labor doula

Pain Relief in Labour: What Are My Options?

While you are thinking about and planning for your birth, options for pain management is a hot topic! While some women will plan for non-medical pain management in labour, whether you intend to use other methods of pain relief, it’s still important to know your options, weighing the benefits and risks of the decisions you might be faced with. 

Depending on your hospital or birth centre, the options for pain management will vary. At our local hospital, the options you’ll typically be offered are: Nitrous Oxide, Fentanyl, or an Epidural.

Each of these are very different, and all of them have their pros and cons. Each labouring person will react and respond differently to each of these methods of pain management, and it’s important to realize that what you might have hoped would work, may or may not work for you. 

 

Let’s take a closer look…

 

Nitrous Oxide

Nitrous oxide is delivered as a blend of nitrous oxide and oxygen, through a mask that the labouring woman holds and self-administers through contractions. 

The Pros:

Nitrous Oxide is fast acting and wears off quickly. It can be used at any point in labor right up until the pushing phase, and doesn’t have an effect on the well being of baby. While you will still feel the pain, a lot of women find it helps them relax and reduce their perception of pain. 

The Cons:

Some women find that it makes them dizzy or nauseous. It doesn’t provide complete pain relief, and it isn’t always as effective as some hope for it to be. 

 

Fentanyl

Fentanyl is a narcotic medication that is administered through an IV and delivers pain relief that should be more effective than nitrous oxide. 

Pros: 

Fentanyl can be easily accessed in labor, and tends to be a stronger pain relief option. You are still able to be mobile and will hopefully find some rest and reliefduring and between contractions.

Cons: 

Narcotics dull the pain, but they don’t fully eliminate it. Fentanyl causes some women to be dizzy and nauseated. Narcotics also cross the placenta and can contribute to fetal distress or impact baby’s breathing after birth, especially if they are administered too close to delivery. 

 

Epidural

The epidural: administered by an anesthesiologist, who for many a labouring women, greatly resembles a knight in shining armour bringing sweet, sweet relief. An epidural is administered through a catheter placed in the epidural space in your lower bak, and can be delivered during the active labor and pushing phase. It is typically recommended to hold off on epidural use until you’ve reached 4cm dilation to ensure that labor is progressing well. 

The Pros: 

The epidural usually provides complete pain relief. This can be incredibly useful if the fear or struggle with the pain of contractions is causing tension or an inability to ‘let go’ in labor. If a labour is long and her body is growing tired, the epidural can allow for rest and prevent the need for a cesarean in some cases. 

The Cons: 

It isn’t always accessible. Depending on how busy the maternity floor is, or the availability of the anesthetist, it can take anywhere from 30 minutes to a few hours to access an epidural; be prepared to wait. 

Epidurals have a few unwanted, potential side effects, like a drop in blood pressure or the risk of developing an epidural fever. Epidurals can sometimes slow labor which can lead to the need for synthetic oxytocin (pitocin). Fetal distress due to the effects of the epidural are greater, and so is the incidence of vacuum delivery.

 

Curious to learn more information? Book a birth planning session with one of our doulas to discuss your options in more detail and feel prepared for your birth. We’d love to chat with you and help you understand your choices and make a plan that works for you!

 

I Won't Ask To Hold Your Baby

There are few things in life as precious as a sweet-smelling newborn snuggled up in your arms. The ‘baby stage’ has passed me by with alarming speed, and I occasionally long for the days of curling up with a frog-legged newborn, with a cock-eyed head to my chest, peacefully sleeping in a cozied up milk-coma. 

You’d think, given the field of work I’m in, that I get more than my share of baby-holding. While I’m fairly well versed in the act of holding, cuddling, swaddling, rocking and bouncing a newborn, it’s not always a usual part of a day in my life with a family. Whether after a birth, during a postpartum visit, or as a postpartum doula, holding babies is actually a lot more scarce than you’d think. 

Why? Because I won’t ask to hold your baby. 

It’s not that I don’t want to. Oh, I want to. But it’s simply not my job to assume that’s what you want or need from me. 

 

My job as your doula is to support you in the ways you need most, giving you the space to bond with your baby. 

 

Those precious hours after birth - those are your moments. That is your time as a family to revel in the miracle you’ve just welcomed into the world; to take in every quick breath your baby takes, to keep him warm and close; the place he wants to be most. 

The weeks postpartum, you may want to revel in every sleepy moment with baby. With visitors coming in to sneak in their cuddle, you may be longing to simply soak up these fleeting moments.  

And perhaps you gladly welcome an extra set of arms so that you can sneak in a nap or a shower, or a hands-free trip to the grocery store. Ok, let’s be honest…a solo trip to the bathroom might be a luxury experience at this point. While I am (more than) happy to provide this for the parents I work with, l also know that sometimes (often) the most valuable way I can support them is to keep the house tidy, prep a meal, do a few loads of laundry, or play with little sister. 

My greatest goal is to be there to give you exactly what you need, and that may not include your newborn, and that is absolutely fine by me.

This One's For the Partners

Guest Post by Jody Richards, Labor Doula and Postpartum and Infant Care Specialist 

Guest Post by Jody Richards, Labor Doula and Postpartum and Infant Care Specialist 

Being a doula in the era of the internet, there is a sea of articles written about birth, and you begin notice some trends. One trend I've seen recently is the emphasis on partner support, and more specifically, physical closeness and intimacy between couples in labor. Experts on birth suggest that kissing, cuddling - all the romantic displays of affection you and your partner may enjoy with one another, can help move the labor process along. This lovey-dovey squishiness brings on the love hormone, oxytocin, which happens to be the same hormone that drives the contractions that bring your baby closer to the world. How wonderful, right? Perhaps, or maybe not so much.

You see, and don’t get me wrong - I am all for the squishy, gooey displays of affection, but this isn't every couples flavour. I have overheard women talk about how disappointed they are that there partner isn't on board with this idea, and how reading about these births leaves them feeling defeated. 

 

When I reflect back to the births that I have been at, the role each partner has played in participating in the birth of their child has been unique, and I realize how much they have all taught me about relationships.

 

There's the dad that spends most of the time checking his phone, and then there's the one who cracks jokes and makes it his mission to keep the labor room light. There's the dad that is tense and always looking to me for reassurance, and the ones who are old pros, lovingly doting on their wife without worry or hesitation. 

Do I look back and see that one was better than the other? Absolutely not! I actually look back and realize that love can be shown in so many different ways, and every couples dynamic is different. Even the dad who seemingly appears to be ignoring his partner during labor can very much be expressing his love for her, and I cannot judge the relationship that exists between partners who are entering into parenthood, together. 

 

As you prepare for your birth, open up the lines of communication, and talk about each of your ideals and expectations. 

 

Women: allow your partner the space and time to tell you how they think it might be for them. Listen to them without judgment and hear what they have to say about how they feel they fit into all of this. You might have to let go of the idea that your partner will everything you hoped he'd be, and that's okay. 

Partners: take the time to think about how you express love and respect for one another. What are the subtle ways you show you care? What do you need to feel like you can be true to yourself, but still meet her needs?  We all express love in different ways, so if we want to get that oxytocin flowing, lets do it, whether it means being the quiet observer, or tender and intimate.

So how can a doula help in all of the above scenarios? A doula gets to know each of you through prenatal appointments and contact throughout pregnancy. She helps you discover what each of your expectations are, what your roles may be, and how she can support you both. A doula doesn't have a single defined role: she is fluid and adapts to the dynamic of each individual couple. Many partners aren't even sure what there role will look like until labor begins; that's okay. Your doula attunes to you from first meeting until your baby is born; she's on this journey with you. I have heard from some spouses after a birth that they had been reluctant to hire a doula, because they didn’t wish to feel like they were being placed under a microscope; they did not want to be judged for how well they supported their partner.

 

This perspective tends to change once they experience how we actually helped them to feel free to be what they needed to be in the moment, and ultimately took the pressure off of them. 

 

Having a child is big, and watching the woman you love in the painful throws of labor is not easy. The intensity that a partner may feel for an impending birth is very different than that of the birthing woman. Something we pride ourselves in at In Bloom, is the ability to provide support for any couple and any birth, partner's included.

 

There's no judgement, and no one is under a microscope. There's no right way or wrong way, there's only you and your experience that is unique to you. 

 

Having these conversations toward the end of pregnancy can actually bring you closer and help you tap into each of your expectations, concerns, and the realities of how things may unfold. Decide what kind of support you need outside of yourselves to make the birth ideal for both of you. A childbirth education class is a great complimentary resource as you each prepare for your birth. Our labor doulas can help you both discover your needs, desires, and roles in labor, and help you create a plan to feel supported and confident.