Anyone who had their babies decades ago may think they had their children too soon.
Back then, 30 or 40 years ago, it was a case of no privacy, communal labour and delivery wards, stay in your bed, limited pain relief options and no partner allowed to stay with you for the duration.
It was a lonely experience, to say the least, but thankfully times have changed. With almost 70,000 babies being born in Ireland every year – around 190 a day – there are now many pain-relief options available.
Dr Krysia Lynch, chief executive of the Association for the Improvement of Maternity Services in Ireland (AIMS), has attended over 300 births, and is glad of the change.
A public and environmental health researcher, a doula (a person who is not a midwife but who is trained to support women through their pregnancy journey) and now a trainer of doulas, she has worked to bring about improvements in relation to women’s experience of labour.
“The system in Ireland is very different from the UK where maternity care is by midwives all the way through unless there are complications,” she says.
“When I came here I was surprised to see that women had to be under the care of a consultant obstetrician. It’s good that there is more information and options available to women now. Most women need and want more information so that they can be properly prepared.”
The power of the breath
So what are the pain relief options? What can help in what could be a 10-hour or more labour? Krysia has plenty of advice.
Learn to breathe deeply. You can do this by attending yoga-in-pregnancy classes or by practicing deep breathing with what’s called a ‘winner flow’.
This is a mouthpiece designed by a physiotherapist that encourages you to take really long breaths.
Some people are very prone to taking shallow breaths when they get anxious so this helps to slow down breathing. Breathing properly, in for a count of four and out for a count of eight, helps reduce the discomfort of contractions.
Heat packs
Heat packs or hot water bottles can help ease the pain during contractions in the early stages of labour. Cold packs can help too.
Dr Krysia Lynch.
Visualisation
Some women find that working with visualisations helps. A hypno- birthing course done during pregnancy can get women used to staying calm. This can be achieved by listening to a piece of music over and over again, a recording either of one’s own voice or someone else’s, repeating positive statements like ‘I am calm’.
There are lots of visualisation/brain training videos or audio tracks to look at or listen to also, eg ‘I am enjoying a walk on the beach’.
All these are about minimising anxiety and fear because when that rises women feel pain more.
Visuals like photos of the baby scan or of your other children or of a sunrise, for example, can be helpful also. Dimming the lights in the room is always helpful too, creating a calmer environment.
Aromatherapy
Having comforting smells available can ease anxiety. A few drops of lavender or mandarin oil on a pillowcase or a partner’s shoulder or shirt can help as there is a pharmacological response to those oils.
Bringing your partner’s pillow to hospital can be a good idea too as it will remind you of home and safety.
Birthing balls
Sitting on an exercise or birthing ball in a wide-legged position prepares the body for labour by increasing blood flow, opening the pelvis, and encouraging cervical dilation.
A peanut-shaped ball is another option. It’s especially helpful if you can’t get out of bed and walk or move around, for example, if your labour has been stalled because of an epidural, health complications, or fatigue from the length of your labour.
The curves help to encourage your body to relax in a way that speeds up the dilation of your cervix and your baby lowering into the birth canal.
tens machine
TENS
A TENS machine may help in early labour. Transcutaneous electrical nerve stimulation (TENS) is a method of pain relief involving the use of a mild electrical current.
The machine is a small, battery-operated device that has leads connected to sticky pads called electrodes.
The patches are placed on either side of the spine and the lower back area and they help women override the contraction. Every time one is coming, they can press the button which releases a little charge which can dissipate the feeling of pain.
TENS machines cost around €50 but make sure you buy the maternity version. It’s a good investment as it can be used for hours – at home, in the car and in hospital.
Massage
Having someone put pressure on your sacrum (the base of the spine) can help during labour too.
Midwives will show your partner how to do that. It involves putting one hand on top of the other and pressing down. This takes the pressure off the coccyx. Many women get a lot of relief that way.
Warm water
Hot water coming down on the base of your back can really help ease the pain of labour. Many women make lots of progress in the shower, standing or kneeling as the hot water is directed onto their back. Bring a ‘squishy’ garden kneeler with you, though, as shower trays can be hard on the knees.
Pools are available in many hospitals with some allowing birth to take place in them. The water is like a natural epidural due to the heat and support it gives because you’re not holding the weight of the baby.
Movement
Moving is the key to progressing labour, helping the baby descend into the birth canal. It’s better to lean against the bed than lie on it but do what helps.
Rotating hips or swaying with your partner can help too – whatever feels good. Holles Street midwives recently published a guide that they call ‘Hopscotch’. As in the game, it suggests doing 20 minutes swaying with your partner, then go into the shower for 20 minutes, then spend 20 minutes rotating on a birth ball. The idea is you’re always moving.
Spinal block
In this case, a woman is completely numbed and won’t feel the pressure.
Gas and Air (Entonox)
Entonox is a pain relieving gas mixture that consists of two gases, 50% nitrous oxide and 50% oxygen.
You breathe this in, via a mask, whenever you feel a contraction coming on and it takes the edge off the pain. The midwife will show you how to use it. Using gas and air also encourages women to breathe very deeply. This helps to centre ourselves and cope.
Pethidine injection
This is a strong, opioid pain relief medication that is often given in the thigh or buttock early in labour. It takes 20 minutes to work and lasts two to four hours. This helps women relax. Some say it makes them feel woozy. It can cause nausea in some cases but may also help women rest during a long labour.
Epidural
An epidural is a procedure that involves a medication that is a combination of a local anaesthetic and an opioid being injected into the space around your spinal nerves known as the epidural space.
The goal of this procedure is to provide pain relief (analgesia) or a complete lack of feeling (anaesthesia) for one region of your body, such as your legs or abdomen.
While the epidural takes away the feeling of pain, you will still feel pressure which you will need in order to push your baby out.
Bring snacks
Labour is hard work and requires fuel in the body. Eat a good breakfast or dinner (but nothing too heavy) before you go to hospital and bring snacks – such as blueberries and mandarin segments. Prepare ‘labourade’ in advance containing coconut milk, water, lemon juice, honey, and a pinch of salt.
A doula provides emotional support and physical comfort measures.
A doula provides emotional support and physical comfort measures. They also provide informational support.
A doula walks the journey of pregnancy and birth with you and your family. She (and very occasionally he) will visit you at home during your pregnancy to get to know you and how to best support you. She will be on call from 37-38 weeks to 42 weeks and be able to support you emotionally and with basic comfort measures during early labour at home.
She will attend the hospital with you if you are having a hospital birth and support you and your partner during your labour.
After you have had your baby, she will stay with you for a few hours until you feel happy for her to leave.
A doula is not a midwife and not a medical professional but is trained to give support throughout the pregnancy and birth if required. It is a private service arrangement between the mother-to-be and the doula.
There are plenty of doula services available. See: irishdouladirectory.com; doula.ie and doulas.ie
Dr Krysia Lynch can be contacted at dublindoula.com See also aimsireland.ie
Read more
Meet the Maker: Caóilfíonn Murphy O’ Hanlon
A Michelin guide to the countryside
Anyone who had their babies decades ago may think they had their children too soon.
Back then, 30 or 40 years ago, it was a case of no privacy, communal labour and delivery wards, stay in your bed, limited pain relief options and no partner allowed to stay with you for the duration.
It was a lonely experience, to say the least, but thankfully times have changed. With almost 70,000 babies being born in Ireland every year – around 190 a day – there are now many pain-relief options available.
Dr Krysia Lynch, chief executive of the Association for the Improvement of Maternity Services in Ireland (AIMS), has attended over 300 births, and is glad of the change.
A public and environmental health researcher, a doula (a person who is not a midwife but who is trained to support women through their pregnancy journey) and now a trainer of doulas, she has worked to bring about improvements in relation to women’s experience of labour.
“The system in Ireland is very different from the UK where maternity care is by midwives all the way through unless there are complications,” she says.
“When I came here I was surprised to see that women had to be under the care of a consultant obstetrician. It’s good that there is more information and options available to women now. Most women need and want more information so that they can be properly prepared.”
The power of the breath
So what are the pain relief options? What can help in what could be a 10-hour or more labour? Krysia has plenty of advice.
Learn to breathe deeply. You can do this by attending yoga-in-pregnancy classes or by practicing deep breathing with what’s called a ‘winner flow’.
This is a mouthpiece designed by a physiotherapist that encourages you to take really long breaths.
Some people are very prone to taking shallow breaths when they get anxious so this helps to slow down breathing. Breathing properly, in for a count of four and out for a count of eight, helps reduce the discomfort of contractions.
Heat packs
Heat packs or hot water bottles can help ease the pain during contractions in the early stages of labour. Cold packs can help too.
Dr Krysia Lynch.
Visualisation
Some women find that working with visualisations helps. A hypno- birthing course done during pregnancy can get women used to staying calm. This can be achieved by listening to a piece of music over and over again, a recording either of one’s own voice or someone else’s, repeating positive statements like ‘I am calm’.
There are lots of visualisation/brain training videos or audio tracks to look at or listen to also, eg ‘I am enjoying a walk on the beach’.
All these are about minimising anxiety and fear because when that rises women feel pain more.
Visuals like photos of the baby scan or of your other children or of a sunrise, for example, can be helpful also. Dimming the lights in the room is always helpful too, creating a calmer environment.
Aromatherapy
Having comforting smells available can ease anxiety. A few drops of lavender or mandarin oil on a pillowcase or a partner’s shoulder or shirt can help as there is a pharmacological response to those oils.
Bringing your partner’s pillow to hospital can be a good idea too as it will remind you of home and safety.
Birthing balls
Sitting on an exercise or birthing ball in a wide-legged position prepares the body for labour by increasing blood flow, opening the pelvis, and encouraging cervical dilation.
A peanut-shaped ball is another option. It’s especially helpful if you can’t get out of bed and walk or move around, for example, if your labour has been stalled because of an epidural, health complications, or fatigue from the length of your labour.
The curves help to encourage your body to relax in a way that speeds up the dilation of your cervix and your baby lowering into the birth canal.
tens machine
TENS
A TENS machine may help in early labour. Transcutaneous electrical nerve stimulation (TENS) is a method of pain relief involving the use of a mild electrical current.
The machine is a small, battery-operated device that has leads connected to sticky pads called electrodes.
The patches are placed on either side of the spine and the lower back area and they help women override the contraction. Every time one is coming, they can press the button which releases a little charge which can dissipate the feeling of pain.
TENS machines cost around €50 but make sure you buy the maternity version. It’s a good investment as it can be used for hours – at home, in the car and in hospital.
Massage
Having someone put pressure on your sacrum (the base of the spine) can help during labour too.
Midwives will show your partner how to do that. It involves putting one hand on top of the other and pressing down. This takes the pressure off the coccyx. Many women get a lot of relief that way.
Warm water
Hot water coming down on the base of your back can really help ease the pain of labour. Many women make lots of progress in the shower, standing or kneeling as the hot water is directed onto their back. Bring a ‘squishy’ garden kneeler with you, though, as shower trays can be hard on the knees.
Pools are available in many hospitals with some allowing birth to take place in them. The water is like a natural epidural due to the heat and support it gives because you’re not holding the weight of the baby.
Movement
Moving is the key to progressing labour, helping the baby descend into the birth canal. It’s better to lean against the bed than lie on it but do what helps.
Rotating hips or swaying with your partner can help too – whatever feels good. Holles Street midwives recently published a guide that they call ‘Hopscotch’. As in the game, it suggests doing 20 minutes swaying with your partner, then go into the shower for 20 minutes, then spend 20 minutes rotating on a birth ball. The idea is you’re always moving.
Spinal block
In this case, a woman is completely numbed and won’t feel the pressure.
Gas and Air (Entonox)
Entonox is a pain relieving gas mixture that consists of two gases, 50% nitrous oxide and 50% oxygen.
You breathe this in, via a mask, whenever you feel a contraction coming on and it takes the edge off the pain. The midwife will show you how to use it. Using gas and air also encourages women to breathe very deeply. This helps to centre ourselves and cope.
Pethidine injection
This is a strong, opioid pain relief medication that is often given in the thigh or buttock early in labour. It takes 20 minutes to work and lasts two to four hours. This helps women relax. Some say it makes them feel woozy. It can cause nausea in some cases but may also help women rest during a long labour.
Epidural
An epidural is a procedure that involves a medication that is a combination of a local anaesthetic and an opioid being injected into the space around your spinal nerves known as the epidural space.
The goal of this procedure is to provide pain relief (analgesia) or a complete lack of feeling (anaesthesia) for one region of your body, such as your legs or abdomen.
While the epidural takes away the feeling of pain, you will still feel pressure which you will need in order to push your baby out.
Bring snacks
Labour is hard work and requires fuel in the body. Eat a good breakfast or dinner (but nothing too heavy) before you go to hospital and bring snacks – such as blueberries and mandarin segments. Prepare ‘labourade’ in advance containing coconut milk, water, lemon juice, honey, and a pinch of salt.
A doula provides emotional support and physical comfort measures.
A doula provides emotional support and physical comfort measures. They also provide informational support.
A doula walks the journey of pregnancy and birth with you and your family. She (and very occasionally he) will visit you at home during your pregnancy to get to know you and how to best support you. She will be on call from 37-38 weeks to 42 weeks and be able to support you emotionally and with basic comfort measures during early labour at home.
She will attend the hospital with you if you are having a hospital birth and support you and your partner during your labour.
After you have had your baby, she will stay with you for a few hours until you feel happy for her to leave.
A doula is not a midwife and not a medical professional but is trained to give support throughout the pregnancy and birth if required. It is a private service arrangement between the mother-to-be and the doula.
There are plenty of doula services available. See: irishdouladirectory.com; doula.ie and doulas.ie
Dr Krysia Lynch can be contacted at dublindoula.com See also aimsireland.ie
Read more
Meet the Maker: Caóilfíonn Murphy O’ Hanlon
A Michelin guide to the countryside
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