2nd stage (pushing) and pain relief

[Thankyouandgoodnight]

Am I right in thinking that you only really need pain relief for the dilation phase and that once you've got to the pushing bit, things are more manageable?

Also - this panic at transition - what's that all about? Why does it happen?

[hannahsaunt]

Pushing, esp with ds1, was agony. Depends on how long it takes. With him I pushed for an hour and was shredded to pieces. The other two slipped out and though sore didn't even graze.

Didn't panic at transition so not much use there. Sorry.

[LaVieEnRose]

I found pushing almost as painful as the dilation so I didn't manage well at all! I'm not sure if they let the epidural wear off when you get to the pushing stage so that you feel the urge to push as I wanted an epidural but there was no one to give me one

[theangelshavethephonebox]

I found I wasn't able to use the gas and air when I got well into the pushing stage - just couldn't co-ordinate the breathing. I panicked a little bit when I realised I would just have to go on without it (was in the water and would have had to get out for more pain relief) but soon forgot about it as I was concentrating on the pushing - so yes, I think the pain was more manageable - or maybe just different - at that time.

Re: the transition thing, at one point I just felt I couldn't do it anymore - that made me think I must be in transition and it turned out I was! That feeling only lasted a short while though.

[Elmosgirl]

I found pushing very painful...up til then I had only had gas and air and was too late for anything else.

I did still had the gas and air but as another poster said I couldn't breathe the gas and air and push at the same time. I desperatly wanted to use it but couldn't.

But as with labour it's not continual pain it's only painful during the pushes which last a bit then stop till it happens again so could use the gas and air in-between to try and numb myself a bit.

[Elmosgirl]

Oh and transition - is that the between right at the end of the dilation process but before you need to push. You won't know it at the time but that is when you will decide that actually you don't want a baby after all / can't do it / hate anyone who dares breathe / think that you may well be dying.

It doesn't last long and hopefully will provide you with some funny tales to tell your friends or share on here afterwards.

[policywonk]

I didn't get transition at all, in either of my labours. Just went from not-pushing to pushing. Didn't find that pain levels differed a great deal either, but then my labours weren't horribly painful (they're not always, you know ).

[ShowOfHands]

I was extremely calm during transition. I felt almost like myself and chatted with the midwives.

I had a 6hr second stage with no urge to push at all. It was exhausting (and I had an em c/s eventually as dd didn't move a millimetre in that time) but less painful than dilation because I had something to 'do'. It was after 4hrs when they said don't bother pushing that it hurt the most as I was fully dilated, had been in labour for 26hrs and couldn't 'do' anything but sit there and feel the contractions.

[littlepig]

I wasn't aware of any transition stage although the way they go on about it in antenatal classes I did have some concern too.

I don't remember much about pain in pushing as I was concentrating so hard on doing the pushing and on getting as much gas and air in as my lungs would allow (guess it probably was a bit sore then! ) I only ever had gas and air though. Fortunately I wasn't pushing for very long either. Policywonk's right - labour's not always as bad as most of the stories people delight in telling you beforehand

[policywonk]

A six-hour second stage! Blimey. Poor you. I didn't think they let things go on that long.

[MKG]

My sil had a 13 hour second stage. She started at 6pm and the midwives decided in the middle of the night that she would need a C-section, but didn't want to wake a doctor up, so they waited until the morning to call, and if she was able to get her baby out before then it was a bonus. I would have sued their asses off.

And in reference to the OP. I found pushing to be wonderful because I was working with the contractions.

[policywonk]

[ib]

I was totally calm in transition. In fact, I took a little breather and put my finger up my fanjo to see what was going on. I felt ds' head (it was right there!). I was so excited that I insisted dh feel it too .

He kept asking the midwife whether she was sure this was OK. Fortunately she was very cool and told him to go right ahead.

[tab1]

Was so desperate to push and get dd out that pain wasn't so bad during 2nd phase as each contraction felt closer to having her. No transition but had a panic when I thought I was too tired to carry on pushing.

[beka277]

The dilation phase was the most painful for me. There was abt 3 hours of intense/painful contractions. As for the transition phase I didnt really notice it. The midwife said i think u mite b ready to push and i was like, no i dont think so...i just need to poo! haha...which meant, yes, i needed to push! Contractions didnt seem anywhere near as bad during second stage! Im not sure if it was becoz I was so focused on pushing (it was HARD work, and exausting!) tht I didnt feel the contractions...or they really werent as bad. I really do think tht i knew it was nearly ova...and tht helped ease the pain!! Although it still did take 2 hrs to push her out! No stitches, just a graze..

[beka277]

oh and I did try and hav the gas and air during second phase, but yeh couldnt coordinate it with pushing so left it alone....hubby had a go instead lol Think I was only really going to suck on it becoz midwife asked me to try it ! I had pethidine during first stage which seemed to really calm me down, instead of saying "I cant do this ....i cant i cant..." I calmed down and although contractions were still painful, I was calm, handled it, and half went to sleep between contractions...

[lulumama]

if you are worried about it, then why not consider a water birth, you can stay in the pool until the placenta is delivered! you have constant pain relief and your body is supported.. you can also use entonox in the pool. most Mws would suggest you don;t use entonox when pushing as it is harder to do what you need to do

not everyone panics at transition, but your birth partner, if they know about transition in advance, can keep gently reassuring you that it is a good sign as you are nearly there

[Pavlovthecat]

In my 'transition' stage - I actually had a moment of calmness, and had tea and toast with a wonderful midwife, my husband and my best friend before getting on and pushing (not a good idea as it all came back up!).
m
The second stage was the most painful. At home went into second stage with no pain relief so think this in part was why this stage hurt more. However I presumed the third stage was more manageable as I had some pain relief by then, and had got used to the pain.

[belgo]

thankyouandgoodnight- with my first labour I found that the pain of the contractions disappeared totally when I was pushing, which I really hadn't expected as I had had no pain relief medication.

The burning sensation of the baby's head crowning is very very brief, even with a slight perineal tear, don't be too worried about that.

Lulumama - I would disagree with a birthing pool providing constant pain relief - I think I must be the only women to find it didn't help at all with the pain.

[Pavlovthecat]

I got the gas and air and pushing well, apparantly I was a 'pro^! My best friend is a nurse and she was present to give support to me and DH. She 'walked' me up stairs to the top of my contraction and back down again, as I walked up, I breathed in on the gas' as I walked down I breathed out. Very effective!

[Thankyouandgoodnight]

I was just wondering why traditional pain relief meds e.g. epidural / pethidine etc are only given for the dilation phase. Let me rephrase that - I know it's because it can be too late / slow things down / affect baby etc so more why there isn't anything much on offer that is effective and useable during the 2nd stage and yet everyone survives it perfectly well. Is it because it's relatively shorter?

I also don't understand the physiology of the panicking that some do at transition. Why does it happen? I remember panicking that I wouldn't manage when I was only at 5cm and I have no idea when transition was with my first labour. I ended up getting in the pool shortly after. I had to get out again to speed things up as baby wasn't moving down at all despite a long time of pushing. That made the contractions feel a bit more serious!!!

[belgo]

thankyouandgoodnight - as I undrerstand it, pethidine passes through the placenta into the baby and can make the baby sleepy when born. This is why it's best not to give it too close to the second stage.

An epidural given at a late stage would continue to work for quite a while after the birth - my friend had one at 9cm dilation, gave birth half an hour later and then felt the effects of the epidural all night. She said it wasn't really worth it!

[lulumama]

fair enough belgo!

i think it is important to share a negative experience of water birth.

nothing will take away the pain entirely, except a general anaesthetic or a full block epidural. everything else is pain relief.. it relaxes you , alters perception of pain, allows mobility to deal with the pain rather than totally alleviating it

i thikn having a mindset that there will be pain, but it is a positive pain, different to other pain that you experience, each contraction is doing something and getting you somewhere, and each one you have is one you don;t have to do again and brings you closer to your baby.

so rather than aiming for no pain, how about a differnet mind set to dealing with the pain> IFYSWIM

[belgo]

It wasn't a totally negetive experience of a water birth, and I'm absolutely in two minds whether or not to have another water birth. It just didn't do anything for the pain, but it did provide a distraction.