Pain Relief

Your circumstance in the labour room may be any one of the following:

Natural delivery
Induced delivery
Instrumental delivery
Elective/Planned Caesarean section
Emergency Caesarean section

The common factor with all these types of delivery is pain; before/during/after.

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When the pain becomes really intense and too much for you to handle, there are specific pain relief medication you can access to help you manage. However, there are points to take into consideration when opting for a pain reliever.

Firstly, medication will be granted to you based on the type of delivery you’re experiencing. For instance, with any type of Caesarean section it would be mandatory for you to be given strong anaesthesia. This is because the process is actually a surgical one and an incision is made for the surgeon to access your baby. The type of anaesthesia used is an epidural/spinal injection to completely numb you.

With natural, instrumental and induced delivery, contractions cause intensifying pain as you draw nearer and nearer to giving birth. If you have crossed your pain threshold, you can also receive an epidural to ease the pain. There is also the option for you to inhale a gas or an injection you can receive (in muscle tissue or intravenously).

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Although it is completely normal for you to feel a strong urge to opt for a pain reliever when the pain surges, you must keep in mind the following. Oftentimes, some of these drugs reduce but not remove the pain completely and you still experience pain. Contractions are significantly powerful and necessary to get you through your delivery. Additionally, there may be short-term and long-term side effects associated with these drugs. Some of these side effects can affect both you and your baby in the immediate postpartum period. Others can impact upon your body for months or even years to come.

Tell-It-Tip: The side effects associated with epidurals include headaches, nerve damage, nausea and infection.

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Psych Up!

Now that you’re more or less at the point of giving birth, what do you need to know and do? Yes, you have done your research and received endless advice but you know for sure you’ll never really be ready to give birth. Even if you had 100 years to prepare for it, during the 99th year you’d still freak out.

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A key point to note is that no amount of theoretical training or shared experiences can truly prepare you for the moment of labour and childbirth. The onus is on you to psych yourself up to face whatever comes your way. As cliché as it seems, only you possess the power to summon your inner badass and show them how its done. Here are a few simple steps to guide you along the way:

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Spirituality is imperative in keeping you grounded. Meditation can strengthen your body by first conquering the mind. When in doubt, also rely on prayer.
Create a list of your desires and fears then a list of your strengths and weakness. Afterwards, see how you can use your strengths to achieve your desires and challenge yourself to work on your weaknesses to diminish your fears.
Make a playlist of songs that cause your soul to feel good or find some books that motivate you to become a better version of yourself. Repeat some key lines like a mantra until you become what you believe.
Have conversations with yourself especially when you experience doubt. Tell yourself that you possess everything you need to succeed within you.
Learn to forgive yourself and forget mistakes that you would have made along your pregnancy. In the face of adversity, use these mistakes as lessons to strengthen yourself.

As long as you spend enough time cultivating these positive habits, you will find it easier to remain grounded during your labour and delivery. The journey is not an easy one but nothing good comes easily.

Tell-It-Tip: Studies have shown that exercise, enough rest and relaxation and a balanced diet can contribute to reduced stress in pregnancy.

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Contractions?

When you first discovered that you were pregnant and after your initial happy thoughts, you naturally wondered about the pain associated with pregnancy. Now that you’re bordering the finish line, these thoughts have only been magnified. You know that you have to expect some degree of pain but just how far will it go? All your life you’ve been used to having a high pain tolerance so you think you’ll be able to manage with the pain.

According to your calculations, you’ll soon begin to experience contractions. You have the timer on your phone all set and ready to record the length of each contraction as well as how frequently they appear. Furthermore, you’re a pro now at breathing exercises so you have everything under control.

All that’s left to do now is await that first “real”, non-Braxton-Hicks contraction. *tick tock tick tock*.

Fast-forward to that moment you actually experience that first contraction either after you naturally go into labour or if you have been induced. When it occurs your try not to overthink it because you’ve been through enough Braxton-Hicks contractions. However, soon you notice a pattern. These contractions are rhythmic and feel different. You can’t really articulate what is the difference but now you laugh at yourself that you assumed that Braxton-Hicks were anything near the real deal.

At first you only mention it to those nearest to you because you’re scared of raising a false alarm. Upon reviewing your record of these contractions, you know for sure that it’s finally happening. They’re coming minutes apart and lasting for a considerable amount of time. You know from your doctor’s visit that you shouldn’t rush to the hospital just yet but these contractions are coming harder and faster. Every time you think that’s the strongest it could get, it gets stronger. When you feel like it’s too much for you to handle, you tell your husband to grab the bags and you head to the hospital.

Tell-It-Tip: The most appropriate time to head to the hospital when experiencing contractions is when they have reduced to less than 5 minutes apart and lasting no less than 45 seconds. You should be able to easily identify a pattern and the contractions should feel strong.

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The Last Resort

You distinctly dedicated yourself to doing all the exercises that you were advised would aid in ensuring you a smooth labour and delivery. All your routine clinic visits were great and you showed no signs of complications; yet here you are.

A scenario something like this…

At first you felt like something just wasn’t right. A feeling you could never articulate and one that will remain with you for life. The next thing you knew was that you started spotting a little, nothing major, but from your own research and advice in the Lamaze class, you knew it meant time to head to the hospital.
You were at home, comfortable in bed and you felt some warm fluid leaking out and you assumed your water broke. To your dismay you saw bright red blood on your sheets and some intense pain took you over. You immediately called your husband who went to run errands to come and take you to the hospital.
You felt nothing which was weird because your baby is usually so active especially after you ate. You went to sleep with it on your mind but you didn’t want to overthink it because maybe the baby was just asleep. You couldn’t sleep too well that night. You looked at the clock until 8:00am when the doctor would get in and you knew you had to call immediately. The lack of movement was unusual and you felt barely anything for over 12 hours. The doctor told you to get to the hospital immediately.

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Regardless of your circumstance, the sequence of events is still a blur to you but last thing you remember is thinking that you weren’t prepared for this. Before you knew it the doctor had you sign a document (that you still don’t fully understand) giving them the permission to cut an incision into your abdomen to remove your baby. With much worry and disbelief, you were put to sleep and woke up disoriented with no sign of your baby and fearing the worst. When you mustered up enough strength to utter some words, all you cared about was knowing whether your baby had made it.

When you found out that your baby was alive and kicking, in that one moment your world was complete again. Never in 100 years you imagined that an emergency Caesarean section would be in your radar but here you are. Perhaps the doctor counselled you that the baby was going into distress with a dropping heart rate and this was your only option. Probably you experienced placental abruption and your placenta separated from your uterus. Maybe your body randomly decided to send you into early labour but your cervix did not dilate in time. At the end of the day, when it was all said and done, you were still grateful that you and your little one were here to tell the tale.

Tell-It-Tip: A Caesarean section procedure lasts between 30 minutes to one hour. The portion of the C-section whereby the incision is made and the baby is removed only takes about 15-20 minutes. The balance of time is used to suture the mother’s uterus and abdomen.

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Name Game

If you’re super organized (congratulations on that), then you probably already have your baby’s name chosen, fully equipped with middle names and back up names just in case they didn’t get the gender right. If you’re like the rest of the world, then you’re nearing your due date and you still haven’t decided on a name for your little one. Chances are that you originally had a long list of both boy and girl names, which you have since narrowed down to some of your favourites.

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Of the remaining names there are a few that you really like, but you keep your mind open still in case better options emerge out of the blue. This continues until you realize that time is running out and you go into a panic. At this point you consult with everyone important, put on your big girl panties and select a couple names with one -okay, maybe two- extra. You convince yourself that you won’t change your mind again yet you repeat this process a few times before your due date.

When you finally get it right you daydream about how perfect the combination of names will fit your unborn love and you can’t wait to confirm that when he/she arrives. There is a possibility that either the baby’s first name or middle name was chosen for a reason of significance. Reasons such as; it belongs/belonged to a cherished family member, it passed down the generations and will continue a legacy through your child or the meaning blew you away so you just had to. Another possibility is that you fell in love with the uniqueness, or even simplicity of the name.

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There will always be a few people who would disagree with your final name choice or feel disappointed that their suggestions weren’t used. Fortunately, only the parents of the baby have the final say and the choice should be respected regardless. After all, this is gonna be your baby’s name forever so you have to ensure that the one chosen is indeed THE name.

Tell-It-Tip: A naming ceremony is the process by which a baby receives his/her name. this process varies across different cultures with respect to how long after birth the baby is named and which rituals are performed.

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Complicated Times

For the last two to three months your anxiety has heightened as you begin to approach labour. Everything has gone well for the most part, but you’ve constantly heard that if you experience a smooth pregnancy, you’ll have a rough labour. The motivational readings you frequently browse have contributed to you maintaining a positive outlook thus far but there’s a sense of worry and doubt that overcomes you from time to time.

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Recently, a few of your close friends have delivered babies and you received mixed reviews on their overall experiences. This has left you feeling unsure about the outcome of your soon-approaching labour. While several things bother you, one of your most pressing thoughts is whether you will have a natural delivery with no complications or have to be induced, but worst of all, will you have a Caesarean section? Of course there is no definite answer to this question and you are right to have these concerns. You have been adamant that you DO NOT want a C-section and you heard that induced labour is excruciatingly painful. As a matter of fact, you know that labour will be hard in general so just thinking about any additional complication stresses you out.

The reality is that anything can possibly happen. Regardless of if you have a natural or induced delivery or a C-section, the main thing to note is that the experience will be nothing as you imagine. There will be moments when you will feel like everything is going wrong, others that you will make you feel defeated and times when you simply feel like giving up.

However, during these times you should aim to meditate and focus on the birth of your infant that you’ve waited so long to see, hold and cherish for the rest of your life. After you have given birth and the stress has subsided, you will be able to appreciate the struggle and realize that it was all worth it.

Tell-It-Tip: There is approximately a 20% chance that a pregnant woman will undergo a Caesarean section to deliver her baby, according to several studies. This has increased over the last two decades by 5-10% and this change has been attributed to modifications in medical systems worldwide.

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Easy-peasy Episiotomy

Many things surrounding labour are associated with deathly pains and episiotomy is not exempt from the list. Unfortunately, episiotomy becomes spontaneously necessary for several women during delivery to assist with birth. How it works is that an incision is done when the mother is experiencing difficulty with the passage of her offspring and is lodged in the passageway. This helps to quickly allow the baby to pass out to prevent further complication like damage to the baby. In most cases, anaesthesia will be administered to make the process as least painful as possible. After the completion of the birth of the baby, the incision is sutured. The healing process can be painful for the mom and the time for healing varies.

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If you are a first time mom and you have no clue what episiotomy is really like, here’s an idea.

During labour: you really just want to get this baby out at whatever length. Although you’re not happy about it, your doctor knows what’s best and the baby is stuck and needs to get out NOW so you roll with the punches.

Right after birth: Your anaesthesia is still in tact and you’ve received your stitches. You feel okay and relieved that your baby is here.

In the days following birth: Pain sets in and you struggle to function with caring for your newborn, as well as this healing incision down below.

Two weeks later: You’ve followed your doctor’s orders as it relates to keeping the incision sanitary and doing what it takes to heal as fast as possible and you finally realize that you’re healing.

Six weeks postpartum: You’ve visited your health facility and you were informed that you’re just fine but you still wish there was a way to prevent the stress of an episiotomy.

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Yes, everyone including you wishes that this will never happen but because labour is unpredictable, an episiotomy is not planned but will be employed as needed. Therefore, there is no real way to determine whether you will have one performed on you before hand. What you should keep in mind is that the probability for episiotomy is always present, with each pregnancy.

Tell-It-Tip: Frequently massaging the perineal area, with oils such as coconut or olive oil, in the weeks prior to delivery assists with the prevention of tearing and ripping during childbirth. These massages improve elasticity to the perineum and vaginal opening, thus reducing the chances for an episiotomy.

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Oh Daddy!

Thus far we have discussed a decent portion of your journey to motherhood and addressed several facts and misnomers concerning pregnancy. Some of the topics have surely hit home for you and you can relate so well. However, a pregnancy would not be possible without the DAD!

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Other than donating his “swimmers” as a contribution to the creation of such a miraculous process, what else is there about him? He has definitely come in handy as it relates to fetching snacks to satisfy your weird cravings and he has paid for many of the cute, non-functional keepsakes that you’ve ordered online. At times, his basic existence has driven you crazy (in the negative way) and you’ve wanted to punch him in his Adam’s apple just for breathing. You have to admit though, that he has been thoroughly patient with you through your mood swings and emotional episodes.

Being the one physically carrying the baby, you feel like a lot of the burden falls on you and dad is lucky that he doesn’t have to bare this weight. While this is understandable, one of the noteworthy things that you may tend to neglect, especially for a first time dad, is that there are many pressures he faces concerning the pregnancy as well. In his moments of solitude he wonders if he is doing the best job possible to ensure the wellbeing of both you and the baby. He questions whether he is ready to father his offspring and insecurities trouble him from time to time. At times, he compares himself to other dads and feels like he can’t match up to them but even then, he tries his utmost best to be a pillar of strength for you because he knows that you need him.

During your lowest moments, consider that just as much as the dad is there for you, you need to be there for him. This is a walk that you both share and pregnancy is not an easy task for either of you. When you feel to curse him out, think about the time be randomly bought you ice cream and he didn’t even know you were really, really craving that exact flavour. When you think that you would be better off without him or that co-parenting seems like a feasible solution, remember that before your hormonal changes, he was the love of your life. Lastly, when you think that he will never understand how stressful it gets to have a human being growing and shifting your internal organs, remember that he wasn’t made to do so.

Tell-It-Tip: Research has shown that 1 in every 10 dads are prone to experiencing depression/anxiety disorders during their spouse’s pregnancy. These disorders may be triggered by emotional, physical, social or mental pressures.

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A Personal Experience: Gestational Diabetes

Gestational diabetes is characterized by a marked increased in blood glucose/sugar levels that was not seen prior to pregnancy. This happens as a result of poor insulin production in the body. Hormonal changes serve as a catalyst for this in many pregnancies but other factors such as obesity, family history of diabetes or previous diagnosis may contribute to its occurrence. Because there is a chance for this condition to occur in any pregnancy, women are screened for high glucose levels. Once detected and confirmed for gestational diabetes, the individual would be then considered and treated as a high-risk patient. Similarly to preeclampsia, dietary and lifestyle changes are urgently recommended but if high glucose levels persist, medication/insulin injections would be prescribed, in addition.

If gestational diabetes is not brought to a controlled level, patients are at risk of delivering a premature or still baby, or a live macrosomic (often too large to deliver naturally) baby, or a baby with hypoglycaemia (low blood sugar) or jaundice. Gestational diabetes can also cause preeclampsia in the pregnancy. Women who develop gestational diabetes are also possess a greater risk of developing diabetes in subsequent pregnancies and/or later on in life. Ms. S. N. shared her own experience of dealing with gestational diabetes and this is what she had to say:

“In my first pregnancy I was 21 years old, unafraid and ready for what I believed to be the best experience in my adult life. I was undeterred by all talks of pregnancy sickness. However this was not the case. Not only did I endure morning sickness but throughout the day I felt ill. I could barely function and I was a university student at the time. I experienced regular vomiting, fatigue and dehydration but thankfully, after having my daughter, it was over. My second and current pregnancy begun last year when I was 29 years old. I was scared remembering just how sick I was and I braced myself for the impacts of my expectations but history did not repeat itself.

I found that when I ate this time around, I would become so sleepy that I would immediately pass out. I kept thinking it was normal but my routine glucose test proved different. I went to the hospital one morning to do the test that required fasting from the day before until the end of the test. I arrived at the hospital at 7:00am ready to get it all out of the way. Hunger made me nauseous. The plebotomist didn’t show up until 9:00am and I felt like I was starving by then. She took my blood sample and I drank my glucose beverage around 10:00am so I could not eat for two hours. At the end of the wait she drew more blood and tested my urine and they found higher than normal amounts of glucose. My body wasn’t functioning as it should to utilise the sugars ingested and I was showing signs of gestational diabetes. I was taken to see a dietician and placed on a strict diet and informed of the possible effects it could have on me and the baby.

Now I can barely eat anything at all because everything makes me sick but I have no choice but to eat. I am depending on a list that explains the foods that I should eat and the ones that I should avoid. However, I am thankful that I do not need to take insulin injections but adjusting is still pretty tough.”

Sadly, women are prone to so many challenges during pregnancy and Gestational Diabetes is no exception. If this happens to you, just know that you are not alone and that this is just temporary.

A Personal Experience: Preeclampsia

Preeclampsia is a medical condition that strictly affects women during pregnancy. Usually, preeclampsia causes high blood pressure and may lead to organ damage because of excess proteinuria produced in the body, if left untreated. Because of its potential impact, medical institutions make it compulsory to routinely screen patients for preeclampsia. Furthermore, if a patient exhibits any symptoms of preeclampsia, a medical plan, to bring the condition under control, is immediately drafted. From then onwards, the patient is monitored to ensure her safety and the health of her unborn.

The main thing to note about preeclampsia is that it can happen to anyone but there is a higher risk of experiencing this problem if there are predisposing factors. Some of these factors include being affected with hypertension prior to pregnancy, having a family history of preeclampsia and obesity. If a patient presents with mild preeclampsia, lifestyle and dietary changes may be advised to bring it under control. However, if severe preeclampsia is detected, medication and frequent check-ups are added to the dietary and lifestyle modifications. In an interview with Ms. S. N. on her personal experience with preeclampsia, she explained some of the things she faced. This is what she had to say:

“One Saturday night after experiencing headaches, fuzziness and swelling in my hands and feet constantly, I instinctively decided that I needed to check my blood pressure. At this point, I was 38 weeks, 5 days pregnant. My BP reading was an alarming 160/110! Naturally, I panicked but at that very moment, I remembered the many lectures given during my Lamaze classes on the dangers of high blood pressure/preeclampsia to me and most importantly, to my unborn baby. I believed that a good night’s rest was the remedy to bringing my BP to some sort of normalcy. I anxiously got up the following morning, retook my BP only to realise that it read a little higher than the night before. I went to the hospital immediately where I was admitted and prepped to be induced. I was officially in a maternal crisis!

I was a bit confused because I was under the impression, until then, that I was having a pretty normal, healthy pregnancy. I was very keen on maintaining a healthy diet and exercising, to avoid occurrences such as the one I was experiencing at that time. The nurses/doctors informed me that preeclampsia can happen at any point of your pregnancy and at no time should be taken lightly. Unfortunately sometimes, “it just happens; no real signs or warnings”.

Sadly, women are prone to so many challenges during pregnancy and Preeclampsia is no exception. If this happens to you, just know that you are not alone and that this is just temporary.