Managing pain in labour - did you take an 'instinct' or 'skills' based approach, and how did it work for you?

[plasticspoon]

I'm 38 weeks with my first and thinking and reading a lot about managing pain in labour. It seems to me like there are three basic approaches to this

• trust and work with your instinct (as in Ina May, Sheila Kitzinger, ARM etc)

• develop and use a repetoire of skills (hypnobirthing, Juju something and books like 'Stand and Deliver' - also my NCT course although I'm sure this depends a lot on the individual teacher)

• take all the drugs asap (which I would prefer not to go for)

I can't make up my mind whether I should be going with the first or second approach...I think my gut reaction is to go with the first, but then I read something about specific skills and get a feeling like I should be cramming for an exam or something!

So, what is/was your approach and how did you find the reality if you've already given birth?

I found learning about what to expect in labour really helped so I wasn't to frightened about the pain, sensations or blood etc... I also learnt some basic breathing exercises which I practised during my early contractions and had an open mind as to pain relief though wasn't keen on the epidural.

In the end I managed with g&a both times and found the positioning really natural and it helped with the pain.

You sound really clued up, I'm sure you'll be fine. :)

what hollyoaks said. Nothing can really prepare you as labours are all so different, but keep an open mind as to pain relief, and practice breathing techniques.

With my first I wanted as little intervention as possible but ended up screaming for pethidine. With my second and third, I had practised my breathing and managed on gas and air.

Also positioning - had my third on all fours and this was alot easier than flat on my back.

I read Michael Odent's book Birth Reborn, which was very good on the actual biology of birth and optimum conditions e.g low light, peaceful etc

With both the most important thing was learning to relax my body. I used my TENS at 38 weeks and it gave me a real feeling of peaceful wellbeing and relaxed me completely. when I was in labour I remembered that and tried not to tense up during contractions.

I found that if I listened to my body I found the right position for me. DD was born when I was on my hands and knees and DS was born when I was lying on my back with my legs hanging off the sofa. Everything I read was forgotten once I was actually doing it and I panicked a bit trying to remember it all, but once I gave up, let it go and did what felt right I got on much better.

I think I read on here that pushing felt like doing a poo, which was really helpful as it gave me such a better idea of what to do to help them out, especially DD who was back to back. DS was breathed out and I would recommend that, I managed to get into a much more relaxed state and was astonished to find it pain free at the end. I could feel everything but it didnt hurt which was amazing. I used TENS and G&A with both, TENS was good for the back to back thing and for the rush of endorphins it gives, you need to give it a couple of hours though to build the levels. G&A was more useful to focus my breathing.

Different things work for different people though. I'm sure it will all go well for you though!

With DC1 I was too ill to attend any sort of Antenatal class so just really read up on pain relief and its side effects and trusted my instinct.

Did the same with DC2.

Was really lucky in that I had 2 straightforward births.

I'm sure you'll be fine.

I hoped for a combination of the first 2 and minimal need for the third. Unfortunately my main instinct was to hyperventilate and shout a lot! (I did have a very fast, intense labour that started very, very suddenly though!)

Oh, and I kept demanding DH pick me up during a contraction while I hung from his neck - this was while I was in the birth pool and the MW was concerned he was going to end up getting pulled in! (Helpfully, as a 6'5" rugby player he was more than up to it!)

Now pg with number 2 and swithering about whether to try for a bit more skills-based approach this time e.g. pregnancy yoga.( The only breathing/calming exercise we did at the NHS classes was was pillows on our knees with our eyes shut relaxing different areas of the body in turn - lovely in late pregnancy as a relaxing thing to do, rubbish in labour!)

TBH, it sounds like you're probably pretty well informed about a variety of strategies which is good. Education will always give you options and but bear in mind that you don't know if you're going to be able to utilise any of them until it's happening - for example, I knew I should take deeper, slower breaths but I physically couldn't slow down until they gave me the G&A ('twas weird...).

I also knew I should be going for a pee regularly so my bladder didn't obstruct the birth canal but I absolutely could not produce anything and had to have a catheter (MW later told me that though it sound sounds quite simple it's actually quite difficult as muscles often go into spasm)

I also knew being on my back isn't the most productive birthing position but when I was advised to get out of the pool during stage 2(DD's heartrate was too fast) I was too tired to keep myself upright.

So basically, you should relax just now and stop filling your head in a panic! If a particular skill is going to work for you, it will come back to you at the appropriate time. Otherwise, just expect the unexpected - and try not to bite your birthing partner on the collarbone more than a few times

I read up on a few breathing techniques and positions and then on the day found myself doing what felt best. In my case it was blowing my breath out in a sort of really loud "shhhhh" and being on all fours with my head buried in a swiss ball. Going with it is a good plan, IMO, but it does no harm to be a bit educated too. I found reading the birth stories in the Ina May book very helpful as they gave me an idea of what other women had done.
I also gave the section on massage in a hypnobirthing book to my DH and demanded he learn it so he could help me, and it gave him something to do on the day.

Beveridge I hung off dh for 14 hours during my first labour, it was the most comfortable position for me, not so much for him. :o

As a mummy the most vital skill you have is to follow your instints. I would follow that with your labour, and labour prep too x

I found the most helpful thing was surrounding myself with positive and funny women during labour - namely my mate and my IM! Then I whinged and whined all the way through, but they kept me going.

I'm very much a believer that if you do whatever feels least scary and most comfortable in labour you're probably doing the right thing to get your baby out. In other words: listen to your body. Having a bolshy friend there to make sure nobody interferes in the chances of you being able to do this is very helpful.

I took the approach that it was going to hurt and there would be a baby at the end of it. For DS1 I didn't have a clue, and didn't really care. I had a vague idea of the pain relief that would be on offer and that I would have to push but (even now) I had no idea about stages of labour etc etc. DS1 was born after a five hour labour.

With DS2 I did go to a pre-natal yoga class but didn't really like it. Was pretty sure I wanted an epidural, got a bit anxious about how much it was going to hurt this tme round. DS2 was born after a 5 minute labour... I literally only had time to get my trousers and pants off.

Used TENS machine. But tbh after several months of going in and out of hospital/bleeding/high blood pressure/being told that baby wasn't growing- labour was really the least of my worries. Same with second baby, except I was also quite ill then. No traumatic experiences, but can't say I did anything very clever either.

I used the techniques suggested at my anti-natal class for the first stage of labour: hot baths, paracetamol, walking around, "counting" through the contractions. These techniques helped me to stay at home as long as possible.

I couldn't stand DH to touch me so didn't try any massage!

I had already decided that I was going to use the birthing pool and gas and air which was helpful as it is really hard to make pain relief decisions while in labour! (Make sure your birthing partner knows what you want)

I've had 3 home water births (last one on Sunday ) and used a combination of 1 and 2 but I would recommend staying open minded about 3 as you never know what will happen. Also I wanted to do different things in each labour which demonstrates how different each labour can be,.

Went for the first and second options - was massively prepared and felt really up for it in a big way - going for active water birth and everything . Had planned on massage helping, but like passion I couldn't stand to be touched - not even having my hand held. Ended up with option 3 - the epidural SAVED ME [thankful face]. I think we can plan and prepare and do our utmost to ensure as best an outcome as possible, but at the end of the day you get the birth you are given and have to work with how the cards are dealt to you.