed under various trade names which include Tramedol, and Crispin amid others.

It is not advisable to not to modify the dosages without consulting your doctor as it can be managing for your health. Adhere to the prescribed dosage and duration of usage for attaining effective results. It is to be noted that over indulgence in this mediation can be fatal.

If you are under 16 years, women in labour or expecting a child, or adult over 65 years; use of Tramadol pain relief medication is not meant for you. Discuss at a length with your doctor about the suitability of this medication in accordance to your requirements. It is an intelligent approach to notify your doctor about your preceding medical current medical history so as to lessen the possibilities of contraindication of the medication.

It is also recommended for effectual improvement in the symptoms of anxiety and depression. But, health professionals usually do not advocate use of the drug for treatment of such disorders.

Do not abruptly discontinue the use of this Pain relief medication, as it can source withdrawal symptoms. If you feel you need to discontinue with this treatment, consult a doctor for appropriate advice.

Adverse effects of Tramadol may be experienced some of the adverse effects can be enlisted as:

Drowsiness

Anxiety

Hallucinations

Nausea

Vomiting

These adverse effects are a consequence of bodily changes in response to this medication. Seek medical advice if you encounter these or any other adverse effects with usage of this pain relief medications.

If you are planning to buy Tramadol, you can choose either street retailers or Online pharmacies in accordance to your convenience.

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When I had my children, relatively recently – they are now only rising 5 and 3, I was determined to be the ultimate earth mother figure and give birth in water and with minimal pain relief. My son, William, arrived after a grueling 21-hour labour with minimal epidural administered by a sadistic midwife. The experience was so traumatic and exhausting that I struggled to establish breast-feeding and couldn’t wait to escape hospital. My daughter, Lottie, came by emergency cesarean after a 22-hour labour. By comparison I was positively serene and established 4-hourly feeds within the first day. My cesarean delivery was the best thing that could have happened to me, though I have to admit that if it had happened with my first I would have been ham-stringed with overwhelming feelings of guilt.

When I had William I felt guilty I hadn’t managed a water birth without pain relief. By the time I went into labour with Lottie I had shrugged aside all my idealism and accepted the fact that for me (and it certainly isn’t the case for all women) childbirth was painful, slow and unpleasant (and for some women it’s even worse). I know it’s something that women the world over do every day without medical intervention, but death in childbirth is still something that happens on a daily basis (with and without intervention).

I know that when my sister had her 3rd child (she’s much braver than me), she had to fight for a natural birth as she’d had a cesarean with her 2nd. She was screaming for an epidural, but when the midwife returned and told her she was too late for one, the baby popped straight out after just 2 pushes (and she was no tiny baby – nearly 10lbs). She hated her cesarean.

It all comes down to perspective and also support. When I had my c-section my son was nearly 2 and such a willing helper that I didn’t even have the opportunity to rip my stitches. In addition my husband took 4 weeks combined paternity leave with vacation and so I didn’t need to lift a finger during all that time and even after that I went to stay with my parents of 3 weeks after he went back to work. Conversely my sister had a child who was only just 1 to look after and her husband was back at work within the fortnight. I couldn’t be much help to her as I lived away and was 8 months pregnant myself.

All this is digression. The emotional toll of a cesarean is guilt with some underlying guilt and layered with a bit more guilt on top. It’s about failure. For many women the decision to deliver by cesarean is not one we make rationally or even have time to think through: we are advised that the baby is in distress and often we are not dilated enough to push and so cesarean minimises the risks of the baby being hurt. There are also the planned cesareans which can be undertaken for medical reasons or even plain old fear. So what. Childbirth is dangerous, it’s scary and women still die. Surely it’s better to plan a cesarean than to risk being paralysed by fear and unable to push with the contractions.

We judge ourselves too harshly as mothers. The actual birth is such a miniscule part of being a mother. It is preceded by 9 months of nurture and followed by a lifetime of the same. Compared with all that it is infinitesimally small. We spend our pregnancy doing everything within our power to provide the best environment for the foetus and then spend the rest of our children’s lives putting their needs ahead of our own. We should rejoice in the fact that, by whatever means necessary, we have delivered our baby safely into this world.

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The question of pain relief is something that differs for each individual mum to be. More often than not, a decision to have a drug free labour is quickly overturned by fear, anxiety and stress in the first stages, especially for those of us who are having our first baby. Personally, I was so happy to be having a baby but at times it was almost overshadowed by the thought of the birth. I even toyed with the idea of asking my midwife if i could elect to have a cesarean section as i was so afraid of the impending birth.

The day finally came (as it inevitably does) and i was adamant that i would try any pain relieving drug that they offered me. I had gas and air and when that stopped taking the edge off the pain i had morphine on more than one occasion. When the pain finally became too much to bear, 17 hours since i had first arrived at the hospital, i was given the option of whether or not to have an epidural. By that time i would have cut my own arm off if it would have made the pain go away so i accepted. I found having the injection itself quite distressing as by this time my contractions were so close together that i found it hard to sit still for the anaesthetist to inject my spine. When the injection had been completed i became more distressed as my movement was now restricted and i found it increasingly difficult to find a comfortable position while hooked up to the drip. On more than one occasion i ripped the line from my hand which left it bruised and sore for days. Finally when it was time to push i literally had to have my legs moved and held by my birthing partners as i was unable to do so on my own. I was unable to feel any contractions at this point and was completely dependant on the midwife telling me when to push.

I thought that when the 21 hour labour was over and my little girl was born the stress would eventually be over but as soon as the epidural drip was removed i felt nauseous and started to be sick due to the side affects of the drugs. So much so in fact that i then had to be given another drug to counteract the side affects of the pain relief. My baby slept for almost twenty four hours after she was born due to the drugs that she was subjected to during the birth and to this day i still regret not being the first person to hold my daughter when she was born. It actually took around an hour and a half after the birth before i was well enough to hold her. I was also unable to walk unaided for hours afterwards and had to be helped by nurses as i could sill not feel my lower body.

The birth of my second daughter was some what different. I admit that second time round you do at least have an idea of what to expect, but never the less i was more wary of the pain relief that i was offered. I delivered my second baby with just the help of gas and air. Yes, it was painful, i wont say that it wasn’t but it is a pain that i cant remember now. It stopped the minute she was born and i was able to hold her, feed her, change her and bathe her. These were all things that i had not been able to do and i feel that i missed out on first time around.

In my opinion it is the choice of the individual. It is not a decision that should be made lightly but providing there is no medical reason why not, then it should be given to those who want it. However, from my experience, I would not choose an epidural again as the pain is not so unbearable that i would ever forget those first moments my my new born baby. They are precious moments that once lost, you can never get back.

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What do contractions feel like?

This is a difficult question to answer because you can only really know if you are having contractions to know what they feel like, but I will do my best to help any expectant mums out there to relax and know that all of those horror stories out there that you have heard, they are simply not true!

Quite a lot of women experience period pains when they are ‘on’ and this is the base from where we start to try and understand just what a contraction can feel like.

Period pains are caused by the uterus contracting to release the womb lining and an un wanted egg and this is much the same when it comes to a labour contraction.

A contraction is the uterus preparing itself for birth, a contraction allows the uterus to dialate enough (usually by 10 centimeters) to allow the baby to be pushed out.

If you have never had a period pain then, aside from being very lucky, you will be more un prepared than most for first stage contractions.

A period pain feels like a crap in your stomach at the very least but for some women it can feel a lot worse, it can make you feel sick, give you back pain and last for a long while.

Many midwives say that a contraction feels like a period pain but ten times worse, this can sound very scary especially if you suffer from bad period pains but when they are happening to you, the pain is gradual.

When my contractions first started they felt just like little stomach cramps, like hiccups in my belly.

After an hour or two they began to feel stronger and took longer to dissipate so what you need to remember when the contractions last a long time is to breath slowly through them and to count to ten and when they do ease this is the time to relax and to calm yourself.

To me, personally they did feel like bad period pains to begin with but as the labour progressed I found that they were more painful and this is where gas and air can help because if you use it as you have a contraction it helps you to breath through the pain and it also helps to ease it.

There are many pain relief’s now a days for contractions and if you opt for any of them then they all help to control the pain.

Such as gas and air being the favourite which I used at the start of my labour, stronger drugs and then to stop all pain you may now be offered an epidural or a spinal tap which means that you will not be able to feel the contractions.

This can be a good thing if you are not coping with the pain but it means that when it comes to push you might not be able to feel enough to push the baby out and you may need to be helped out with forceps. (This is not true of all cases.)

In conclusion, you never really know what a contraction feels like until you have one but if you prepare yourself and know that contractions are simply pains to help your body get ready for giving birth then you will be fine and at the end of it you will have a beautiful baby and what contractions feel like will no longer matter to you!

Good luck!

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What’s in Your Birth Plan? – Planning Your Home Birth

Why do you need a birth plan?
There are many options available to support your home birth experience ranging from a water birth to hypnotherapy in birthing. The idea of a birth plan is to choose your preferred method of giving birth, and also to specify your views on interventions that will be offered to you. While many women do not have the birth that they planned, preparing a birth plan gives you and your partner a starting point when labour kicks in. Also creating a birth plan enables you to discuss all the options with your partner and midwife and confirm what your preferences are. This is important, as your partner may need to speak for you while you are focussed on your labour. Also if your midwife is aware of your birth plan she will also be able to ensure there is a midwife available to support a homebirth and adequately trained if you need assistance with a water birth.

What to put in your birth plan?
This will be different for every person, and you will gain ideas about your ideal birth from antenatal classes and talking to mothers who have been through the process, or even your own experience if this is not your first child. Below is a template for a birth plan that covers the main areas to consider when planning your home birth.

How to put your birth plan together – try this template

The sections below are the common areas to consider when planning your home birth; you may come up with more requirements or may have no preferences on some of the sections below. You can use this as a guide to start your birth plan.

People present

• You may only want your midwife and your birth partner present, or you may be happy for close relatives and friends to support you. If you specify this then your partner or midwife can tactfully ask people to give you some privacy if required during the birth.
• Also consider any other children that you have and whether you would like them present and if they would like to witness the birth. Make a contingency plan if you think that it may not be a good idea for them to attend the birth.
• You may consider it helpful to have a friend or your mother present to help out, especially if you have a birth pool that needs to be filled.
• A doula, acupuncturist or a hypnotist are also popular for home births.
• Have the names and numbers of anyone that you would like at the birth available in case someone else needs to call them for you.

Pain relief

If you have a home birth you can only use natural pain relief methods. Options to help you with your home birth may involve, the use of movement, massage, relaxation, acupuncture, hypnosis, aromatherapy, a TENS machine, or a birth pool. Your midwife may also make gas and air available for you, but remember that she may not arrive until the end of the first stage of labour or the start of the second stage of labour.

Immediately after birth

• You want to keep your baby with you / Can take the baby away for examination
• You want to keep the umbilical chord attached until it stops pulsating / Can cut the umbilical chord straight away
• Partner wants to cut the umbilical chord
• You want to breastfeed straight away

Third Stage – Placenta Delivery

You would like to deliver the placenta naturally / you would like an injection to help speed up the delivery of the placenta.

What if your birth does not go according to your birth plan?

Midwife Does Not Arrive on Time

In the vast majority of cases the midwife will arrive on time. If you feel that she will not make it then call 999. Ambulances can get through traffic a lot faster than a normal car and the paramedics are trained to assist childbirth.

What If There Are Complications

The midwife will only support your home birth if there have been no complications with your pregnancy and your baby is in the expected position and expected size for his age, so the risk of having complications in childbirth are minimised. The midwife will continually monitor your progress, and if concerned she will transfer you to hospital before any issues arise. This is something you will discuss with her when going through your birth plan. Many planned home births result in a transfer to hospital as the midwife will always err on the side of caution to ensure the safety of you and your baby.

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