Facing prospect of second labour with no pain relief. Scared now. Advice please. (long)

[Cooperoo]

Hi there
I have kind of posted about this before but couldn't find my thread to resurrect it. I am currently 38 + 4 weeks with my second baby. I live in Cyprus as DH is with the forces. Due to various problems at our military hospital the theatres are out of action (and have been since November) and so they are not allowing us to deliver our babies there as they say it is not safe as they have no emergency contingency. Consequently we are being sent to Limassol General to deliver as this has been deemed the 'safe' option. I have been for a tour and although I have various problems with it (particularly the delivery suite) it is safe and practical and clean. The problem is that the only form of pain relief they offer is pethadine. There is no gas and air, no epidurals and not even access to a bath. I was lucky enough to have a water birth with dd using gas and air and so pethadine would not be my first choice anyway having not used it last time. They also do not administer it after you are 4 cm dilated so it is likely that when I want the pain relief it will be too late for pethadine anyway. I do have a TENS machine that the hospital have given us but didn't use this last time so don't know how it will help me this time. Basically I am scared that I will not cope and panic. In fact I already am panicking and have had a very emotional few days. This fear of delivery without pain relief is coupled with the fact that enemas, shaving and episiotomies are standard practice in the hospital and although I can say no (and will) and they will follow my wishes I feel I need to be very aware of what is going on around me which is adding to my fears.
Can anyone offer any advice or support? How can I make sure my instincts kick in over the fear?
I think I know that it will all be OK deep down because it has to be and this baby is coming out whether I like it or not but I currently don't feel able to cope very well and am dissolving in tears several times a day and unsurprisingly this is affecting my blood pressure (although not to cause a worry) and I feel will be having an impact on this poor baby. I really don't want to go to this hospital but my hands are tied. (It is also affecting my dd age 2 who knows Mummy is upset.) I am beginning to get quite depressed and feeling hopeless about the whole thing and know that I probably have another two weeks of feeling like this.

are there any natural remedies that might help relax you in labour - sorry if i'm talking crap.

Cooperoo, we spoke on your other thread (I'm in Greece remember?)If you want to have a chat, send me your phone number to adele @ in. gr (with no gaps obviously!) and I'll call you.It is exactly the same here as you describe.

That is utterly shocking that in this day and age labouring women are not offered all the methods of pain relief available to modern medicine.

You poor soul!

Oh Cooperoo - It's totally undertandable for you to be scared. Having all these rules and procedures that we in the UK arejust not used to. I had Gas&Air and a hefty dose of diamorphine with ds. It had mostly worn off by the time I pushed, but by then I was concentrating so hard on the massive contractions and pushing that I don't think it would have made any difference. And they took my Gas&Air off of me to push so I could concentrate! Now that pissed me off!

2nd time I didn't want diamorphine as it made me feel very groggy after ds's birth and he was lethargic too. At 6-7cm dilated I asked for half a dose as the pain was too much..... however dd had other ideas and was out before it took effect!

If its any comfort to you I really don't think when it comes to the pushing stage that pethidine/diamorph really makes that much difference..... it just makes the journey there a bit more bearable.

And also the pushing stage for a 2nd is almost always shorter than the 1st baby. Ds I pushed for 1.5hrs! Dd was out in 5mins.

I would be scared in your boat too being in a strange place etc.

Gas&Air is probably more about distracting you during a contraction than serious pain relief. Is there something else you could use?

Can you hire gas & air canisters?? (long shot)

As you say, this baby is coming out one way or another. Please just try to look forward too it. Pethidine really isn't that bad and I'm sure your labour will be over in a flash!

I dont know if you have an expat paper or magazine , I'm in spain and I noticed a company with private midwives who provide gas and air. Maybe there is something similar, I dont know your country very well but maybe if there is a large town or city there might be an expat service. ill see if I can find the company name incase they are international.

cant you go through the forces,i thought you got private health care.with my second one i was only at the hospital 2 hrs ,i arrived at 7.50 gave birth at 9.50.i only had gas and air .it was it much easier birth.stay at home as long as you can,good luck hoping all gos well i am sure it will.i would look into what toothache suggested about hiring gas and air.you could try taking rescue remedy homeopathic this is for to calm you down for nerves.

Cooperoo,
DOn't panic....try and think of your first birth and how you got through it, you will get through this one no matter what.
I had no pain relief for either of my two births, NOT through choice, I might add, both times I was too late and so had to do it on my own, the gas and air was no good for me. IT was so so bad the first time around. The second time was a lot faster and easier. However, the thing to keep in your head is that there is an end to the pain, and you know that. I know it is so easy to say this, and not so easy for you who is 8mths pregnant, but you need to beleive that this is all within your control, (not the pain....just the ability to manage it!) and it will feel less scary for you. Will you have dh there or not? If not do you have someone calming for you that will be able to hold your hand through it?
I remember being in a real panic for my first birth, but somewhere in the middle of the contractions I realised I just had to focus on getting the baby out and not the pain, if that makes sense. You CAN do this, you just need to talk yourself into it...(or have someone to keep talking to you about it for the next couple of weeks.
As for dd1, mine was just under 2 when I delivered dd2, and I had not wanted her to see me in labour at all. She did see all except the last 20 mins, but it did not affect her at all. We had just told her that mummys' tummy was hurting becauase the baby was coming out and that it was ok. Try and enjoy time with her, make the most of the last few weeks with one dd, and don't worry about how it will affect her.
I know it sounds like I am being blase (can't put an accent on my e!) but I just think you should not feel like it is all out of your control, you will cope much better if you take control of what little you are able to, and not feel so at their mercy. This is YOUR birth, and although you may have to do it in their hospital, you can still feel that it is up to you to make the best of it...
Good luck and let us know how you are getting on...

I had no pain relief at all with ds for similar reasons.

And it wasn't that bad, really. At least, it was nowhere near as bad as I thought it would be. Second labours are often very quick and I just concentrated on pushing. It was a million times better than dd's birth (for which I had an epidural which eventually wore off). They do epesiotomies as standard in Spanish hospitals too, which annoyed me, but it wasn't the worst thing and at least you can say no.

But anyway, if you're worried, why not buy a portable TENS machine? Or look into yogic pain relief methods?

I had ds with just one shot of pethadine (gas and air made me feel awful so gave up with that after 2 minutes) and it was ok. 8 hour labour and not too bad.

when I was pregnant I used to watch a lot of those discovery health programme and do you the know the two best births I ever saw were with out pain relief. One woman learnt to meditate and used mind over matter and calm inner chants and she dealt with the labour like it was a walk in the park. Apparently if you allow yourself to try and relax your natural endorthines (sp??) will kick in.

Your instincts will kick in and you will be fine.

I wanted an epidural with dd (had one with ds) but ended up giving birth without any pain relief (long story). It was incredibly fast and thoguh it hurt at the time, my recovery was almost immediate and when I recall dds birth I remember an absolutely amazing experience, I dont recall the pain at all. Second labours are usually much quicker so any pain you feel is hopefully short-lived. Also, your body is meant to produce it's own endomorphins which act as a natural painkiller.

I had ds with just pethidine (like you, Emily, gas and air made me naseaous) and although it's rather hazy I don't recall a 4cm rule here. I was induced so the whole thing was pretty painful, but not so bad I needed to use anything extra. I think with 2nd pregnancy it's always going to be scarier cos you know what to expect. On the other hand all the indications are that it will be a lot quicker and easier than no1. I really recommend pethidine, personally.

Hi bunny! How are you? People have been asking after you on our post natal thread!

Coooperoo, I got to 10cms without any pain relief. It was very painful, but it wasn't untill just before they checked me they realised I was not only in established labour and indeed ready to push!! I had only just been given the gas and air just prior. This was my first baby. Lots of people all over the world have to do the same, and as it is your second baby you will be likely to have an easier labour. Make sure you read up on your Tens machine NOW, i didn't and it was useless to me - didn't realise there was a booster button , as was in labour when got the pack. I am sure you will be fine, when you are in labour you focus on what you have to do, try and stay at home as long as you can. I would avoid the pethidine if you can. It isn't great as it often slows labour down, lots of places no longer use it. Try and stay calm and look forward to the moment your baby is in your arms.

hi cooperoo - just wanted to send you support - one of my good friends is in Cyprus too (husband posted there), and when we were visiting a few weeks ago, she told me of the hospital situation regarding delivery of babies

anyway, only word of advice I have to add to all the other good advice on this thread is to have an advocate with you (whether it be friend or partner) to make sure that your wishes are followed

good luck, and come back when you can to let us know how you get on

Wow, I am overwhelmed that so many of you have replied to me so quickly. Your comments are exactly the sort of thing that I needed to hear so thank you so much for taking the time to post. Just reading through them makes me feel more rational about the whole situation.
Bigdonna - This is the forces option . They are taking over a private clinic soon apparently whereby the UK midwives will do deliveries and gas and air etc will be available like in the UK but it is going to be too late for me (was supposed to be May, then 6th June and now they don't have any date.....bit of a fiasco really.) I am going to re-read all of these when I am having a panic as they really do help. One of my friends went privately (which is what all the Cypriot ladies seem to do) and so has a recommendation for me but the hospital boss has advised us that he does not consider the clinics to be 'safe' whatever he means by that. Also it will be CY£1000 min which we could find but it is obviously alot of money for something which should in theory be over within a day. I think part of the prob is I had such a nice time with dd, no stitches and quick recovery etc and I just see this whole thing as so far removed from that experience....nothing will be the same. DH will be with me and is doing his best to be sensible and rational but I can't help interpreting his concern as patronising poor chap. He can't say anything right. I am too close to him IYKWIM and just want to say that it is OK for him as he won't have to go through it. That is why your feedback is so helpful as you have been there. Thank you.

coop - re the private clinics, could the reason be why they are not deemed "safe" because they don't have the emergency facilities for infants, as well as the surgical facilities for the unlikely event of emergency section?

Can you get a private doula or midwife to support you and look after you in hospital as a birthing partner. It might at least take the away the anxiety of having to make sure your wishes are followed.

I'm someone else who had 2 drug-free deliveries, not through choice but speed . (I don't categorise G&A as pain relief as I found it about as helpful as breathing into a paper bag, ie only useful as something to concentrate on , as Toothache has pointed out. A Tens machine would fulfill the same function.) I'm a total coward, and was very keen to tank up on every drug known to humanity, but fate had other plans. And it was fine.

If your first labour was very straightforward, and you didn't feel the need for the heavy pain-relief artillery then, isn't it likely, on a logical level, that you won't need it this time either? Can you take any comfort from that at all?

How far is the hospital? Can you stay at home, in the bath, for as long as possible? Water was obviously helpful to you as it was for me (both times, I did all of my dilating in the bath, though I wasn't aware this was what was happening at the time). Or would you be able to use a bath at the hospital?

38 wks is a horrible time anyway. It's the doldrums, you're just waiting for a breeze. And your hormones are going ape. Of course you're feeling low.

lots of love cooperoo how stressful for you.

if its any consolation, I had no pain relief with dd2 (not through particular choice, they had no one at the hospital to administer it) and it was fine - really, honestly it was fine.

Cooperoo - please try not to panic! It is likely that the staff have methods of helping with pain. Pain relief is not all about drugs. It is being mobile, adopting different positions etc.

As you managed so well in the pool I am sure you will do well this time. Some women regard the pool as ineffective pain relief.

TENS and the pool work a bit on the same principle which is the Gate Control Theory. The stimulation of the electrical impulses of the TENS block the pain signals going to the brain. The warm water of a birthing pool does the same.

TENS can be a very effective method of pain relief and I am sure it will help you as well as the pool did last time. Definately read the instructions because it needs the pads placed properly on your back. You also need to know how to increase the intensity of the impulses.

Keep as upright as you can. Do they have birthing balls and mats so that you can adopt different positions? In units where there are no epiduaral, the midwives are more expert at helping you cope with the intensity of labour IMO.

How far do you have to travel to the hospital? Try and stay at home as long as you can because you will be able to use bath/shower there.

This link for active birth might help

Hi Cooperoo,
I really really understand how you are feeling, as 12 months ago I was in a very similar state. We were living in Faro, Portugal at the time and I had been told terrible things about Faro hospital where I was to give birth and I was terrified. Along with no pain relief, I was told they don't give you anything to drink and the father has to leave right after the birth. All true!

I am not going to lie to you that the birth wasn't scary, and I wish it could have been different. HOWEVER, I got through it, and had a very healthy, beautiful little girl who is now 1 year old.

Mears - I have to say that none of that was allowed where I gave birth. I don't know how it is in Cyprus, but I was strapped to a monitor the whole time and not allowed to move about. Birth was in the old fashioned feet in styrups position (dh tells me I swore at them when they made me put feet in stirrups).

Cooperoo, they also tried to give me an enema, but I was given it to administer myself and I just pretended I had taken it.

As you have a little girl already, hopefully your labour will be quicker and sometimes these things happen so fast you wouldn't have time for pain relief anyway.

My MOST IMPORTANT advice would be to make sure there is someone around who SPEAKS ENGLISH or have someone there who speaks Greek. The most frightening thing for me was not being able to understand what was going on because my Portuguese was crappy and dh was only allowed to be with me for some of the tme. Fear makes the pain much worse (clinically proved!)

That is the best advice I can give except to say that I would do it again in a flash because my dd made it all so worthwhile. Remember that labour and birth rarely work out as the mother would have liked and as long as the baby is safe and well, that's the main thing.

Good luck!! (CAT me if you want, anytime)

Have only read the initial post, but I just wanted to say that you may not even need pain relief. I spent my 2nd pregnancy dreading the labour (although first was relatively uncomplicated & 10 hours, I didn't have any pain relief & there was quite a lot of pushing, which I hated). 2nd time round, I gave birth after 2 hours of labour (about 1 hr of which was excruciating) and 2 minutes pushing - I didn't even make it to the hospital! Gave birth in the car, actually. This will probably terrify you in a different way, but honestly, once I realised it was happening & that it would be over very quickly, I felt quite exhilarated. (sp?) I think what I'm trying to say is that you don't know what's going to happen so it's pointless worrying - it may not be as bad as you think. HTH. Good luck.

I had a home birth and the days leading up to it I was constantly asking myself if I had done the right thing. I had a long labour with my first and had an epidural, so I had no idea what I was in for! All the books I read said that if you were the kind of person who took a painkiller the moment you got a headache, then a home birth wasn't for you - I was that person! I was worse than a man when it came to pain! But in the event I coped pretty well using the breathing techniques I had been taught - breathe in slowly through the nose and equally slowly out through the mouth, do not quicken your breaths or you will panic.

By the time it got very painful, he was coming out and just half an hour later it was all over. I knew what was going on all the time, even whilst I was pushing him out, I knew what position he was in and I knew that I had torn. You are very sensitive down there and can feel everything, so they cannot do anything to you without you being aware of it.

I think you'll be ok. Once you are in labour you won't have time to be scared, your instincts will tell you what to do and you'll just find yourself doing it.

I always had a comforting story in my head, that of the Rwandan woman during the floods who actually gave birth in a tree whilst being rescued. I thought that if she could go through all that, then I could give birth in the relatively safe surroundings of my own home!

Good luck and try not to worry, fear will only make the pain worse, practise your breathing and you'll be fine!

Thank you again.
Lottie G - Thankfully my experience will not involve constant monitoring etc like yours. It really helps that you point out that your dd was worth all of it though, as of course they are, I am just losing sight of it at the moment.
Scampadoodle - You made me lol about having the baby in the car. The hospital is 30 mins away and I am certainly going to try and stay at home for as long as poss so having the baby in the car had crossed my mind. VERY stupidly this doesn't worry me as much! How ridiculous is that. This is what I mean about losing my rational thinking.
Koalabear - The clinics are set up for emergency sections etc but I think there is an issue over blood reserves and this sort of thing. If the babies are seriously ill and need intensive care they are whisked off to Nicosia Hospital anyway as this is the only place on the island to deal with premature/seriously poorly babies.
Mears - Thank you for your post too. You are right that the midwives MUST have other ways of helping the ladies cope. From what I have heard they do encourage ladies to be active and walk around. They have nothing like mats or balls but I do and so I will be aiming to take my ball in with me. Thanks for that link to. I will get reading it. The problem is we have not been able to speak to the actual Cypriot midwives who would deliver us to find out their practices. We have been reassured by our UK midwives that they all speak English and that there is a bath for us to use for pain relief and that episiotomies are not routine and that the babies don't get put in a heater/incubator when they are born, and none of that seems to be true, so I have lost faith in what I have been told.
I am going to have a practice with the TENS this afternoon.
BakedPotato - You are right about 38 weeks being the pits. Everything is ready and I am just waiting and obviously have too much time on my hands to think about everything....
Meant to say earlier thanks to Grrmum too for your offer of a phonecall. I may take you up on it.
Thanks again.....

Rhubarb - Xposted. Very good point about the lady up the tree.
I think is it partly the actual hospital that scares me and the thought that things will be taken out of my control. I was so in control with dd and left to get on with everything as I wanted. Had I been in the UK I would have opted for a homebirth preferably with a pool and I guess I am kind of sad still that these options are not available here....