ļ»æEpisode 170 - Managing labour without pain medication
[0:00] Welcome to the Great Birth Rebellion podcast. I'm your host, Dr. Melanie Jackson. I'm a clinical and research midwife with my PhD, and each episode, I cast a critical eye over current maternity care practice by grappling with research and historical knowledge to help you get the best out of your pregnancy, birth, and postpartum journey. Welcome to today's episode of the Great Birth Rebellion podcast. I'm your host, Dr. Melanie Jackson.
[0:30] And today I want to talk about pain management strategies for labor that do not involve medication. There are so many sensations that happen when you're in labor and giving birth and the pain of contractions is one of those things. There are other unique things that you'll feel in your body. So we'll talk about the sensation of labor and how to manage that, but we're not talking about medication or pharmaceutical things. There's pharmaceutical ways to manage pain in labor such as epidural, morphine, pethidine or gas but that is not what this episode is about. If you want to avoid using those kinds of pain medications in labor this is the episode for you. So today is all about strategies that you can use if you want to avoid pain medication.
[1:17] A lot of women know in their mind that they want to avoid medication because there can be undecided effects to using it and a lot of the non-medical ways of managing labor pain have very few or very little kind of minor side effects. So there's not a lot of harm in considering using non-pharmaceutical pain relief and gathering a toolkit of what you could use, at least giving them a go. You might find that they're incredibly effective and that you get through your whole labor without needing any additional pain relief just because you had a plan to do so. So that's what this episode is going to help you to do. Gather a toolkit of things that you can use, both things that are completely free or things that you could pay for and have handy to at least give them a go. And I believe that you will surprise yourself with how much capacity you have to manage the pain of labor. If you just have a bit of preparation, a bit of education, your support people are on side, and you've got this toolkit ready there for you to use.
[2:23] Now, this episode is not only for you, it's also for your support people. They need to be on board with this as well because one of their main jobs in your birth space is not only to protect you from people who might distract you from the birth process or protect you from people that you don't want to have in your space. They're there to protect your flow, your labor flow, but they're also there to support you to have whatever you need to manage every single contraction.
[2:51] It's a big job to be a support person. So this is a perfect episode for them to listen to because it gives them the strategies, the exact strategies that they can use to help you get through every single individual contraction. So today we're talking about pain management strategies in labor that don't involve medication. And that means they involve all the people in your space because often pain medication can be a replacement for poor support. So if you're taking away pain relief of an epidural, you've got to add the support, the very good support of the team that you've got around you.
[3:28] So before we kick off, though, there is a movement of people, of birth advocates, who suggest that birth could be pain-free if only you didn't feel tension, or if only you didn't feel fear or stress.
[3:45] Or that maybe we shouldn't even use the word pain when referring to contractions. Some people will call contractions different things, like waves, or they downplay the activity of your body during labor. Refusing to use the word contraction or pain. Today though, I am going to use the word pain. I'm not going to acknowledge contractions as waves. I'm going to acknowledge them as contractions because your uterus in labor does contract. And that's why we call it a contraction. Your uterus is a muscle and it contracts. And this can be, and most often is experienced as painful. That's how most women experience labor. There's definitely a proportion of women who have painless labors though. So they're not sensationless labors, but there is a small number of women, and I've witnessed them myself, that describe their labor as painless, but you can't rely on that. If you're not prepared for pain, you are not prepared for labor. So that's what we're talking about today, how to prepare yourself.
[4:48] Because most likely what will happen to you is that you'll experience labor as painful. But guess what? That's okay. We don't have to be scared of pain because pain is big, but we can do it. That's what we were made for. We're women. We were made to grow babies, labor, and birth them. So instead of downplaying and denying the pain of labor or being scared of it, let's just mentally clock the phrase that, yes, it will probably hurt and that's okay. I can do hard things.
[5:21] Honestly, we're women. I just, we can do this.
[5:25] So today what you'll learn is that the pain of labor is purposeful, manageable, that we are powerful and capable of working with and through labor pain. In fact, going through labor with the pain and coming through that, it actually changes your brain. It changes your body. It changes you as a person to have gone through labor, overcome it, managed it. You find some new capabilities and you can be so proud of yourself. There is a purpose to the pain of labor and you are capable of working with it. So it's time to stop running away from labor pain and just admitting that it's probably going to hurt, but that's okay.
[6:05] Marathons hurt too. And people do those all the time. Of course you can do labor. The biggest lie that we've been told as women is that labor is the worst pain you'll ever feel. And that's total rubbish. For some women, it's true. They've never felt anything so painful, but honestly, it's not as bad as everyone says it is. That's the thought I had in my mind when I had my two babies. Huh. This is not as bad as what people say it is. I've had urinary tract infections and toe injuries that hurt more than labor. I would have the pain of labor over a kidney infection and an injured toenail any day.
[6:45] But society wants us to feel scared of the sensations of labor so that we hold on to fear about birth.
[6:54] The world, medical society, whoever it is, is invested in us not realizing our full capacity. It's invested in us saying scared of labor and birth so that we don't realize what we're capable of. We are so capable of managing the pain of labor. Once you do it, you are a new woman. So today I want to tell you that the truth is, is that women are strong enough to work with and through the sensations of pain in labor. I've seen it. I've witnessed it for 18 years. I'm a home birth midwife. Very few of my clients ever transfer for the sole purpose of pain relief. It's never about the pain. It's usually about the length of the labor, how long it's gone for if they need some kind of interventions it's not about transferring for pain women can do this you just have to be prepared and of a mental state to be willing to work with it okay we can do this if you're prepared and you have great support you've got a recipe for being able to work through it and that's what we're going to share today.
[8:05] Can I just say, though, if you want to tap out of labor pain, and there are so many reasons for that, there's so many reasons that women feel like they can't meet the pain of labor. And I'm not judging the decision to avoid labor pain. If you want to have an epidural, episode 169 of the Great Birth Rebellion podcast
[8:25] is where you want to go to learn all about it and to understand that decision. But I'm just here to tell women who maybe aren't sure about labour pain not sure what they want to do maybe they want to avoid medications but they just don't know what the alternative is but if you're scared of labour because what if people have told you or your previous experiences.
[8:49] You could attempt a mind shift is all I'm asking and just saying to yourself of course I can do hard things instead of saying labor is so painful that I don't think I can do it. It can be as simple as reframing the pain of labor, but I realize there are events in people's lives who make it necessary for them to dissociate from the sensation and pain and experience of labor and birth. So I don't want to minimize the fact that that is a reality for a lot of women. So there is no shame in choosing to avoid the pain of labor, but if you're listening to this particular episode I'm going to assume that you do want to avoid pharmaceutical pain relief and that you're looking for strategy so that's how I'm talking today okay but there's no shame if you choose to have an epidural in the end just know that you know this episode is not conscious of your personal feelings this I'm just offering solutions and opportunities here all right let's kick off how to prepare to manage the pain of labor and how to prepare your support people to help you with that. So let's go.
[9:56] So we're talking non-medicine, drug-free strategies that aim to help you work through the pain of labor. So pharmaceutical methods and medications for pain management, they aim to reduce or remove pain. Whereas non-pharmacological interventions, so non-medical interventions, aim to help women get through and manage pain and give them strategies for working through pain. So the idea is not to get rid of it. It's not even to minimize it necessarily. It's to get through it. So don't expect that these pain relieving techniques that I'm going to talk about are actually going to.
[10:36] Take away pain or reduce pain. Some of them do have the impact of that. What it's going to do is increase your capacity to manage and cope with pain. So that's a whole different thing. You feel the same amount of pain or maybe slightly less depending on which method you use, but your capacity and ability to deal with that is heightened by the use of the things that I'm going to talk about today.
[11:00] And this is the thing that's different. So the thing is, is that when we talk about the pain of labor and the real issue is is that we've medicalized labor and birth and when you medicalize something so things that are medical the whole idea behind pain is it's bad we've got to get rid of it so medicine and society generally sees pain as pathological and something that we all want and should avoid it's considered a disease state a sign of illness as something that's wrong. And that's just the medical way of thinking. And because we think about labor and birth as medical, we immediately apply pain relieving strategies to labor and birth because of course, if you've gone into hospital sick and you're feeling pain, it's reasonable to expect your pain to be managed. But the pain of labor is purposeful, meaningful, physiological, and necessary. The pain of pathology is not necessarily that. And so we only seek to control pain if you sit in an illness mindset about birth, believing that there's something wrong with labour pain and that it's so painful that.
[12:12] And that there's no purpose to it. Now, of course, some women experience labor pain and feel like they can't or don't have the capacity to overcome it and it's negatively impacting their experience of birth. And, you know, we spoke to Dr. Sarah Buckley way back in episode 15 and we talked about the hormones of labor and how they're perpetuated by the sensation of pain in labor and that it's important that pain remains because it helps to facilitate the hormonal cascade. Without pain, and we learned that in the episode 169 about epidural, without pain, the hormonal cascade of birth changes. And so I guess what we're bringing to this conversation is actually a midwifery physiological mindset that pain and discomfort in labor is an important part of the hormonal cascade, but also remembering that it's very likely that the pain of labor birth is not going to be as severe as you're imagining it to be. It is a manageable pain for a lot of women. A lot of women find it manageable. So we can let go of the idea that it's the most painful thing you'll ever feel. In fact, there's those ridiculous social media memes that say things like, oh, being in labor is like breaking 50 bones in your body. That is rubbish.
[13:35] Never listen to that information the pain of labor and birth is manageable for most women if they have good support and they're prepared so a mantra that you can remember instead of childbirth is so painful you won't be able to do it remember remind yourself regularly the pain of labor is purposeful and meaningful and I've reflected on my births like you can hear my personal birth stories I shared those on episode 119 of this podcast. I'll link it down in the show notes. But the first one was so boring. That's how I would describe it. I wouldn't describe it as painful.
[14:13] It was boring, long, and tiring. Just went on forever. And then I pushed out my baby and I just remember feeling really tired. I don't recall the pain. I mean, I was definitely in pain and it was really hard, but not because of pain and you know the pain of it is not what sticks the long the length of it and how tired I was is what sticks now the second one was heaps shorter but a lot stronger and definitely more painful because I remember saying it and thinking it in my birth like whoa this is way more painful than Charlie's birth but I could definitely do it I didn't think gosh I can't do this anymore but yeah it hurt a lot more but I actually enjoyed it a lot more and there's something in that so the hard part about the first birth was the endurance and how long it took.
[15:05] But there was less joy in that because I guess the hormonal cascade was different. The second was more painful and faster, but I way preferred that more painful labor over the tiring one. And we'll learn as we go. Actually, when you feel pain, your body responds with these pain relieving or pain managing hormones. You're not doing it on your own. It's not just your mental capacity to deal with pain. Your body actually physically comes to the party, recognizes the pain of labor, and then offers you these natural drugs, these natural pain-leaving hormones that have an impact on your state of consciousness. You do appear somewhat more spaced out, a little bit drugged out. I've never had drugs myself, but women appear to just be in a days, in a labor days. And that is your body gifting you with the most incredible pain-relieving hormones that you've ever experienced, that you will ever experience. This is peak human experience. I loved labor and birth, and I'm guessing that the hormonal part was a big contributor of how I felt about birth. And also, I welcomed pain. I didn't run away from it. I believed in my capacity to deal with it.
[16:25] You know, when you're in labor, you have a minute of pain, it's really strong, and then it goes. Then there's nothing, and then you have another little minute of pain, and then you deal with it, and then it goes, and then you squish out a little baby, and then look at you. It's a minute of pain. You can do it, but obviously, it's over and over and over again, so let's work out how to deal with that.
[16:48] Before I kick off with all those other strategies, though, I will say that while the pain of labor is physiological and normal and meaningful, there is another type of pain of labor that can be pathological or that can be pointing you to a sign that something's not right. So I've had clients, for example, who've been laboring and feel a pain that they would believe is that they feel is unusual. And it could be anything. The baby is in a position that's not ideal. So particularly posterior babies or babies whose heads are slightly off to the side, you know, And when there's a baby knocking into your pelvic bones, that can hurt in a different way than contractions. And the back pain of labor is something else entirely in labor and birth. We'll talk about strategies for that, but you can consider things like sterile water injections for back pain in labor. We did an episode on sterile water injections as well, way early, about episode 25 of the podcast. But if your baby's malpositioned, you could experience pathological labor pain. And that is, it's a different level. It's on top of the pain of contractions. So, you know, when people say, oh, you know, labor's the most painful thing you'll ever feel, I think there is a level above that and that is a malpositioned baby that's really stuck up and women experience posterior labor very differently to labor when the baby's easily rotating through the pelvis.
[18:17] And the other time I've seen women experience pathological pain is, for example, with a uterine rupture. That can be very, very painful, not always, but particularly for women who are planning a VBAC or there's other reasons that your uterus can rupture during labor and birth and that's experienced as pain. Any blood in your abdominal area, all these things can cause pain. So the pain of contractions is different to the pathological pain. So that is also a possibility. and it's about being tapped in and not having any other pain relief that's on board like an epidural where not only do you not feel labour pain but you also don't feel pathological pain.
[18:56] But let's talk about tools to work through it, tools to manage the pain of labour. What I would suggest is getting a bag or a basket and literally get everything that I'm going to talk about together.
[19:09] Put it all in one place and then you can pick and choose through the bag like it's a pantry full of snacks so during labor you can go to your kit your birth management or pain management kit pick and choose all the different tools that you might have gathered there to see what you might want to use next so make sure everybody around you knows what the pain management plan is and how to use all the gadgets make sure that the tens and everything has batteries that it's all in there that you've read the instructions ahead of time everyone knows how to use this kit. And this is your pain management toolkit. Have it easily accessible, take it with you to hospital, have it ready at home, wherever you're giving birth.
[19:53] All right, so let's talk about it. Let's talk about strategies for working through physiological pain and usual pain of labor. Working through pathological pain is going to be a little bit of a different thing. Now the first one, number one, which you're already doing because you're here, the first thing to do is just learn, just education and preparation about your pregnancy. Just understanding pain in labor, understanding what your body's doing, helping you reframe the pain as something that's good and productive rather than bad and destructive. So already by thinking and realizing that the pain of labor can be good and productive instead of bad and destructive, you've immediately got a different mindset about the pain in labor you maybe you'll be welcome it great here's a contraction that means my uterus is working that means my hormones are working that means my body is working hopefully that means your cervix is dilating and your body is going to be capable of pushing out your baby the pain of labor is a sign that your body's working so just by mentally understanding that the pain of labor is purposeful helps you to mentally accept the job of labor and birth. So if you can reframe the experience of labour and mentally prepare, then it's likely that you're going to be strong, strong, strong, strong, strong, strong, strong, strong, strong.
[21:10] To manage that. Now, the pain of labor is strong, but boy, is it exquisite because the pain relieving hormones that your body gives you just make you feel like this incredible natural high. So you might even be thinking, oh, I really want to feel that. I want to see what my body can do. And that makes labor and birth a little bit more exciting rather than not looking forward to it, just going, whoa, I wonder what my experience of contractions is going to be. Am I going to have a pain-free labor and birth? Is it not going to be as bad as I thought it was going to be? Is it going to be pretty strong, but boy, am I going to get those amazing hormones and just get the best high of my life? Let's see. It's kind of exciting.
[21:54] It's sort of delicious that us as women get to have this experience, this out-of-body, otherworldly experience, and just to have this incredible natural high of labor. Childbirth in itself is an exquisite experience if you are well supported, you feel safe and comfortable. And if you're with people who are willing to help you work through the pain and your care provider respects and loves you and you're interested in this experience, it is just the peak human experience. Why not give it a go? And just knowing this, Just knowing that this is possible, that we don't have to fear pain, that we actually are capable of managing pain and just knowing there's going to be some discomfort, but that you can overcome it.
[22:45] You're already part of the way there to being able to manage the pain of labor. Just having heard that, you are part of the way there to managing the pain of labor.
[22:55] So there is going to be labor pain, but not as much as you think. And it's a good pain. so it's okay to let yourself have a mindset that welcomes the labor process so that as a contraction is building you think you're not thinking no no no no you are more thinking okay good contractions are good yes let's do this contractions are important let's go let's do another one remind yourself that the contraction pain and sensation means that your uterus is contracting working and doing what it needs to have your baby and not every woman gets to do that you're in a privileged position here it means your cervix is likely going to dilate it means your body's hormonally working yes it's good this could get my baby out this sensation you can set yourself up to be more welcoming of the discomfort of labor rather than being frightened of it and wanting to get rid of it so this brings me to my second strategy number two.
[23:56] And that's positive self-talk. I know sometimes it sounds a little bit woo-woo when you say, oh, positive information, just talk yourself through it. But don't underestimate this because yes, it's a big job, might be a hard job. It's a big job anyway. So you've got to have a strong mental game. And it's just like an athlete that's hustling to get through something hard, a marathon, for example. So part of working on your labor mental game is saying some phrases to yourself during labor that are going to talk yourself through it and encourage you to keep going it'll be one contraction at a time every contraction you might need to talk yourself through it right so mentally preparing for birth is like mentally preparing for a marathon so more specifically a hundred kilometer marathon so your birth might not be as hard as a hundred kilometer marathon, but at least if you're prepared for it as if you were doing a marathon then you're kind of ready for anything.
[24:57] So long distance runners will tell you that just as important as your physical preparedness and training for a marathon is the mental game. It doesn't matter how fit you are, how many tools you have, how much education and preparation you've done and how many courses you've bought and classes you've attended. If your mental game is not strong that is going to be your downfall. It's the same for labor, that if you go into a marathon and your mental game's not strong, it doesn't matter how fit you are. Same for labor, if your mental game's not strong, it doesn't matter how much preparation you've done. So don't underestimate the mental game in labor.
[25:35] No level of preparation will allow you to fully control what your body does in labor, but you can have full control over your mental game. No one can take that from you. That is all yours to control. So grit and mental toughness is what's going to get you over the line. And this is where the positive self-talk or strategic self-talk comes into play. So I personally, I didn't prepare specific affirmations for my labor, but they did come to me as I went. And that can be something that if it's already part of your life to talk yourself through things, I've just got a general personality that I back myself all the time. I believe I can do hard things. So I'm constantly talking myself through hard things. So for me, labor was no different. The self-talk sort of came naturally. It's something that I've, you know, accidentally trained to do. So I started with the knowledge that I was capable of doing hard things. It's just my general demeanor. And I wasn't scared to do labor. So I didn't really prepare any pep phrases. I didn't doubt that I could do a hard thing, but I did notice that I found myself using some that felt helpful at the time. So as I labored, I noticed which of my thoughts made me feel like keeping on going and which ones made me want to escape and give up, which ones made me think, oh my gosh, I can't keep going.
[26:56] So I noticed the phrase, I can do another one. And that when I, when I thought to myself, I can do another one, I felt that it made me felt more positive about the next contraction that was coming. I didn't dread the next contraction. My brain was immediately trained to think I can do another one. So if you're not in the habit in life of talking yourself through hard things, you might need to train that part of your brain in labor of thinking this is hard, but I'm going to keep going. What can I mentally say to myself to keep myself going through these hard things?
[27:32] So what I did when the contraction ended, I said to myself, I can do another one. And sometimes I said it in my head. Sometimes I said it out loud. When I said it out loud, you know, my team went, yes, yes, you can. And I thought, oh, it's a bit too much excitement. It's okay. I could just keep saying it in my head. And that's what my brain remembered when I started the next contraction. So the contraction left and I went, I can do another one. I sunk into the rest in between contractions. And then as the next one started to come up, my first thought was, we can do another one. We already told ourselves that. So that's what we're going to do. We're going to do another one. And then what I found is a visualization came to me. This is just kind of how my brain worked in labor and quite possibly how yours will work in labor. And this is why women start to collect affirmation cards or they'll do visualizations through pregnancy. Maybe it's not your usual habit to visually work through things or mentally have to work through things.
[28:36] And so women sometimes train themselves to do this. This is what sometimes hypnobirthing involves, that sort of technique, the affirmation cards, visualizations, meditations, whatever it is. So then as the contraction started to build, I immediately imagined a mountain. So I was climbing up the mountain as one of those comical peaks, you know, cartoon peaks. And I was climbing up the mountain and that represented a tightening, tightening, tightening and kind of worsening of the contraction pain. It felt stronger and stronger and stronger. And then it would peak. There was this point at the top where it felt like this peak. That was the strongest part of the contraction.
[29:15] And then that's what I was, as I was going up, it's like, okay, this is not as bad. It's not as bad. It's not as bad because I know at the peak, it's as strong. And then once I felt the peak, I knew that the strongest part of the contraction was over. And I would, you know, in that moment, I could say to myself, this is going to come down and it will. Your contractions will peak and then they'll dissipate. So I just reminded myself, okay, that's all it's going up. This is going to come down. Well, you're going to hit the peak and then it's going to come down. I reminded myself in the difficult part, which really only lasted sort of 30 or 40 seconds, that what was coming next after the most pain was less pain, that the pain was going to reduce and it was going to come down and I was going to get a rest. So I kept reminding myself that the feeling the strongest feelings are fleeting so rather than arriving at the strong part of your labor and fighting it like no no no no no oh my gosh it's too big I can't do it some women like that but I found it helpful to just remind myself yeah you're in the strongest part it's gonna last a few a bit few seconds more long longer but it's going to come down. So just that reminder.
[30:33] So then it will come down and there would be that rest, the mental log. I can do another one, which I kept mentally reminding myself that I can do another one, that there were moments of rest and relief. So I just had to do the hard part of the contraction for a little bit. Then there's going to be rest and ultimately a baby at the end. But it's hard to remember that in the peak of contraction, but it's okay. Just concentrate on one single contraction at a time. Don't think about all the ones that have already gone. Don't think about the ones that are coming. Just think about that short 30 to 40 second moment where you need to deal with the strongest part of your contraction. That's the only thing. Be fully present for that and have your support people be fully present for that really tricky moment.
[31:19] So I made a really specific point of being grateful for the rest times. And I reminded myself, I can do another one. I can do another one at the end of the contraction. Then I just sank into the relaxation. I let my body go soft and floppy. I checked that I wasn't holding on to any tension in my hands and in my shoulders and in my face. Just go soft and floppy. I can do another one. And that made the restful times more restful and less stressful because I wasn't stressing about the next thing that was coming because I'd already just told my brain I can do another one I just kept telling myself that so your brain just starts to believe what you tell it, now there was definitely times in labor though where thoughts came of like whoa that was big that was strong and maybe maybe I didn't want to keep doing it but I was really careful, not to tell myself that I couldn't do it there's one thing about I don't want to keep going I don't want to keep doing this. And another thing of thinking, I can't do it. So that would be a negative thought that I did not let dominate or take over. So what you can say to yourself repeatedly is important because it can make or break you. If you repeatedly say to yourself, I can't do this, then that's what's going to happen. You're not going to be able to do it. But if you could say things like, whoa, that is strong. This is powerful. This is big. I need help. Somebody help me.
[32:46] But, or maybe even like that was strong. I don't want to keep doing this. But that's different to I can't do it. So you can do it whether you want to or not. That's the difference. But if you let the negative thoughts take over, you can't do it, you can't do it, you can't do it. You're not going to do it. I mean, it's just in life anyway. If you're trying to do something hard, but the whole thing, your mental game is saying, you can't do this, you can't do this, you can't do this, you're going to reduce the chance of you being able to do it. So notice those thoughts.
[33:15] If they come up, replace them. Don't deny them, but don't let them hang around and set up shop. Yeah, it's strong. Yeah, it's big. I don't want to do it. That's different to I can't do it. Okay, so you got the message. Your mental game is important. And one way to impact your mental game is your own self-talk.
[33:36] But that's just the one part of the puzzle. You also need a crew. So when you're doing labor or a marathon, your mental game is paired to your support crew and how much they also believe in you. So imagine you've been training for a 100 kilometer marathon and you reach race day. You've got all your gear, your bags are packed, you've got your crew, you've organized your pit stops or whatever they call you. You've got your trainer with you and they're there to help you get to the finish line. They're going to give you nourishment, encouragement. They're going to give you whatever gear you need to finish, repair any shoes or fill up your snacks. I don't know what happens. But that's what they're there for, for the marathon to get you through it. So you're all in the car and one of them says, I'm worried you're not going to make it.
[34:31] Are you sure about this? And then you start the race and you get to the first stop where your crew's waiting. And your coach says, you know, oh, actually, you're not really going as fast as I thought at this stage. There's no time for a drink, no time to stop. Just keep going. We'll see if we can make up some time. And then when you get to the next stop, someone says, oh, look, you're really struggling. There's just no way you can win from here. You know, what do we, why do we keep going? And then the final stop, so you're like 75 kilometers in and one of your support crew, as you run past them, you see they're holding up a sign and it says, this is too hard. Give up so we can all go home.
[35:11] But then despite the mole, you push on and you finish the race and they all went up to you and they go, wow, aren't you amazing? Oh my gosh, you did it. We didn't think you could do it. We thought you were going to give up. You were sort of so slow in the middle there. Your response should be, yeah, and no thanks to you. You got yourself through that. It was no thanks to your support person. You can be physically prepared and turn up to your birth mentally prepared. But if your birth team is full of people who say negative things to you the whole time, who throw you off your mental game, they could sabotage your whole birth journey if you let them. And it's with their own negative mental attitude. There's no place for it in the birth space. They need to be saying things to you that are going to boost your mental game and build you up.
[36:01] So what you need in birth is the same as what you would need at a 100-kilometer marathon. So if you're a support people listening to this support person or a partner and your partner's going through labor and birth, just imagine her currently in a hundred kilometer marathon that she's trained for and that she wants to be at. And the goal is to get to the end. What would you say to her to egg her on to get to the end of the line? That is how you talk to somebody in labor. You need all the preparation ahead of the race, but on the day, it's about mental toughness and a good support crew who will be in your side. They're spurring you on, they're believing you in you, they're encouraging you, they're giving you everything you need to finish the race. So the people that you have with you could be the make or break of your mental game in labor. So take a moment to consider, if you're a woman listening to this, take a moment to consider who will be with you at your birth and are they on your side can you rely on them to speak positively and encourage you on to the end of your 100 kilometer race, do they know how to care for you when things get hard and there might be a point in labor where you want to give up do they have the capacity to talk you through that and to strengthen your mental game.
[37:26] Are they robust enough to defend and advocate for you and spur you on? Because it's a special kind of person who can do that. And your partner might be that person or you might need to select a friend who
[37:38] you believe is that person or maybe a doula who can fill that space. It's okay if your partner is not that person. You just need to know that ahead of time so that they don't accidentally sabotage your birth and you don't accidentally allow them to.
[37:52] So just take a moment take stock of the reality of who's going to be in your corner, and what you think they're going to say to you in labor and then send them this podcast episode so they know how to help you if you think oh now that I think about it I was going to have my mom there and maybe she's not the best pep talker or maybe my partner is not the best pep talker maybe you need to just consider a great friend a robust friend who's always got your back or a great doula it's okay if the people closest to you can't do it but think about how you're going to find somebody who can do it okay so that was number two that's your crew number two is your crew so number three there are two more things that will impact on your capacity to manage pain and on your capacity to do something hard and that is the location that you're at, and your care provider so we just spoke about the importance of your support team giving you constant pep talks and keeping you going but imagine now that your midwife or doctor comes in and says you look like you're really tired this seems like it's really hard for you.
[39:07] Okay now your care provider is holding those signs on the side of the road in the marathon that says hey this is really hard are you sure you can do this that is a massive red flag these words of like the signs are you sure you can do this you look really tired you've had a really good go at it and I can see you're really trying. These are called seeds of doubt. They are planting seeds of doubt. I'm showing their mind they're thinking gosh I want to give this poor woman an opportunity to escape this pain.
[39:45] But what they're saying is the subtext, when somebody comes in and says, hey, you look really tired, the subtext, what the woman is hearing, what you might be hearing is, I don't think you've got the capacity to do this. They've planted a seed of doubt. And then they say, you can have some pain relief if you want to.
[40:04] We've got an epidural. You don't have to do this. You don't need to be a hero. So first they plant a seed of doubt, tell you, oh, you're looking pretty tired. Subtext, I don't really think you can do this. hey I've got a solution for you you can have some pain relief look it's not all midwives but I've witnessed midwives and doctors doing this they see a woman who needs support who needs more support in labor because maybe she's feeling the hard parts of labor but instead of encouraging her and supporting her and feeling confident and safe to enter that space and just and not be scared of women's pain, instead of doing that and offering support, they plant seeds of doubt and negative talk into a head. I'm sure they mean well, but just be prepared that even if your care team is offering you lots of support and love and they aren't bringing negative talk and planting doubt, it might be accidental that your midwife or doctor actually does that. So the impact of their words is powerful. So if you're listening to this as a care provider, don't ever tell a woman or give an impression that you don't think she can do it honestly as a parent I don't think my kids can do half the stuff they think that they're going to do but I will always always encourage them to give it a try always I would never say to my kid oh I don't think you can make that jump I'll say give it a go let's see what happens what do you think.
[41:33] It's the same thing in labor. I once stood in for a midwife. She couldn't get, it was her client and she couldn't get there for, I can't even remember why. And she asked if I would go in her place. And then when I arrived, I knew sort of how important the relationship is between a woman and her midwife. They'd been together for the whole pregnancy. They would have built a rapport. So I assumed that this woman would be devastated that her chosen midwife couldn't be there. So I met her. She was planning a hospital birth actually and I met her and I said I'm so sorry that your midwife couldn't be here but I'm here I'm with you I'm going to help whatever you need I'm not going anywhere I'm staying with you all the way through you can do this she thanked me and she was like oh thank you yep it's okay and she labored and I did what I said I would do they're encouraging her supporting her through the whole thing you know I was really like almost over midwifing her because I thought, gosh, you know, she doesn't have a midwife here. I'm going to be the best midwife I could possibly be.
[42:33] And she had this beautiful water birth in hospital. And, you know, after everything settled and she'd met her baby and it was all nice and quiet and peaceful, I just said to her, I said, you're so amazing. You're so amazing. And she looked me in the eye and she said, my midwife, she said the midwife's name, my midwife didn't think I'd be able to do it.
[42:56] And I was just flabbergasted because that was the thing that was in her mind through labor. The first thing she said to me was my midwife didn't think I would be able to do it.
[43:07] And this, I mean, this was a private midwife, really the one to often talk about as being some of the best woman-centered midwives that I know. And I was so sad that this woman had to overcome that mental thought, but also glad that I was there to be a different voice.
[43:23] So if you're listening to this as a support person or a doula, and you notice this subtle behavior where the care provider is saying little things sort of to undermine the woman's confidence and undermine her resolve and planting seeds of doubt. It is good for you and okay for you to interrupt that conversation and say, actually, babe, you've got this. I'm with you. Let's hustle. You can do this. You might be tired, but you have got more energy than you think you've got. It really sends a message to the other people in the room. You don't have to say it directly to that care provider. Just by saying it to the woman and then witnessing you saying it to her is an indictment on the way that they were speaking to her. It sends a message to other people in the space that we are in the business of boosting mental energy and not sapping it. Do not add anything negative. The
[44:13] woman can come up with her own negative thoughts. She is capable of that. The only thing you need to do is add energy boosting words into that space. So having a care team that's going to help you manage without pain relief by not even offering it or suggesting that you need it is the next thing that you can do to work through labor without medication. And you can put that in a birth plan if you want. If you haven't met the person who's going to be with you for birth, put in there, do not offer me pain medication unless I ask for it.
[44:43] Sometimes midwives can be well-meaning and every time they see you, go, let me know if you want any pain relief. Let me know if you want any pain relief. Subtext, maybe you're not going as well as you think you can when you're ready to tap out, let me know. So it can become very tempting if they're reminding you every hour. So you can ask them, please don't do that. So if you're a midwife or doctor listening, this is for you. When you say to a woman, maybe you should have an epidural, I can get you an epidural, what she's hearing is, oh, they don't think I'm doing a good job. They think I'm not coping and they don't believe in me. Your words are really powerful. Just give encouragement. You can never hurt giving encouragement.
[45:29] And I remember being called to a birth. She was one of my clients this time. and she was planning home birth and she rang me because it all just felt really big. It was her first baby and she wanted support. She didn't feel like her baby was coming yet, just labor. And when I got there, she said to me, I don't think I can do this. She was really worked up. She was breathing really fast. She just looked really stressed, really distressed and uptight. And I sat down next to her and I just was super calm in myself, massaged her back. And all I said was, of course you can do it. You're already doing it. You've been doing it this whole time.
[46:07] And her whole body changed. Her face changed. She looked at me and she went, oh, okay. And she just like relaxed and went into this labor zone. And her demeanor completely changed. And she just got calm and went on with it. And her husband looked at me and saw how relaxed she got. And he said, why didn't I just say that? He wasn't sure how he could have helped her when he saw how upset and distressed he was. And so I think he didn't realize how powerful positive words could be. It's all I said. Of course you can't. You've already been doing it. You are doing it. I mean, I think you're doing great. So that's number three is just having supportive care. And that means having a midwife care provider, support people, doula, friend, partner, whoever you choose. But make sure they're holding up the signs that say, you've got this. Don't give up. We're with you. you know but if they're holding up signs of like oh give up let's go home make this end it's going to be it's going to play with your mind there's some really clear research on this I'm not going to harp on about it but having one-to-one constant care and attention during labor it statistic has a massive statistical impact on how many women will choose epidural so just by having people with you encouraging you changes how much pain relief you perceive you need and how much you'll choose yeah so that was number three that was people all your people.
[47:35] We talked about mental game talked about people number four is the location that you're at makes coping with the pain of labor easier easier to cope with cramps and pain of getting your period when you're at home on the couch with a heat pack right compared to if you were sitting at work in an office chair or on a train or you're in your work clothes dealing with pain is easier when you're comfortable in a place that feels safe, where you can be yourself. It's more easy to do a poo in your own home than it is to do it in a shopping centre public toilet. Location matters. That's the same with pain. So if you're giving birth at a place that feels awkward and cold and uncomfortable, and there's not enough furniture and not the right infrastructure, there's going to be challenges to how you deal with labour, especially it's just the environment's not ideal. So then one thing you could do if you're not even pregnant yet or you've got choices is to choose a birth location that feels comfortable where you might think yeah I could definitely do a hard thing here. That could be at home at a birth center at a fresh and new hospital that's got great facilities. Not everybody gets to choose where they're going to give birth. So.
[48:53] If you can't, you know, if you don't have an option of choice about where you're going to go, try and make the birth space more home-like, more peaceful, not as bright, not as noisy, not as cold, so that you feel more comfortable to cope with labour. So bring things with you that have sentimental value or that make you feel cozy maybe your own blankets and your own pillows some soft and cushy stuff things that you can add to the space that you know I'm going to feel comfortable with this stuff we're going to have more capability of giving birth if I have a few of these comforts with me all right so that's what I'll say about positive self-talk the people with you the mental game helpful locations we talked about helpful words now like these these are some really super practical tools this is the stuff that you're going to put in your pain management toolkit so firstly the things that are completely free there's some stuff that you can do that is completely free and the first one is soft jaw.
[49:58] Soft body so reducing tension and softening your body it doesn't have to necessarily be even during contractions but I mean that would be ideal but remembering to soften everything immediately after but pay attention if you can during a contraction if you are hardening and tightening your whole body during contractions hands jaw forehead shoulders like oh if you are becoming super clenched and super tight something you can do completely for free is to soften and this can be hard for you to remember for yourself so again pass this on to your support people or your doula or midwife whoever it is you're going to have with you they can be the ones to remind you to soften and it can be as simple as okay soften drop your shoulders soften your shoulders and if you're having trouble doing it during the contraction just try and do it between so soften let everything drop go floppy open your jaw a little bit of that so at least you come back to neutral in between contractions and that can help when you reduce tension in your body it can help you to cope with pain the other thing you can do is use your voice vocalize through contractions don't feel the shame to be noisy noise does not mean you're not coping it's a release and so that's okay Okay.
[51:26] You can have some control over the type of noise that comes out of your body. So if your body's tight and tense, you might end up making a screeching sound. Yeah, like these really type screeches.
[51:43] And the sound is just a symptom of what your body's doing. But you can help soften your body by softening and lowering your sound. So, it's hard to make a low sound if your body's tight and it's hard to get tight if you're making a low sound. So, it can be a sign to your body like, hey, we're going to soften here through this contraction.
[52:06] But it's okay to vocalize, scream, yell, whatever you need to do. It can be a release. All we're trying to do is get through every single contraction. We're not trying to take pain away. it's just a strategy for getting through a hard thing so if you need to scream yell and screech through that by all means go ahead also by the way there's some excellent research about swearing it hasn't been a lot specific to to labor and birth but for people who need to endure pain especially short bursts of pain the perception of pain is less if you're swearing particularly the F word and more so if you don't usually swear. So if you're a regular sweary potty mouth, you know, curse word user.
[52:53] Then you're going to feel less impact, less pain relieving impact from swearing than if this is kind of your first go at it. So feel free to drop a few F-bombs, see if that helps, just at the peak of contractions. All right, all for free, softening, noises, breathing, relaxing, all free.
[53:13] And, you know, Ina May talks about laughter and humor in the space and keeping it lighthearted and not letting it become this really tight, tense situation in the room. If it's a light, comfortable mood and there's jokes and laughter, probably you're going to be able to stay more relaxed, which will increase your capacity to manage the pain of labor.
[53:35] The next thing you can do is release emotions or worries. So crying is a great release. If you feel like crying, let that all come out. And if the people in the room are not comfortable with that, then they've got the problem, not you. You can talk through it. I've had women say, I'm really worried I'm going to tear. Like I can see that they're holding their baby in and I'm like, hey, do you want to see if you can release your baby? And they're like, I'm worried I'm going to tear. I'm like, great. Okay. Now I know why you're holding your baby in. And so we can talk through it. So unburden yourself of thoughts that are occupying you and unburden yourself of emotions that are overcoming you. If you feel like crying, you've got to let that out. There's nothing wrong with that. It doesn't mean you're not coping. It just means there are some specific emotions that need to come out so that you can keep dealing with labor and birth.
[54:26] Now, you might laugh. I laughed. It was just uncontrollable. It came out of me and I didn't stop it. You might laugh, cry, scream, hit, bite, squeeze. is. This is where the comical woman yelling at her husband for making her pregnant comes. It's okay to just like rage a little bit and let that all out. Don't hold it in because it's going to reduce your capacity to deal with this sensation of labor. And a key part of this is being with people who are comfortable with these kind of emotional expressions. So some people are uncomfortable with this. They might ask you to stop. They might ask you to be quiet. They might sort of, oh, it's okay. It's okay. It's okay. You know, just.
[55:05] You just need to be with people who say, yeah, let it out. It's totally fine. That's just your emotion coming out. Go for it. All right, next thing you could do for free is move and change positions. So the way your body works in labor and birth is that your pain can prompt behavior. And so you might try and move in a way that helps to mitigate, reduce the pain of each contraction or that just slightly makes it feel a little bit better and easier to manage I would say go with that instinct go with chasing a birth position that makes it easier to get through the contraction and usually that involves movement do whatever movement feels good I've seen women women stomping I've seen women in the pool kicking their legs out to the side just move any way that feels right labor and birth and movement go together and so sometimes pain can prompt which types of movement you might need to help the baby move through and to help each contraction feel more manageable so movement and position change you can do that anywhere you are if you don't have an epidural.
[56:15] The next thing you can do for free is use the room differently. So moving the birth bed up high and out of the way. Now, we have a whole podcast episode on this, actually. It tells you how to rearrange the birth room and make it more conducive to movement and comfort. And this is particularly, you know, for active labor. That's what I'm advocating for here. If you want to work through the pain of labor, you have to be active and moving and comfortable. And that's episode 83. So I'll put that episode in the show notes as well. It's called warnings about the bed and what to do instead. So there's some great strategies in there on how to adapt the layout of the room to make it more conducive to your comfort and your position changes. Right. Next thing you can do for free is water immersion. So if you're at a birth center or a hospital and they have a bath, you can immerse yourself in water. You can use heat, the heat of the shower. So even standing in the shower, obviously if you're at home, these might come with a little bit of a cost of using a birth pool or the cost of water. You know, my clients don't pay for a birth pool, so it's free for them, but your midwife might have a fee.
[57:27] But yeah, water immersion, shower and heat, and that could include heat packs. Again, I've got that in the part where it might cost you a bit of money, but hospitals often have heat packs. Water and heat can help with you in every individual contraction. And I'll say here, you might find that movement helps with one contraction, that heat helps with another contraction, that a positive self-talk helps with another contraction, and massage helps with another one. So it's about picking and choosing different strategies for each contraction. You might combine multiple strategies all at once to help you get through each contraction. That's how it is. You do need to employ these strategies repetitively in order to keep plodding along to the end of your labour to get to birth.
[58:15] Now the next thing, and this kind of goes along with using the room differently, is just assume that you own the room that you're birthing in. It's your territory and that'll impact on how you use it. That'll mean that you'll feel confident and safe to just move the equipment around. It means you won't ask permission to get in the shower or the bath. It means you'll just rummage through shelves to find the things that you need. So don't ask, can I get in the bath now? mate you own that space you get in the bath use the toilet just assume ownership it will make you more comfortable in the space and you'll be able to use it the way that feels more intuitive to you and you know we did an episode on this one you know I won't talk about it too much but the sterile water injections these are particularly good for back pain in labor but really pain anywhere so you can go back to that episode with Nigel Lee we've done it it's a sterile water injections episode 20 so your care provider should be able to do this not all of them are trained to do it it won't cost you anything but that's one option but I would encourage you to listen to that sterile water injections episode it is a medication-free pain management strategy but I'm not going to go into the details.
[59:28] All right, the next thing you can do for free, cold face washer. I know this sounds really pedestrian.
[59:37] Oh my gosh, but labor is hard and it's hot work and you're running a marathon. The feeling of a cold washer on your face and neck is heavenly during labor. It's a little mini holiday. Gives you a mental boost. It offers you a taste of relief and comfort. it. It also communicates that the people around you are aware of your circumstance, that they're tapped in and that they want to care for you. When you feel that cool washer come onto you, because a lot of time when you're in labor, you might be really shut off. But when you feel that cool washer on you, it says, oh, there's people here who are working with me through this. They're responding to my needs. So put the face washer in some icy water and keep it close by. Have a bowl there and just periodically after every few contractions dip the the face washer back in the cool water replace the water it'll get warm and pop it back on oh my gosh it's just a taste of relief it's completely for free but it makes a massive difference the next thing that your support people can do is massage you and pressure points so look don't over complicate massage it doesn't take an expert. Basically, if it feels good to you when somebody massages you, then they're doing it right. So again, if you're listening as a support person, this is going to be your job to massage.
[1:01:04] My tips to you are don't be too gentle. A laboring woman likes a firmer massage than when they're not in labor.
[1:01:12] There are, you know, just listen, if she sort of goes, oh, no, not there, don't like that. You're like, okay, not that spot. If she says, oh my gosh, that is good. That's a good spot. That's where you need to keep focusing your energy and just get some feedback. Is that too firm? Is that too soft? Should I go harder? And just work out how firm do I need to be?
[1:01:30] There are spots that many women appreciate on their back that are sore, and it's the sacral points. Now, if you look down someone's back, there's two little dips at the top of the tailbone. They're at the sacrum in the lower back. And if you massage those spots, it's the tight areas over their hips and lower back. Oh my gosh, during labor, you might need to lay an elbow in or really use your thumbs or the palm of your hand because it's going to be a firm massage and your partner will probably have bruises at the end of her labor because that's how firm they like it. But just any tight areas over the lower back, the bony areas, muscular areas.
[1:02:17] And after being an awesome birth support person like that, you're going to need to massage yourself because it will hurt your body, not it won't hurt your baby. It'll hurt your body because you will be really digging in there so consider alternating thumbs knuckles palms hands swap out support people but massage and every contraction you know if she really loves it and the contraction is happening you're in it for every single contraction just so you know all right next thing you can do for free and don't underestimate the power of a strong and confident hand that's just there to hold her hand during labor. Again, she might be shut off, you might be shut off during labor, just having your own internal experience. And a little hand on your shoulder or on your forehead or on the back of your neck or holding your hand is just enough to say, I'm here with you. And that can make all the difference to your emotional and mental capacity to keep going. Don't underestimate the power of just touch.
[1:03:23] Now temperature control again mostly for free. Anything that makes you more comfortable in any way making it cooler or hotter that's going to increase your capacity and energy to deal with labor. So managing maintaining a comfortable temperature not too hot not too cold so that your body doesn't have to invest energy into not only trying to get comfortable, trying to get cool or warm, then it can just concentrate on labour pain. And this just gives you reserves to focus on managing labour pain. And it will be the job of the people around you to help regulate the temperature to your needs and not their needs. I can't tell you how many times I've been in a birth space and been so hot or so cold are all because the woman, we're really setting the temperature to the gauge of the woman and that's okay. That's important. Now the next thing you can do for free is the visualizations and I spoke about that earlier.
[1:04:25] I know some people will think, oh, it's a bit woo-woo, but again, it's free. It lives in your mind. No one can take it from you. So you can think of these ahead of time or you can just come up with them in your mind. And it might even be helpful to have in the birth space some images that just make you feel calm, that immediately elicit a sense of calm. And they can be images of anything and that can help with your visualizations.
[1:04:52] Okay those are the free things that you can do and now here I'm going to offer you some things that you could invest some money in and I don't really encourage people to inconspicuously waste their money on gadgets for labor and birth over the 18 years of being a midwife I've just seen the collection of things that are sold to women for labor and birth pain management is just increasing and I've watched birth unfold with very few tools in the past and it really really does work you're not putting yourself at an advantage by buying all of the labor and birth tools I can it just there are no magic gadgets honestly it's I would choose some carefully curated ones that you genuinely believe in so if you do have some money to spend here are the things that I would back as bang for your buck remembering my work is mostly at home birth where women don't have the option of pain relief so I've seen the things that they use and that they've found most beneficial and I've seen the things that either never come out of the packages or where they try them and just really didn't like them so the first thing that I would suggest having in your kit you can either hire or purchase these, is a TENS machine, T-E-N-S.
[1:06:13] And TENS machines have been used for a long time in other areas of pain management, so surgical recovery, a lot for physiotherapy.
[1:06:23] So they've studied it a lot for those kinds of things, but it's a newer technique to be used for pain management in labor and birth. Now, the research is catching up, but there is a lot of benefit. I've seen women really, really love them or, you know, some of them don't really like them, but there's the theory of how they work. So basically the TENS machine is it's got these four pads and I would encourage you to get ones that are labor specific and I'll talk to you about which ones are those. But there's these four pads, they're about the size of a playing card, and you position them on the lower back and over your bum, wherever you want to put them, but usually lower back area. And they deliver these little, it sort of feels like little mini electric shocks, I wouldn't, maybe that's what you call them, but they, it really tingles and buzzes over those pads.
[1:07:17] And it uses what's called the gate control theory of pain. And what we learn about the gait control theory is that our body has a limit to the sensations that it will be able to feel. There'll be a point where your body stops telling your brain how much pain and sensation you're feeling. There is sensation overload.
[1:07:39] So your body can only sense or receive messages for so much pain or so much sensation before it'll kind of mentally shut off and it will say, right, we are not willing to receive any more pain signals. So our body can do that by closing the sensation gates and limiting pain messages that get back to our brain. And that's what the TENS machine does. That's the theory behind the TENS machine is that the TENS machine delivers or provides a type of stimulation that will overload the pain sensation messages that go to your brain and it'll close the gates to any further pain sensation. So essentially, the idea is that it will limit the amount of pain receptor messages that get through to your brain. So I know that there are some people out there who know way more about me than all of this. And they're going, oh my gosh, she made absolute porridge out of that explanation. But you get the idea. That's the idea is that it works on the gait theory of pain. There's a range of TENS machines that you can get, T-E-N-S machines.
[1:08:50] But I would recommend the ones that are specifically designed for labor and
[1:08:54] birth. So they have different settings. You can start with a lower setting and as labor gets stronger, you can move it up to a stronger setting to match the sensation of pain that you're getting. And because they're designed for birth, they also have a boost button. So you can turn the boost button off when you're in rest, which kind of keeps the tens as a little hum. And then as a contraction, when you feel it start to build, you boost it. It'll deliver more sensation during a contraction, and then you can turn the boost off again for your rest periods. And some people say that the TENS machine is more effective if you put it on earlier in labor rather than throw it in as a rescue measure when things were already overwhelming. So it can be kind of a maintenance strategy, but I would encourage you to experiment with that.
[1:09:41] And, I mean, there's no harm in trying it because there's no danger to a TENS machine. The only danger is if you wear it into the bath or shower, do not do that. It's not waterproof. And the other thing, top tip, is if you're going to take it off, make sure you turn it off first before you pull the pads off because they can really give you a zap if you take them off and you haven't turned off the TENS machine. Now, if you don't want to buy a TENS machine, you can hire one. And my preferred supplier is L10s, so E-L-L-E-10s, T-E-N-S, L10s for labor. Theirs is really specific for labor. It's the one I have in my birth kit and they're really well suited. I've seen some that women like kind of buy cheaper online and they just don't have the right settings for labor and birth. Some of them turn off all the time. Some of them do these weird palsy things. Honestly don't waste your time just invest in the L10s one if you're going to buy one or they have a higher service so I'll put the links in the show notes below for the 10s machine you can also see the links on my website melaniethemidwife.com, and if you're on the podcast mailing list all of these resources and products that I'm talking to you about will be in the resource folder and so I send an email out every Monday if you're on the.
[1:11:04] All the resources for that episode, but also the previous episode. So, you know, you can find those in the resource folder. All right, next, heat packs.
[1:11:16] My favorite, favorite heat packs. So these, usually women will put them on their lower belly, underneath their belly button, or on your back and bum. That seems to be the preferred places during labor and birth. And ours is just buying the really big, wide wheat bags. so they're really large and soft and flexible. Some of them even have straps that you can tie it on. So if you're walking around, you can also tie on the heat pack to keep it on. Or if you're on hands and knees, you can tie it on and it won't keep slipping off. It means somebody doesn't have to hold it the whole time. They're my favorite ones. They're the ones I find most user-friendly during labor and birth. And just a warning here, some hospitals won't let you take your own heat packs to their hospital or use them there. I assume it's some kind of OH&S issue somewhere down the line. Someone burnt themselves on their own heat pack and then now there's a policy that women can only use the hospital heat packs. I don't know if that's everywhere, but certainly the hospitals that I transfer to, that's how they do it. The issue is, is they give you an alternative. They give you their own, but they're usually not as good and it's hard to find a midwife to just keep replacing the heat pack to keep it warm. And often they're giving you one because they're controlling the temperature and they're just not hot enough that's that's been my experience hopefully yours has been different.
[1:12:38] If I were you, I would just take the heat packs. There's usually the wheat packs. There's usually a public microwave that you can travel back and forth to heat them up, especially if you have a doula or extra people in your space who can manage keeping your heat packs nice and warm. It's possible that staff will say something like, oh, no, you can't use that. You've got to use ours. I mean, you can just say, look, she really, really wants this one. We're going to use this one. That can be, you know, the battle that you might have to have to fight.
[1:13:11] But just a warning, yeah, not to make them too hot because women are feeling strong sensations of labor. Sometimes, you know, we spoke about the gait, the gait theory of labor. Sometimes her body doesn't realize it's being burnt by a heat pack that's too warm because her body is concentrating on a bigger sensation. So it might be up to you as a support person to just have a little experience with the heat pack that you just heated up. How long can you put it on before it feels like it's starting to burn maybe you overheated it so just go easy on those but that's also why the hospital staff might be keen for you to only use theirs but if you're purchasing them on your own these the big big sort of square wheat packs.
[1:13:54] And a few little ones so that you've got options are really handy all right so we talked about it being completely free to move around in labor and birth and things you can do to enhance the comfort of your movement. And one thing, again, that I have in my own birth kit, that's the only reason I'm mentioning it, is that I really do back this product as an option to help with comfortable movement in labor and birth, is the birth sling. Now, you can take it anywhere. You can take it to hospital because it hooks into a door very securely and creates a sling that you can hang from that you can rest in and it helps you get into more comfortable positions. It can also mean that because you're resting and hanging from the sling that your support people are now free to do other things like hold a heat pack on your back or massage your back because they're not they're not tasked with holding you up. So the birth sling can just create a new level of comfort and free up one of your support people so that they can help with something else. Getting you a drink, whatever it is that you might need. Now, again, I'll put the links for that in the resource folder and in the show notes below. That's the birth sling. Highly recommend it if you're going to put some money into your labor and birth program.
[1:15:10] The next thing you can get, and this can be manufactured anyway, it doesn't have to be a formal one, but an eye mask. And the reason why this is good is it's great for blocking out external stimulation, including light, and it just helps your body slip more easily into labor without the interruptions. It's particularly good if you're transferring to hospital, but every little bit of stimulation into your space can become overwhelming and make it harder for you to deal with the contraction pain. So if you're reducing the amount of stimulation that's coming in, you might find that you have more capacity to deal with each individual contraction. And so an eye mask can be great. You can get a formal one, the, you know, ones with that's so beautiful and lovely. Or, you know, if you just want to tie a towel around your face, whatever you need, a hoodie to just block out external light and stimulation. And what goes along with that too is some ear pods or headphones. Again, the reduction of stimulation will help your body function more efficiently, but also help to reduce the stimuli that's going to enter into your space so that you've got more capacity to deal with pain.
[1:16:21] And we spoke about the positive self-talk, strong mental game, and visualizations. So if those are the things that you believe would be helpful is having some training around mental gain, positive self-talk and visualizations, then you could invest in a technique that can help with that. And the hypnobirthing technique is something that can really work. I've had clients who've practiced hypnobirthing through their pregnancies and I've watched it play out so beautifully in labor and birth. Now, there's a very accessible resource. It's online. It's one of my favorites.
[1:17:05] And it's one of the most accessible resources for the hypnobirthing method. And that is Pop That Mama. She's got an online hypnobirthing resource called the Birth Box. And there's a discount code for that, by the way. In the show notes, if you want to use the hypnobirthing technique to just help you with mental game you could invest in that and the one that I recommend is through pop that mama the next thing and I'm reluctant to mention this one but birth combs right I am of a time where birth combs did not exist I never saw women thinking oh my gosh I need a birth comb so I've been a long time I've seen them come into fashion and I've seen them also be quite pricey considering for what they are but they weren't a thing until recently personally i think they're an unnecessary fad they're adding some consumer in this consumeristic value to the money machine that exists around lab and birth however.
[1:18:09] I've seen women use and love these. So it would be remiss of me not to mention it because it's not my labor and birth, it's yours. But don't feel that you have to buy these things. They're, you know, it's low tech, it's accessible.
[1:18:24] If you've got $20 to $40, you could buy one. I mean, maybe you could ask your friend, maybe they bought one and you can never used it or they used it just for labor.
[1:18:32] You can borrow it. but it's basically a strong wooden comb and you lay it across your hand and hold onto it tight and it puts pressure on this particular area of your hand if you're watching this on video but you can imagine holding the comb within your hand and the idea is that the teeth go down into the palm of your hand and you hold on tight and part of it might work because there are particular pressure points in there that could work and help others it might redirect your focus on that sensation that's occurring in your hands could give you a focus but you know you don't have to you can definitely do labor without a birth comb if that's what you want to do but if you want to have everything in your kit and have lots to pick and choose from that's something that you could choose all right that's a lot of tools that's what I've got for you today for pain management strategies in labor that don't involve medicine and my top tip is to make sure you know how to use all of those tools that they're all easily available that your support people have listened to this episode and that they know how to use all the tools in your kit as well so let's do a very quick run through quick fire shots of free things that will cost you nothing to do to help mitigate the pain of labor so supportive birth team and partner accepting pain as productive and positive You've got to have strong mental game and positive attitude and your approach to pain.
[1:19:59] Positive to help talk. Listen to this podcast episode, of course, for your education purposes. You've already done that, but listen to it again as you get closer to birth.
[1:20:09] Move around the room and use different birth positions. Heat packs, massage and touch, companionship and presence from someone who loves you. Rearrange the birth room to suit your purposes. Use the shower, submerge in a bath, vocalize and swear, release emotions with some crying, laughing, hitting, grasping, squeezing, whatever you need to do. Add some comedy to the room, joke and lighten up the energy in the space. All of those things are going to give you more capacity to deal with pain. The cold face washer, making the room a comfortable temperature and the soft comfortable place with privacy and with some comforts from home. Now the ones that will cost you a little bit of money if you want to use them, you could buy them yourself or you could borrow them from a friend or from your care provider. The TENS machine, heat packs, birth pool, birth comb, birth sling.
[1:21:10] Ear pods or headphones, an eye mask, the hypnobirthing resources or lessons, a doula. If you've chosen to hire them and add them to your team, you might choose to hire a private midwife and you might need to pay to choose for a comfortable birth location that feels right to you okay that is today's episode of the great birth rebellion podcast heaps of resources if you need to know what to do what strategies you can use to deal with a pain of labor without medicine and in the show notes you'll find all the links to the resources and products that i spoke about in today's episode but also i would really encourage you to join the mailing list for the podcast because every monday i send out a full resource list which includes all the research, all the links, all the products. I'm Dr. Melanie Jackson and I will see you in the next episode of the Great Birth Rebellion podcast. To get access to the resources for each podcast episode, join the mailing list at melaniethemidwife.com and to support the work of this podcast, wear the rebellion in the form of clothing and other merch at thegreatbirthrebellion.com. Follow me, Mel, @MelanieTheMidwife on socials and the show @TheGreatBirthRebellion. All the details are in the show notes.
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