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Cara Lee holding a newborn model and birthing person model pelvis with the title

Episode 52: Methods of Pain Coping in Labor

Oct 06, 2022

Link to "Pain Coping in Labor & Bir" YouTube Video

Full Transcript:


Have you ever wondered about the pain of labor? Or how you'll cope with the pain when you're laboring. Have you ever had someone tell you or imply that if you do labor "right", if you do the "right" things when you're laboring and giving birth to your baby, that you won't feel pain? Today we're going to go through non-pharmacological pain coping practices.

So in another video in the future, I'm gonna talk through pharmacological pain coping practices and what's available to you in terms of pharmacological pain medication in labor. Today we're gonna talk about nonpharmacological, pain coping practices. We're gonna go through them one by one. I'll talk to you about why science thinks they works, what I've seen as a birth doula in my practice with birthing people, and a little bit about my experience when I was giving birth myself.

I'm Cara Lee Kiggins. I'm a certified birth doula, childbirth educator with Birthing From Within, and a mother of two school-aged kids. And let's talk about non-pharmacological pain coping practices for labor and birth.


Today we're gonna talk about meditations, breath work and mind state as a form of pain coping. We're going to talk about the gate control theory, which is how our brain perceives actual pain in our body. We're going to talk about counter pressure and things like hip squeezes and back pressure as a form of pain coping.

We're going to talk also about the TENS machine, sterile water injections, as well as positions and hydrotherapy as forms of pain coping.

So let's get started.

First off, I wanna address meditation, breath work, and mind state sort of approaches to pain relieving, because that's a big emphasis in the natural birth movement right now.

All of these are helpful, and all of these are somewhat similar because they're all focusing on the fact that our brain is an incredibly powerful organ.[00:02:00]

And the fact is that everything that's happening in labor, all the sensation you're feeling, whether it's pain or intensity, or pressure, all of that sensation is normal and wonderful. Labor is wildly different than if you've broken your leg or stubbed your toe .

All of those things, right? We wince, so we're like, Oh, something's really wrong. When something like that happens, we hit our head on the, on the cabinet, all of those are pain because something is wrong. Something is not okay with our body, and our body is saying, Be careful and be tender and take care of this body part. You are injured.

The sensations of labor are different. The cessations of labor are this baby's coming and get yourself to a safe place. The substations of labor are open and allow this baby to come through. And yes, it is intense and yes, some people experience it as pain and some people don't. And whether or not you experience it as extreme pain or not depends on where you are in your labor.

Depends on where your baby is in your body in terms of your baby's fetal position. And it also depends on your anatomy. How are you [00:03:00] built where are your. H everybody has a different pelvic anatomy. And I'm not saying whether you're small or large, that's not what I'm saying. I'm just saying where is the baby's head in relation to where your nerve endings are in relation to where your lower back is.

Everybody's built differently has, has very little to do with size and very, very much to do with the individuality of our bodies and how this infant in our body is fitting into this body. Which also brings me to my point that if you've given birth before, different babies will feel like a different labor. So every baby is different and it really depends on where they are in their position.

All right, so gay control theory is the next thing we're gonna talk about. Gate control theory is legit. My husband's a trained neuroscientist, so I asked him about this cuz the birth community is talk about this all the time. And I'm like, Love is this real, Justin, is this real? And he says it is. So I've also looked into some of the data myself.

It is real gate control theory is the fact that our body. I'm gonna try to simplify this. Our body and our brain can only perceive pain [00:04:00] along one pathway. So there's one pathway from our whole body where all, any pain from here or here, or here or here, any sensation really goes to our spine and to those nerves, and there's one pathway to get to our brain.

if you interrupt that highway, that path with other sensation, it will disperse the pain sensation. So the the messages your body, your brain gets from your body, that pain is spread out. So this is why what we're gonna talk about next massage may be helpful because of gate control theory. This is why people do the comb where they hold and grip a comb in their hand. This may have something to do with gate control theory. That sensation of the of the comb, that that little bit of pain when you're gripping it and pushing the comb into your hand is going to disrupt the pain sensations coming from elsewhere in your body.

This is why sometimes counter pressure, we're gonna talk about it in a second cause it's not just about gate control theory, but sometimes a super strong [00:05:00] counter pressure. That's a little bit on the side of pain, and it also like deep tissue massage that's a little bit on the side of pain can help relieve the pain sensation of a contraction.

Because of that gate control theory, all those other sensations are mixing up the signal, so your brain receives more of that moderate pressure slash pain. and less of whatever severe pain or, or you've been experiencing labor. So that's gate control theory. So there's massage for that. Massage and counter pressure may work because it's somewhat painful.

That's also why the TENS machine may work. So the TENS machine, I'm just gonna mention this, you can get this, this at any like corner pharmacy in your neighborhood. The TENS machine has been used for back pain since like the seventies or sixties. I'm not sure exactly when, but it's really been around. They're little electrical currents.

You attach it with tape to you're lower back and there's a little controller you can have and it's little electrical currents. And at the low rate it may be a massage, sort of like a releasing of tension. And at the high rate it may be [00:06:00] working because of gate control theory. It's a little bit painful, and this may also be why it helps with back pain that just that little bit of pain in that area disperses the very more severe pain when people have back problems.

And this is why some people use this in labor. Some units carry TENS machines at hospitals.

Now, counter pressure and massage may work differently than gate control theory if they're applied in a different way.

One reason that counter pressure may work, so counter pressure is either squeezing the hip really strongly like this. Like this is somebody's bottom in front of me and I'm squeezing their hips towards each other or pushing on somebody's lower back. Really... some, some people really want, like I have to move my ring and really push on their lower back.

That triangle tailbone and that counter pressure may work because it's literally keeping the pelvis and tailbone in place as the baby moves through those structures and pushes on those structures.

So counter pressure may work because of gate control theory or counter pressure may work because it's literally [00:07:00] holding those structures in place as the baby's head is moving through and inviting those structures to move, which can feel uncomfortable.

It can feel like a tremendous amount of pressure. So that may be why that counter pressure can work for some people and some babies, depending on where that baby is in your pelvis, right? So this is why, for me, as a birth doula, every birth I go to, somebody wants something different. So we just run through a, we try a bunch of things until someone's like, Yes, do that again. It's always really clear when it helps someone through a contraction.

So the there's, and it may work earlier in labor when baby is in one position and as the baby drops they want something completely different, and that's awesome. That's why you're just continually moving through labor, even if you have pharmacological pain medication, including an epidural. Okay, so what's, What were you gonna talk about next?

The next thing that works for pain relief is positions and position changes. So what position you are in labor will completely change how labor feels.

Laying down tends to really hurt. Somebody who is laying down will, I'll [00:08:00] walk into that hospital room or they're home where they've been laying down and they're like, I can't do this anymore. This is too tough. We need to go to the hospital. I need an epidural. And then I'll say, Have you gotten up? Have you been moving around? So we get them up and they're moving around and oh my gosh, they so much more comfortable and they could do this all day. Very different sensation. Some people, they've been up and moving around all day. That's how they've been laboring. They're hardly noticing their contractions, but the contractions are coming closer together. They decide to go to the hospital, get checked, and they check in, and they have to lay down for the hospital to strap the monitors in place. And they all of a sudden cannot cope because laying down hurts.

Now, this isn't for everybody. Some people can lay down perfectly comfortably, or they're just so tired that the rest is worth it. But I just, I use that as an example, that what position you are is gonna change how it feels. So if you're in a position where all of a sudden you're like, I can't do this anymore.

Try getting up and moving around and finding a new position that feels comfortable again.

And then the next thing is hydrotherapy. So hydrotherapy has been used for pain relief for all [00:09:00] sorts of things. I'm sorry, I bumped that. The, my microphone. Hydrotherapy is used for pain relief.

If you have a back pain or have had a rough day, some people will go home and take a hot bath, Hydrotherapy. Is absolutely something that our culture has used for a long time for pain relief. Think of spas, hot tubs. People get into pools because it feels good after they've had some hard workout. It feels good.

So hydrotherapy can be really helpful. Hydrotherapy includes a bath or a shower, and now the bath shouldn't be too hot. You don't wanna overheat your body for your safety and your infant safety. So usually the water is warm, not hot. I keep saying hot bath, but. Hydrotherapy can change a labor. Somebody may

just really in a place where they're just struggling to cope and then they hop in that tub and oh, you just see it on their face. They just sink in. Additionally, in the shower, sometimes at the hospital, they won't have a bath, but they'll have a shower. So you can take that shower head your partner or your birth doula can and place the shower wa head water in, [00:10:00] in this case you want it pretty warm on your lower back through a contraction.

And that water and that pressure can really feel good and. And help with that sensation of labor. It really can. Some people will labor their. Transition through shower. I shouldn't say some people. I literally, I've seen people who I'm Birth Doula for labor, their whole transition in a shower. But I spent both of my transitions for both my babies in the shower, in the hospital, and it felt wonderful.

So now I wanna talk a little bit about my experience as a birth doula and what I see people using in terms of labor coping and pain coping through their labor. So for early labor, people tend to be sitting on a birth ball or with their knees on the ground with their arm on the birth ball, or their knees on the hospital bed with their arms on the birth ball.

Or they're walking around and swaying their hips. Through a contraction while they're doing something. Sometimes in early labor, you're, you're having those very, light contractions that stop unit tracks and you have to sway through them, but then you can go on with your, with your day. So sometimes that's what labor will look like for people[00:11:00] in early labor. Another thing that people will do is to kind of dance with our partner when labor's kind of between early and active, then you can say, Oh, you know, if the contractions are five minutes apart or 10 minutes apart, you can say, Oh, here comes another one. Call your partner over. Wrap your arms around their shoulders and kind of sway your hips, maybe put your head into their shoulder, and it just can really feel good to help you release the sensation release tension in your, in your hips and your pelvic floor.

In terms of, in terms of active labor, this is when active is when people are getting in the shower, they're getting the temp, they're trying hydrotherapy and they're trying lots more positions. So in early labor positions are pretty straightforward and, and you kind of find them intuitively in active labor.

It's, you've gotta find them, you don't have any other choice. Active labor is when people may be still sitting on the birth ball, but really more focused, they're, they're really focused on their labor process and then in transition, I often see people in, on all fours.

So they'll be either on all floors on the ground, or they can be on [00:12:00] their knees with their forearms on the back of the hospital bed. This is when everybody is usually behind them giving some sort of massage or counter pressure, or even just loving touch, letting them know that you're there and letting lead the way as they work through whatever meditation they may be doing in their mind or whatever. They're leading the way. And we all are just kind of surrounding the birthing person and, and giving them whatever support we can.

And then pushing people tend to push on their side. So laying on this, this is with an epidural place to pharmacological pain medication or not. People tend to push either on their side or all fours if they are in a more flexible birthing environment, like a birth center or if it's a OB that's used to working with unmedicated folks or a midwife.

Or sometimes folks are on their back with a rolled up towel under their tailbone to kind of lift their tailbone up. You'll see a lot of doulas on TikTok right now talking all the time and Instagram talking all the time about how you shouldn't push on your [00:13:00] back. And I never wanna say anything like that because what I wanna tell you is you should push in the way that feels right for you.

So just make sure that your medical care provider and your team is ready to help you find a position to push in that feels right. Some people push on their back and that feels right for them. There are ways to angle your pelvis fine. Some people, lots of people push on their side. That really tends to work for lots of folks.

Then you can go side to side to continue changing positions as you push. And then of course, all fours is very common for unmedicated folks to find intuitively in their body. So you just have to see what works for you and what you find yourself doing. Okay, so that is it today on non-pharmacological methods of pain coping and labor coping. Uh, in the future, I will do a video addressing epidural, narcotic, IV pain relief, and a few other pharmacological pain and nitrous oxide. In terms of pharmacological pain relief and ways to cope with labor with those tools that have benefits and risks just like anything else, and absolutely want you making informed [00:14:00] decisions, but birthing in whatever way works for you because there is no one right way to birth.

There's no one right way to birth. I wish you the best on your brave birth journey. Please like and subscribe to my channel. This helps make sure that it starts to grow and other people see my videos and I'm so glad you were here. I'll see you next Thursday. I post every Thursday.



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