Early labour coping tips anyone?

[BertieBotts]

I have a bit of a history of ridiculous labours

DS1 I had planned a home birth, but after struggling with the pain (and to be fair, tiredness) at 1-2cm after 24 hours the community midwife strongly advised me to go into hospital, have pain relief and a sleep and carry on. Actually when I got there I was 4cm, so I decided to stay awake and carry on and the rest of the birth was OK/manageable.

With DS2, I planned a hospital birth but my waters broke first and I was GBS+ so I had to go in within 12 hours of them breaking. Contractions were still totally manageable, but I went in after about 8 hours because it was getting into the evening and just felt like the right time. When I got there, I was only 1-2cm dilated again (which they didn't explicitly say) so they asked me to go for a walk. We did this and then came back and they put me into a room (this is not in the UK). Then there evolved several hours of me becoming more not-coping and hysterical while they said "Ah yes you're dilating" so I assumed that meant things were moving on and I got into the pool, rejected the pool, asked for an epidural (which didn't work). Only an hour after the failed epidural when I suddenly dilated to 6cm in one go did they explain to me that I had only been at 1cm for the whole time before!

Anyway.... I seem to struggle with this really early labour phase. With DS1 I didn't really calm down until the midwife gave me some clear direction and instructions, and with DS2, nobody gave me any instruction so I didn't calm down at all, and just found the whole thing really stressful and frightening. If I was in the UK I know that I wouldn't have been allowed into a private room, let alone the pool or to have an epidural at less than 4cm, but I think because of the infection risk they didn't want to tell me to go home... maybe they don't have an early labour ward in Germany.

I need to know... what are you supposed to be doing at 1cm dilated? Are my labours just fucked up/am I just a giant wimp that I find the pain so unbearable at this early stage? Because childbirth classes kind of give you the impression that it will all be manageable with breathing/swaying/walking until 4cm, but this is not the experience that I have had, for me it seems to get unmanageable long before then and I have read all the books, done classes etc... just none of the tips seem accessible to me because the pain is all encompassing and makes me curl up into a little helpless ball.

DH thinks I got the epidural too late last time, but looking at the timescale of dilation etc it was actually much much too early. I'm kind of thinking if I can avoid going in too early then maybe it would make more sense. But then I probably need to work out how to manage the labour pain at home a bit better. And obviously I'll have no info about how dilated I actually am when I'm at home. I have also forgotten everything in terms of when you should go in (assuming my waters don't go early again). I will have a chance to discuss this but I will only have one meeting with hospital staff before labour, so I really need to get all of my questions clear in one shot.

Any tips/info?

That sounds tough!

A few thoughts, based on what I’ve read + heard from my midwives (though I’m no expert!)

• with subsequent pregnancies, the body can “learn” to react better to oxytocin and early stages of labour can speed up. That was certainly true for me. I had to have my labour augmented with a drip for DC1 but had much faster and easier labours with DC2 and DC3
• The body responds better to oxytocin when it’s dark and when you aren’t stressed. So being in a bright and busy labour ward can slow progress versus if you can stay home and walk around with the lights dimmed (or at least close the door and turn out the lights in your hospital room)
• for early pain relief, breathing exercises really do help. Also try different positions (walking, squatting… I favour leaning over a counter or a high table or bed). Sitting or lying down can be weirdly uncomfortable.
• another thing to try as the baby descends, is to have someone stand behind you and provide VERY firm pressure on your back at the position of the baby’s head. I’d get my DP to practically stab me with his elbows in my lower back during my contractions and it helped soooo much. This is a pretty common trick most midwives should be able to show you.

… and remember that no matter how crappy the pain is, it really won’t last forever!

You sound like you need a doula,obviously that may not be n option for various reasons, just trying to think what the alternatives might be.

I had two planned home births and I coped OK, but of course I can’t know what your pain is/was like!

Could you have a very calming birth partner (in addition to your DH) to try and keep you very focussed but relaxed? However I don’t want to sound like I think it’s all in your head, as I say, I can’t know what your pain is/was like. But I do think psychology plays a big part.

I don't think doulas are a thing here, I remember reading that they aren't allowed into hospitals, so aren't very popular, and everyone (hahaha) has a midwife who helps with the emotional side of preparation for birth and also comes to your house and helps with the newborn, but in any case I couldn't even get a midwife due to being too late (At 8 weeks pregnant ) so I highly doubt I would be able to find either a midwife or doula now at 33 weeks. Also, only one birth partner allowed in hospital currently due to COVID rules. So I'd literally just be hiring someone for that home portion which seems a bit strange? I will look but I don't think it makes sense.

I am sure it is all in my head, because I coped so much better with DS1 when the midwife actually told me what to do. But I don't see me having that option of someone telling me what to do, unless I go into hospital early, and even then if there is no reason for me to be there then I might just be told to go home again? No idea. Hmm I had been writing plans based on being able to ask for more input, but the more I think about it, the more I think I should probably still be at home at that stage anyway.

DC2 was a much shorter stint at 1-2cm - about 13 hours compared to 24. So hopefully that stage will be even quicker this time around and maybe I won't get so tired and exhausted due to that.

All those other tips I was doing but didn't really seem to help. We had this beautiful labour room with mood lighting, rainbows on the ceiling and a birth pool. I wasn't stressed when I first went in - I felt like it was going a bit "too" well really as I was easily able to cope with contractions but then they quickly ramped up into this place I couldn't manage them and that was still while I was in this "early labour" stage - just like with DS1.

Breathing was not really enough for me, I was in various positions - mainly standing/on all fours. We did the back massage thing because I made DH watch videos and practice it but I didn't really like it in labour either time. DS2 was back to back, not sure if DS1 was, possibly. There are 10 years between them (different dads) so DS1's birth is a bit of a hazy memory now.

Have their heads been engaged before labour OP? I only ask because none of my babies got their heads properly down until contractions started. So whilst I wasn't making any progress dilation wise early on the pains, like yours, were stronger almost than when I hit active labour.

I had my second a few weeks ago, was advised to get the epidural early due to health complications. My contractions started and I hung about at home, but after an hour or two felt they were getting unmanageable. Went in and was only 2 cm so you are not the only one that struggles for sure!!! First baby was induction and didn’t get the epidural till I was 8cm. It wasn’t for lack of begging as I was in agony and I said never again! Luckily enough it didn’t stop me having another but I’ll be honest, the epidural worked and the rest of the birth was genuinely bliss. I got to just lay there and let my body get on with things till it was time to push which was also easy! So although against the grain I would say to you, if it’s an epidural you would like ask Ahead about getting one early, I know yours didn’t work the last time but the odds of that happening again are slim. I also didn’t find that it slowed my labor or had any negative effect on me. I was bloody glad of it too getting stitched up after!

I was very surprised at what a difference my TENS machine made with DC2.

I think they were engaged. I had to go and look back at my old journal for DS1 and I remember my doctor saying something about DS2 not being engaged, because I was meant to call an ambulance if my waters went (in case the umbilical cord slipped out first) but then at some point she said that didn't apply any more, and I presume that was to do with engagement.

DH reckons I should get the epidural early, before I get into can't cope mode, but then it just seems a bit silly to plan to get an epidural at 1cm dilated? And if I do manage to stay at home a bit longer then hopefully I'd be in hospital later anyway so I'd have to wait. This should be something I can discuss at my appointment - I've already told them I want to discuss what happened with the epidural last time and they said I definitely can talk about that so hopefully I'll get some reassurance and a plan. They also have gas and air at this hospital which they didn't at the other one I delivered at so I should be able to use that regardless.

Things I found helpful.

1. Raspberry leaf tablets!
2. Hot shower with water focused on contracting stomach
3. When out of the shower a heat pack on contracting stomach.

Honestly when I've gotten to hospital and they've taken my heat pack away all I want to do is take it back and go home!

I hated the TENS with DS1, unfortunately, so not really keen to try that again.

Hot high pressure shower on the bottom of my back whilst leaning over birthing ball in the shower. My baby a was big and back to back, and early labour fucking hurt. You’re not a wimp.

Hi there @BertieBotts

Sorry to hear you've had such difficult experiences twice. Hopefully this time will be quick and easy, with no prolonged first stage. That usually happens with back to back babies and can be really painful. And I think its so unfair that there's no real pain relief options available before 4cm, you're supposed to just cope well at home- even though clearly many people don't.

For me, a doula has been a godsend and I would even hire one just to use at home (luckily my hospital currently allow 2 birth partners so I can have both).

Like others have said, I found a power shower over my lower back very effective at pain relief. Gas & Air if you like it can really help-but you'd need to be in hospital for that.

Keeping upright, swaying through contractions, and telling myself "i'm opening up to let my baby out" or something to that effect stopped me from tensing against the contractions, which is obviously counterproductive.

I can't think of anything else, as I honestly only had prolonged early labour with my first but all I can add is that i hope this time you get lucky with a quick, easy birth.

Good luck!

I was in latent labour for roughly 36 hours and was surprised at how effective regular paracetamol, hot water bottles and controlled breathing were at taking the edge off the contractions. I used to work on labour ward (I’m a doctor) and loads of women shout down paracetamol as it’s “too weak” so won’t take it. Complete rubbish - when taken regularly it is really good for pain relief, when labour was established I took dihydrocodeine and then later pethidine on top of the regular paracetamol and I don’t remember much tbh so must have worked well

Ohh to be fair, I never actually considered using paracetamol in early labour - that may well work well for me! I don't remember it ever being a suggestion 13 years ago, and then just didn't think about it with DS2 even though I'd heard of it before.

I will write it down on a big list of things to try.

Shame that they don't sell codeine over the counter here :o but oh well!

Our shower is great so might well try that one as well.

I think this baby is in a better position already, so hopefully he doesn't move too much from now until birth.

The dihydrocodeine was from the maternity unit (given by midwives) - I’m sure they would have no problem giving you some. I had a dose after being checked out before going home again (I was only 1cm -sob!) and it took the edge of my pain for ages, managed to actually get some sleep.

German doctors are notoriously stingy cautious with pain relief. I got told off for combining ibuprofen and paracetamol a couple of years ago after an operation to repair my finger where I'd managed to sever the tendon, nerve and artery!

@BertieBotts tens machine helped me quite a lot ? I was 2cm when I went in after 15.5hours after waters going they were getting bad 6 hours later stuck at 4cm had a section after a failed epidural I was in so much pain I couldn't cope I certainly don't class myself as a wimp,, looking back do I wish I had 'tried harder' yes but in the moment you do what you have to do
What about a best friend as a birthing partner would that help do you think? X

@BertieBotts that’s ridiculous. Paracetamol + ibuprofen are completely safe, it’s what I took when I was bedbound with covid for the awful muscle pains. It’s possible that German Drs just don’t like ibuprofen- indeed they are hard on the gut and the kidneys but fine for short term use in otherwise healthy people

They are always giving DH ibuprofen in massive doses so I don't think it's that It's definitely not allowed in pregnancy anyway so I won't take that :o

I can't have a second birth partner, only DH -this is COVID rules I think. I am not really bothered if I have an epidural, c-section etc, whatever it takes to get baby here safely, I am just anxious about having another experience where I feel like I don't cope. Totally happy to take the epidural early if that's what it takes (if they'll give it to me) - just musing really and trying to work out what the problem was so I can try to work around it next time!

I had a fairly unpleasant labour with DC1 that I was keen not to repeat. I read a hypnobirthing book and listened to the CD that came with it before DC2 (despite being massively sceptical) it seemed to work and I managed to get through a 4 hour labour from waters breaking to giving birth to a 10lb baby on just gas and air.

It was painful and I think probably more intense than DC1 because it was so bloody quick but I felt more in control and better able to handle the pain if that makes sense?

I was on continuous monitoring so wasn't able to stay mobile like I'd planned but I just seemed to feel better equipped to handle it.

In early labour you are at home though so can have who you like in your house to get you through it? @BertieBotts

I did hypnobirthing with dc2 and it was amazing in early labour! I used it along with a TENS, a birthing ball and lots of walking.

I got some wireless ear buds so I could move about and still listen to the meditations, watch tv shows and listen to podcasts or music. The TENS wires were unavoidable but it came with a handy neck strap so it was at least hands free.

I'd recommend hypnobirthing, it really did help me a lot. My first labour was about 14 hours so tried it for the second, which turned out to be closer to 24 hours and I'm so happy I did. Once I was relaxed I switched from meditations to distractions, TENS came out at the earliest discomfort rather than waiting until it was genuinely painful.

Ah yes I see what you mean Mrs Sunshine. Not sure who I'd ask though!

I've read a bit of hypnobirthing stuff but tbh can't get on with the fluffy side of it, but maybe I should listen more to the meditations just in case. I remember there being a hypnobirthing CD in hospital with DS1 and I listened to it. I am planning to have some more relaxing massage or new age type music this time as I had more pop/stuff I like last time and it just didn't really register at all.

I am genuinely quite curious though, what other people's experience is of the early stages. I always believed that the early bit (1-4cm) was meant to be relatively pain free, maybe a bit uncomfortable, but definitely manageable and then the pain steps up at 4cm which is why they only give you pain relief starting then.

But perhaps my understanding was wrong? Is there meant to be a clear shift there, or not? Or is this all somewhat moot - I am finding online now a lot of references to the definition of "active labour" changing from 4cm as a threshold to 6cm, so maybe what I understand as early vs active labour isn't correct anyway.

In my case early labour was definitely painful, needed to stop to breathe through them, but manageable pain. But I definitely noticed a shift in the intensity of the contractions once I was in "active" labour.

I always get annoyed when the midwives say you're not in labour until you're open 4cm. Its jolly well labour before that!

@BertieBotts might be wrong but my understanding was that you can't have epidural etc until 'active labour' incase it slows things down ? They want you to be well progressing x