Childbirth & Pain- Advice Needed

[isfa]

I need advice, particularly from moms who have given birth more than once. Warning: I do talk about a lot of birth pain.


I gave birth to DD two years ago and I am due with another one this fall.
Although I practiced meditation prior to giving birth, I did not do any kind of class or method to get ready (e.g., Bradley, Hypnobirthing, etc.). Around 5 p.m., my water broke. By 6 p.m., I was having painful (but manageable) contractions that were about 8 minutes apart. We got to the hospital around 6:30 and I was admitted. Over the next hour, my contractions went to THREE minutes apart. I could not walk because of the overwhelming pain. At this point I wanted an epidural (though I'd hoped to not have one). However, due to the loss of amniotic fluid (a gush followed by a constant trickle) and the contractions that were right on top of each other, DD's heart rate had become very erratic (swinging between 60 and 180). They were talking c-section. In order to stave off that decision, they asked me to wait on the epidural, since it could mess up my blood pressure and make it harder to get a good read on DD's heart rate. If DD's heart rate didn't stabilize, they were going to do the c-section. At this point I was only dilated to a 3 (which is where I'd been for two weeks prior to labor). They started an amnioinfusion, and her heart rate stablized a little. Around 10 p.m., I got approval for an epidural, but they couldn't find the anaestheseologist. By the time he got there, I felt like I was being ripped apart. There was literally not enough time to take a breath between contractions. They were off the chart. You couldn't see peaks or valleys. The epidural worked, and immediately DD's heart rate stabilized. They continued the amnioinfusion and I labored through the night, without pain. In the morning, I was fully dilated and gave birth with only about 20 minutes of pushing. She was posterior.

So here's the thing. I am considering doing Hypnobabies, but I am very concerned that I will just be throwing away my time and money. Maybe I am just one of those women who has especially painful labors. It's hard to imagine anything helping me get through that labor. On the other hand, maybe the labor was particularly bad because of the loss of fluid and DD's posterior presentation. Maybe the next one will be completely different.

Please share your wisdom.

[BtotheG]

That sounds like a tough labor, to put it mildly.

I know that posterior positioning can make for a VERY painful labor - and I think low fluid exacerbates it. When the baby is posterior, the hard, bony back of the skull is pushing on your spine - which obviously causes a lot of pain, as you experienced. Also, I think that the low fluid means there will be less cushioning, and even more grinding of bone on bone.

I think it's perfectly possible that with your next baby, the positioning and fluid level could be more optimal, and you could experience less pain.

One question: were you able to move around at all during your labor? Could you change positions?

[emnic77]

your birth sounds a lot like my first. my daughter was 10lbs 4oz, i weighed about 100lbs pre-pregnancy. she was also posterior, the nurses that hooked me up when i first got to the hospital told me the contractions looked like pitocin contractions, and that was at 3cm. i had no break in between contractions, ever, i was in labor for 30+ hours, i ended up consenting to them breaking my water, nubain, then an epidural and a big episiotomy. i'll spare you the details, but back labor/posterior labor can SUCK.

fast forward to my second baby, who was also posterior and came out with a hand near his head - i didn't get to the hospital until i was 8 cm because i didn't believe i was truly in labor. i woke up dh to leave just before that because i was fine on my own and figured i had at least a day left, that i was in easy early labor. at the hospital, i was in the jacuzzi and laughing and joking during transition. pushing was intense because of his position but it was nothing i couldn't handle, and i did it completely drug free.

first babies can be a doozy. they really can. i'm homebirthing this time, and also using hypnobabies because i want that help through the pushing stage. i love hypnobabies at least for the insomnia cure

i'm not sure anything could've gotten me through that first labor, besides the epidural. i have a lot of "highsight is 20/20" ideas that could've made my labor easier (working towards better positioning, which i was unaware of, not agreeing to the AROM, etc) but i try not to dwell on the past. the biggest thing i learned with the birth of my ds is that every birth is different. his birth was so easy, i kept telling everyone that i felt like i cheated.

try to set aside your past birth and just take this one for what it is. it's different. it's not the last time. use water if you can, a tub is just wonderful for pain relief. i like hypnobabies, if for nothing else, i think the guided meditation will help me in labor just to relax.

eta: with hypnobabies, there is a lot of guided meditation about 'fear release', which i think could be very helpful for getting over the fear from your first birth. for my second, i didn't know about hypnobabies and ended up doing my own sort of 'fear release' which involved a prenatal massage and imagining sending all my fear out on a raft into the ocean but if you are as afraid as i was about my second birth after that...'intense'...first birth, i think that hypnobabies could be very helpful in that regard.


i know how much a difficult labor can weigh on you for a subsequent birth.

(sorry for the lack of capitalization, my left shift key is sticky)

[zinemama]

Your labor sounds a lot like my first, amnioinfusion and all (except that I didn't get the epidural - which I regret).

I was determined that the second time would be better. In some ways it was: I didn't have to be induced, I could move around, no infusion. But I had back labor. And to be honest, looking back on it, the pain level was just about the same.

With #2 I went for the nubain, in an effort to avoid the epidural. This was a mistake I hope no other woman makes. Nubain makes you fall asleep between the contractions and wake up for them. WTF!

I don't think there is any harm in doing the Hypnobabies. But there's no reason to feel guilty if you decide that your pain threshold is such that you need the epidural, either, when the time comes.

[gemasita]

There are definitely people who had painful first labors and then went on to have pain-free subsequent labors or much less pain. I always think about that and how amazing it is. Even with those memories, hypnosis can still change the way your mind interprets those sensations. I often have mostly first-time students in my Hypnobabies classes and I remind them of that fact when they are asking if hypnosis can work for anyone. You can read some birth stories like I've mentioned at http://www.pregnancybirthandbabies.com/

[Xavismom]

I've only had one birth, but I would guess the position and the low fluid would account for a tremendous amount of your pain.

DS was born posterior as well, and the pain was intense. I went into the hospital thinking I was almost ready to push because the cntrx were so painfull, and I was at a 4!

We did AROM while I was in transition, and it easily quadrupled the pain level, which was already intense at that point.

I cant imagine how much worse it would have been if I had asked for an epi and then had to wait, so sorry that happened to you!

I'm really hoping if we have a second, the babe will not be posterior, I'm convinced thats why I had so much pain, but if its not, then I'm hoping the fact it will be my second baby might make it a little easier/faster (DS was 30+ hrs of labor)

FWIW, we did Bradley, and I think it helped a lot, as did being in a warm tub and counterpressure.

Good luck Mama

[isfa]

It is so great to read all of your responses! I am definitely going to try hypnobabies now. I really want to feel less fear during this birth. Hopefully I will also have better positioning and fluid this time. I really appreciate these thoughtful and reassuring responses.

[zoebird]

there are a lot of reasons why women have pain in birth, and one of them has to do with their neurology, another with how their body labors, baby's position, and a variety of others.

other factors are more amorphous. Fear, panic, intervention . . .lots of things can affect the mind and therefore affect the body making it more difficult to accept.

and usually, it's such a massive combination of factors that it can be hard to say what can be done to change the situation.

Assuming one manages all of the emotional/psychological/and situational (hinderances, interventions, interruptions) elements, then one has to question whether it is simply neurology or the process of how that body labors. could be just that.

from what you describe, your body just went full-on, didn't it? and you had a posterior baby--which is known to have more pain. but i think that being in the hospital increases fear, and being the first birth probably did as well. and all of that c-section talk probably increased the fear too.

so it seems like there were a few factors in all three "camps."

i would look at how to create the best outcomes at all three levels. first, physically--you may not be able to change some things, but you might have some control over others. spinningbabies.com has information about helping babies find the best positions to birth (even so, my baby was also posterior!).

emotionally, hypnobabies and the like--in addition to your meditation practice--can greatly help moving into labor and birth without fear, regardless of physical elements or contextual ones. it just seems to have a lot of success in that way. i do not think it would be a waste of time/money.

contextually/culturally, you might want to look at where you birth and look into the information by Michael Odent (MD in france) regarding hinderances and it's impact on birth physiology. it's fascinating. you may not believe all of it, but even if some of it is valuable to you, then you can create the birthing space you need--in hospital, birth center, homebirth, or UC--so that the stresses of those environments can be reduced for you.

good luck with it all. so much of this is a mystery.

[gemasita]

Great post zoebird!

[Erdbeer]

I agree with zoebird about the fear/discomfort factor. My second birth was at home and I was very relaxed. In my birth prep course, the midwife had us practice going on all fours or leaning over one of those big gym balls and rocking back and forth while our partners applied pressure to our tailbones. I didn't think much of it at the time, but when I went into labor (which lasted 3 hours from start to finish), this worked like a charm. I leaned over a pile of pillows on the couch while he pressed my tailbone. I had almost no pain at all when my DH pressed this spot during my contractions. It took a few tries to get just the right spot but once we got it, it got me through almost my entire labor in relative comfort. Only when I decided to get into the tub did I feel pain because he couldn't press so hard. Maybe this would help you!

[rparker]

How much time did you spend hooked up to the electronic fetal monitor? This may sound weird, but the only times that my labor really HURT were riding in the car, transition, and the 2 times I had EFM. It sounds like you had other factors that may have made your labor painful, but could the EFM have contributed? I also had intermittent monitoring with a handheld doppler and that felt fine.

[isfa]

Yes, I agreed to the internal fetal monitor when they threatened c-section, so I was stuck in the bed with the monitor. :-( I couldn't walk anyway, but I would have liked to labor in the tub at least. I think being hooked up definitely increased my stress, and also prevented me from trying other positions to alleviate discomfort.

[RedOakMomma]

My first birth was very different from my first. With my second, too, I stayed home to labor (went into the hospital when my contractions were about 3-4 minutes apart). I was amazed at how much staying at home seemed to ease my contractions. I was just more relaxed at home, and I could do whatever I wanted to do.

Things you might want to try:

1. If your water breaks, concentrate (a lot!) on replenishing fluids. Drink, drink, drink.

2. Labor at home and see if that helps keep your contractions more manageable.

3. Do what you can to keep your baby from presenting posterior. Mothering magazine just had an article about this (womb massage? I think they called it). The main point of the article was about fertility, but the author also spoke of having her first baby be posterior, but then after treatment her second baby was not. You can also do stretches and positions throughout the day that might help encourage your baby to present differently. I think some of the spinningbabies website information would apply to this. Someone mentioned on a thread I started a while back that she had read that that reclining sitting/sleeping positions in the third trimester contribute greatly to having a posterior baby. Sit on a birthing ball or more straight-backed chair instead.

4. Have a lot of confidence that second labors are often very different than first labors. My friend, who had both of her girls posterior (actually BORN sunny-side-up...they never turned!) even had two very different labors. I was there for both of them, and the difference was remarkable. She was in a lot of pain in the first labor, and it went on for a long, long time. She had an epidural that everyone, incuding her super-crunchy OB, agreed was appropriate and needed. With her second birth, it went so quickly that she really didn't need an epidural. When she started asking for one, I think she confused the intensity of her labor with her memories of her first birth. She thought she was in another long haul of posterior birth pain, but she was actually in transition. She was dilated fully not long after.

5. I think a hypnobabies type thing might be really great for you, actually. Second births can go so quickly, but staying in control and away from fear helps a lot. I've read a lot of positive stories of hypnobaby births, and I think they really help women feel in control. Best of luck to you!

[Veritaserum]

Originally Posted by isfa

So here's the thing. I am considering doing Hypnobabies, but I am very concerned that I will just be throwing away my time and money. Maybe I am just one of those women who has especially painful labors. It's hard to imagine anything helping me get through that labor. On the other hand, maybe the labor was particularly bad because of the loss of fluid and DD's posterior presentation. Maybe the next one will be completely different.

I'm sorry your first birth was so rough. My first baby's birth was very painful (before I got an epidural). I had wanted to go natural, but had no tools, no education, and no support to do so. I used hypnosis with my last four and those births were much better. Aside from one of the births (which had complications), those births were more comfortable than my epidural birth. Nothing was ever has bad as the contractions I felt pre-epidural with my first--even when my fifth baby was posterior.

Hypnobabies was enormously helpful during my pregnancies, births, and even postpartum.

[mambera]

I hear that subsequent labors are often (not always) easier. I've only had one and it was freaking painful (despite laboring at home through transition and into pushing). However when it was over my midwife said, "Look on the bright side, you'll never have to do that (meaning primip labor/delivery) again!" I hope she's right.

Hypnobabies did nothing for me (hurt too much to breathe at all, never mind controlled breathing/self-hypnosis) but I see it's helped a lot of women. Why not try it? It's not really a loss either way.

[Sudonk]

I used hypnosis for all of my birth, and Hypnobabies specifically for my second and third. My first birth had the potential to be very dramatic, with a mal-positioned baby, 19 hours of intense back labor, a uterine spasm that didn't let up for several hours, and shoulder dystocia. But even with the elementary guided relaxation skills I had, I was able to remain comfortable and give birth without ever feeling the need for an epidural or other pain meds. And trust me, I do NOT have any pain tolerance, and the complications I had are considered extremely painful. With the help of my preparation, I chose to experience it as intensity and not pain.

My second birth (first Hypnobabies birth) was similar in some ways. Baby wasn't positioned very well, same back labor and uterine spasm as the first time, but my Hypnobabies skills made even the repeat of those complications easy to handle. I was able to move around easily, despite have a non-stop birthing wave that lasted over 3 hours. My third birth was 3 hours start to finish, and while it was intense and took a bit more focus than my all-day-long previous births, it was never difficult to handle, thanks to Hypnobabies.

[mamallama]

My first birth was so horrifically painful. My baby was anterior, but she had her arm over her head. The epidural was my favorite part of her birth.

My second was born at home with a midwife. I had a lot of fear going in--esp since pain relief wasn't an option at home. It turned out fine. I laughed through transition. Crowning was really surprising because that was the first time the intensity of labor registered as pain.

My third was even easier. I never felt the urge to push, so I didn't. I could tell he was close, though, because I could feel his head less than a knuckle in. With the final contraction he pushed his feet off the top of my uterus & his whole body slid out into my hands. No part of his birth was painful.

I wonder if I would have perceived my 2nd and 3rd as painless if I had not had so much pain with my first.

[honeybee]

I'd also recommend seeing a chiropractor trained in the Webster technique to help promote optimal positioning of baby and avoid the whole posterior thing this time around.