contractions

Natural Ways to Manage Labor Contractions

Labor and birth /
Pregnant woman sitting on a birthing ball trying to manage labor contractions in a natural way

Preparing a Birth Preferences Document (Birth Plan) Knowing When It’s Time: When to Head to the Hospital for Labor Rupture Of Membranes (Water Breaking) I’m a Doula: This Is What a Doula Does VBAC (Vaginal Birth After Cesarean) Epidural: What It Is, Procedure, Risks & Side Effects Breech Baby Pain Management During Labor Pitocin: What It Is, Procedure, Risks & Side Effects Induced Labor Natural Ways to Manage Labor Contractions Labor contractions are a natural part of the childbirth process. While experiencing pain during labor is normal, there are several natural ways to help manage labor contractions and make the process more manageable. By Liat Salomon, doula February 27, 2024 Share on In This Article: Natural ways to manage labor contractions Should I try to sleep through contractions? Other positions to try to get relief Natural ways to manage labor contractions It’s important to remember that every pregnancy and labor experience is unique, so what works for one person may not work for another. Here are some natural ways to manage labor contractions: Breathing techniques Deep breathing: Inhale slowly through your nose, allowing your abdomen to rise, and then exhale slowly through your mouth. Try to control your breath, and almost “surf” on it. Also, see if you can feel (when practicing) that with every exhale, you relax your perineum. Making low sounds or grunting can be a way to release tension and manage the discomfort of contractions. Relaxation techniques In the weeks leading to the birth, learn and practice Hypnobirthing meditations. One very good tool is the GentleBirth app, which offers a variety of great meditations. Visualization: Close your eyes and imagine a peaceful place or visualize your baby descending through the birth canal. This should also be practiced in the weeks before the birth; during birth you will not struggle with trying to think of a place or a time, and your body will already be “programmed” to do it almost on command. Position changes Change positions frequently: Walking, swaying, rocking, or changing your position can help ease discomfort. You can take short walks around your room or corridor, or simply sway back and forth while standing. Use a birthing ball: Sitting on a birthing ball and gently rocking back and forth or in a circular motion can provide relief. Use a birthing stool, and if you do not have access to one, sitting backward on the toilet can offer the same effect. Hydration and nutrition Stay hydrated: Drink water or clear fluids to prevent dehydration. Coconut water is a good alternative but keep away from other fruit juices.  Eat light, easily digestible snacks: An omelet, yogurt, salads, and soups are great. Massage Gentle lower back or foot massages from a partner or a trained doula can help relax tense muscles and reduce discomfort. Heat therapy Warm compresses or a heating pad on your lower back or abdomen can alleviate pain. I love using the good ol’ hot water bottles. Aromatherapy Some women find relief through the use of calming essential oils like lavender or chamomile. Ensure you’re in a well-ventilated room and use tissue paper or a separate cloth to put the oil on (in case you become nauseous). Music and distraction Create a playlist of soothing music or listen to guided relaxation exercises to divert your attention from the pain. Support and encouragement Think of affirmations that might help you manage contraction and regain confidence in your ability to keep going. Warm baths or showers Soaking in a warm bath or taking a warm shower can help relax your muscles and ease tension. Note: Sitting in a bath is not recommended if your water already broke. Visualization and affirmations Create positive affirmations to focus your mind on the strength and power of your body during labor. Also Read: I’m a doula: this is what a doula does Knowing when it’s time: when to head to the hospital for labor Should I try to sleep through contractions? Sleeping through contractions during the early stages of labor is highly recommended. Resting during this phase can help you conserve energy for the more active phase of labor when contractions become more intense and frequent.  The side-lying position is often considered the most comfortable. Here’s how to do it: Lie on your side with your knees slightly bent. Place a pillow between your knees to support your hips and keep your spine aligned. Use another pillow to support your head and neck. You can switch sides if one side becomes uncomfortable, or you can lie on your preferred side. This position is beneficial for several reasons: It helps relieve pressure on your back, which can be especially helpful if you’re experiencing back labor. It allows for good blood circulation to both you and your baby. It’s a relaxed and natural position that can make it easier to fall asleep or rest between contractions. It’s essential to listen to your body and adjust your position as needed. Be prepared to change positions or use other comfort measures as your labor advances. Other positions to try to get relief Here are some positions that you can use to try to find relief: Sitting upright or semi-reclined Sitting up slightly or reclining in a semi-upright position can also provide relief during early labor. Use pillows or cushions to support your back and find a comfortable angle. Supported hands and knees Some women find relief from back pain by getting on their hands and knees, either on a bed or on the floor. This position can help take pressure off the lower back. Prenatal yoga poses Prenatal yoga poses, such as the child’s pose or cat-cow stretch, can help you find relief and relaxation. I wish you a wonderful and happy birth! Questions? If you have any questions about this topic/article, please feel free to contact me through email at:  liat@doulatalks.com Liat Salomon is a certified doula since 2010 and is working in the San Francisco Bay Area in California. She has assisted

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Induced Labor

Labor and birth /
labor induction procedure explained to a pregnant woman by a healthcare provider

Knowing When It’s Time: When to Head to the Hospital for Labor Pitocin: What It Is, Procedure, Risks & Side Effects Rupture Of Membranes (Water Breaking) I’m a Doula: This Is What a Doula Does Epidural: What It Is, Procedure, Risks & Side Effects VBAC (Vaginal Birth After Cesarean) Pain Management During Labor Breech Baby Natural Ways to Manage Labor Contractions Preparing a Birth Preferences Document (Birth Plan) Induced Labor In the U.S., it is very common for health providers to offer an induction at 39 or 40 weeks. There are some medical conditions that require it, but oftentimes the recommendations have to do with outdated protocols or convenience reasons—and are not justified. By Liat Salomon, doula February 27, 2024 Share on In This Article: Labor induction methods How painful is induced labor? Does the cervix have to be dilated before starting an induction? How long does it take from induction to labor, and how long will it take to give birth? What happens if you don’t dilate after being induced? What are the risks for mom and baby of inducing labor? How many inductions end in C-sections? When should you not get induced? When do you ask for an epidural during induction? How to prepare for labor induction How to make labor induction easier Can you walk around after being induced? Can you sleep during induced labor? How to induce labor naturally How long do you stay in the hospital after an induced birth? When I moved to California I thought that my days talking about excessive inductions were over. Boy, was I wrong…. I was blown away by the staggering number of inductions done here! Labor induction is the process of artificially starting labor in a pregnant woman. This may be done for a variety of reasons, including if the woman is past her due date, if there are concerns about the health of the mother or baby, or if the woman has a medical condition that makes continuing the pregnancy risky. In the past few years, there’s been an increase in the number of inductions being performed. There are multiple reasons for it, but the bottom line is that there are too many inductions being done—with no real medical reason—due to a protocol that does not look at someone’s actual condition and only takes into consideration a generic birthing person. One common reason for labor induction is if the birthing person is past their due date. Pregnancy is typically considered full-term at 37 weeks, but the average length of pregnancy is actually closer to 41 weeks. In fact, statistically, first-time babies are born at 41+5. Another reason for labor induction is a health concern for either the baby or the mother. For example, if the baby is not growing as expected or if the mother has a medical condition such as high blood pressure or liver issues, it could potentially put her and/or the baby at risk if the pregnancy continues. In addition, certain medical conditions can make continuing the pregnancy risky for the mother, such as pre-eclampsia, placental abruption, or placental insufficiency. In these cases, inducing labor may be necessary to protect the mother’s health. Labor induction methods Several methods can be used to induce labor. One common method is to use medication to stimulate contractions. This can be done using oxytocin, a hormone that naturally occurs in the body and helps to stimulate contractions, with the medication Pitocin or through the use of prostaglandins (such as misoprostol), which are hormones that help to soften and thin the cervix. The choice of method will depend on various factors such as the woman’s health condition, the baby’s health, and the stage of pregnancy. Here are some other common methods used for inducing labor: Membrane sweeping This is a procedure in which a healthcare provider will use their fingers to sweep around the cervix, separating the amniotic sac from the cervix. This can help release hormones (prostaglandins) that may start contractions and initiate labor. Balloon catheter This method involves inserting a small balloon catheter into the cervix to help it dilate and soften, which can help trigger contractions. Breaking the water A healthcare provider can manually break the amniotic sac (which contains the fluid surrounding the baby) using a special tool. This can stimulate the release of hormones (prostaglandins) that may start contractions and initiate labor.For further information on water breaking, you can read my article: “Rupture of membranes (water breaking)“. I will say that breaking the water is my least favorite form of induction. I feel that it starts a whole new set of protocols and is not reversible. Also, after the water is broken, you can expect contractions to get a lot more intense—right from the start—instead of building gradually. It’s important to note that all of these methods carry some risks, and induction should only be considered and done when medically necessary! Also Read: Pain management during labor Epidural: what it is, procedure, risks & side effects How painful is induced labor? Induced labor can be more painful than spontaneous labor as the body is being forced into labor before it’s fully ready. The intensity of the pain can vary depending on the woman’s pain tolerance and the methods used for induction. The contractions experienced during induced labor can be more intense and frequent, and may feel different than natural contractions.It’s important to have emotional support from partners, family members, and healthcare providers, as this can help manage anxiety and stress during labor and delivery. Does the cervix have to be dilated before starting an induction? The only induction method that requires dilation is membrane sweeping (stripping).Other forms of induction do not require a certain dilation to begin, and some of them, like a catheter, are intended to start dilation. How long does it take from induction to labor, and how long will it take to give birth? The time it takes from induction to the start of active labor can vary depending on

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Pain Management During Labor

Labor and birth /
Hands held in support of pain during labor and birth

Knowing When It’s Time: When to Head to the Hospital for Labor Epidural: What It Is, Procedure, Risks & Side Effects I’m a Doula: This Is What a Doula Does Natural Ways to Manage Labor Contractions Pitocin: What It Is, Procedure, Risks & Side Effects Rupture Of Membranes (Water Breaking) VBAC (Vaginal Birth After Cesarean) Breech Baby Induced Labor Preparing a Birth Preferences Document (Birth Plan) Pain Management During Labor By Liat Salomon, doula February 27, 2024 Share on In This Article: Nitrous oxide (laughing gas) Opioids Epidural anesthesia Conclusion The discussion around the use of pain medication during labor tends to be an emotional one. Some women feel it is important for them to give birth more ‘naturally’, i.e. unmedicated, and may feel that they are giving up and get disappointed in themselves if they end up asking for pain medication. I personally feel that pain medications are simply tools and that the decision to use or not use them should be made after considering and reviewing all the subjective information in real time, during labor. I also think women should feel free to change their minds during labor (in either way) without being judged or criticized. I feel that it is important to remember that labor pain is a natural and normal part of the childbirth process. I recently read an interview with a midwife that spent time with African tribes, watching and documenting women in labor. What struck me the most was  her saying that when she asked the local midwives how they help manage pain, they seemed surprised at the question. To them pain is such a natural and expected part of labor, and there is no reason to “help” with it. They just go through it. I often tell the women I work with that each woman’s experience of pain during labor is unique, and there is no “right” or “wrong” way to manage it. The intensity of labor pain can vary greatly from woman to woman, and even from one labor to another.The pain can be felt as a series of waves or contractions that build in intensity and then subside. It is typically felt in the lower back, pelvis, and abdomen, and may radiate down the legs. The pain can be accompanied by other physical sensations such as pressure, stretching and pulling. While labor pain can be managed in several ways, including using breathing and other relaxation techniques, movement, such as changing positions, walking, swaying, massage to the lower back, shoulders and legs, and hydrotherapy such as a bath or shower, (for more information on this, check out my article “Natural ways to manage labor contractions”), in this article I will talk in detail about medical pain management – pain medication. Here’s a review of the different types of pain medication that can be used during labor: Nitrous oxide (laughing gas) Nitrous oxide, also known as laughing gas, is a gas that is inhaled through a mask.When inhaled, nitrous oxide can help to reduce the sensation of pain and anxiety, making it a popular option for women who want to avoid more invasive pain management options, such as an epidural. Nitrous oxide can also help to increase feelings of relaxation and reduce the intensity of perceived pain. Some women may find that it provides only partial relief and may need additional pain management options. Nitrous can also be used throughout labor, including during the pushing stage. Another advantage of nitrous oxide is that it does not interfere with the woman’s ability to move around and change positions, which can be beneficial during labor.I feel it is especially useful when a woman is tired and needs a short break. I like that it has relatively mild side effects, like nausea and lightheadedness, and I mostly like that once a woman decides to stop using it, it clears in a minute or two. Also Read: I’m a doula: this is what a doula does Knowing when it’s time: when to head to the hospital for labor Opioids Fentanyl (sometimes referred to as “IV medication”, without naming the medication itself) is often offered during labor, and is administered through an IV. Fentanyl can help reduce pain, but can also cause drowsiness, nausea, and respiratory depression in both the mother and baby. Personally, I would not recommend using fentanyl during labor because it crosses the placenta and affects the baby, potentially with dire results. If the labor suddenly picks up (due to the pelvis relaxation) the baby will be born under influence of fentanyl, which may result in a “sleepy baby”, a watered down term for a baby that has serious respiratory difficulties. Epidural anesthesia This is a common pain relief option that involves the insertion of a small catheter into the epidural space in the lower back. A local anesthetic and sometimes a narcotic are then administered through the catheter to numb the lower half of the body, including the uterus and birth canal. An epidural is typically very effective at relieving pain, but it may also have side effects, such as decreased blood pressure, headaches, and shivering. In rare cases, an epidural may cause more serious complications, such as infection or nerve damage.It is important to know that use of an epidural may decrease the frequency of contractions, causing them to occur at wider intervals after it is administered. This usually happens if an epidural is used in early labor, and rarely during active labor (5-6 CM). If the problem of contraction infrequency persists, your provider will typically suggest adding Pitocin. After getting an epidural you will stay in bed until giving birth, but in most cases you can still change positions while being in bed to continue promoting and advancing toward a vaginal birth. For a more in-depth look at epidurals, check out my article “Epidural: what it is, procedure, risks & side effects”. Conclusion The decision to use pain medication during labor is personal, and, if requested, the different medications should be

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Pitocin: What It Is, Procedure, Risks & Side Effects

Labor and birth /
Pregnant woman receiving Pitocin through IV during labor

I’m a Doula: This Is What a Doula Does Natural Ways to Manage Labor Contractions Induced Labor Pain Management During Labor Knowing When It’s Time: When to Head to the Hospital for Labor Preparing a Birth Preferences Document (Birth Plan) Rupture Of Membranes (Water Breaking) VBAC (Vaginal Birth After Cesarean) Epidural: What It Is, Procedure, Risks & Side Effects Pitocin: What It Is, Procedure, Risks & Side Effects By Liat Salomon, doula February 27, 2024 Share on In This Article: Oxytocin and its role in labor induction The right time to use Pitocin Administration and dosage of Pitocin Does Pitocin affect dilation? Will I be able to rest while receiving Pitocin? How to manage pain while on Pitocin Understanding the risks: common side effects of Pitocin for mom and baby Does the use of Pitocin increase the risk of a C-section? Boosting your oxytocin: tips and techniques for increasing hormone levels naturally Conclusion In the last few years, there has been a significant rise in labor induction rates in the U.S. The medical community happily adopted the ARRIVE trial without questioning it, and doctors began recommending induction to a growing number of women at 39-40 weeks pregnant, regardless of the subjective medical situation. Some medical conditions indeed require medical intervention. However, an induction is a tool that is best used in moderation and only when absolutely needed. There are different methods or medications that are used to induce labor. This article will review the use of Pitocin. Pitocin has had a very bad reputation over the years. I feel that recently, as it became more and more clear what the best ways to use Pitocin are, it became safer, can allow more control over the process, and, when used correctly and for the right reasons, it is a good tool to have. Oxytocin and its role in labor induction Pitocin is a synthetic form of the hormone oxytocin, which is naturally produced by the body. Oxytocin is also known as the “love hormone” and is involved in various physiological processes, including stimulation of contractions in the uterus during labor and the release of breast milk. The mechanism of action of Pitocin is like that of the natural oxytocin hormone. It acts on the uterine smooth muscle to cause rhythmic contractions, to either start labor artificially or to augment slow or irregular contractions. The right time to use Pitocin For best results, Pitocin should only be used when it is determined that the cervix is ripe and ready. The cervix must be soft enough to allow contractions to be effective and, in turn, get the cervix to shorten, which will then cause it to open (dilate). If the cervix is not ready, there might be a need to offer prostaglandins (either vaginally with Cervidil, or orally with Misoprostol/Zitotec). Also Read: Induced labor I’m a doula: this is what a doula does Administration and dosage of Pitocin Pitocin is typically administered intravenously (IV) through an IV line inserted into a vein in the arm. It is delivered continuously through an infusion pump, which is carefully monitored to ensure the correct dosage is delivered. The dosage of Pitocin depends on several factors, including the woman’s gestational age, the stage of labor, the strength and frequency of contractions, and the health of the baby. In general, the initial dosage of Pitocin is low and is gradually increased until the desired effect is achieved. The half-life of oxytocin in the bloodstream is about 3 to 5 minutes, meaning that it is rapidly metabolized and eliminated from the body. Does Pitocin affect dilation? Pitocin can help stimulate uterine contractions and facilitate dilation of the cervix during labor. However, the rate at which dilation occurs varies and can depend on several factors, including the woman’s previous pregnancy history, her age, and the position of the baby. In general, dilation of the cervix typically occurs gradually over the course of several hours to a few days. The average time it takes to progress from 1 cm to 10 cm of dilation is usually between 6 to 20 hours, although this can vary widely and can be shorter or longer depending on the individual woman and the specific circumstances of her labor. It is important to note that while Pitocin can help to speed up the dilation process, it can also increase the risk of certain complications, such as uterine hyperstimulation or fetal distress. Will I be able to rest while receiving Pitocin? The purpose of using Pitocin is to help labor progress, and just like with spontaneous or natural contractions, we hope that at some point the contractions are intense enough to promote labor. In that case, sleeping or even lying down will not be comfortable. I always suggest getting as much rest before labor really kicks in, and usually, when Pitocin levels are low, it is still possible. When it gets uncomfortable to rest, you can start walking around the room, get on all fours in bed, sit on a birthing ball, and even use a shower (the nurse can cover the IV tubes). How to manage pain while on Pitocin Pain during labor and delivery is a subjective experience, and women may experience pain differently. The pain associated with Pitocin-induced contractions can vary from woman to woman. Although Pitocin-induced contractions can be stronger and more frequent than natural contractions, it may also depend on several factors including individual pain tolerance, the stage of labor, and the strength and frequency of the contractions. Same as with natural contractions, you can choose to use pain management techniques, such as breathing exercises, massage, shower/bath, and pain medication. Understanding the risks: common side effects of Pitocin for mom and baby Pitocin is a commonly used medication, but like all medications, it has associated risks and side effects. Some of the most common risks and side effects of Pitocin include: Uterine hyperstimulation Pitocin can cause the uterus to contract too strongly or too frequently, which can lead to uterine hyperstimulation and

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Epidural: What It Is, Procedure, Risks & Side Effects

Labor and birth /
Epidural being injected to a pregnant woman during labor

Pain Management During Labor Pitocin: What It Is, Procedure, Risks & Side Effects Rupture Of Membranes (Water Breaking) Knowing When It’s Time: When to Head to the Hospital for Labor I’m a Doula: This Is What a Doula Does VBAC (Vaginal Birth After Cesarean) Induced Labor Breech Baby Natural Ways to Manage Labor Contractions Preparing a Birth Preferences Document (Birth Plan) Epidural: What It Is, Procedure, Risks & Side Effects By Liat Salomon, doula February 27, 2024 Share on In This Article: How is an epidural administered? At what stage of labor is an epidural given? How long does labor with an epidural last? Does an epidural make you dilate faster? Does labor still hurt with an epidural? Can you walk after an epidural? Epidural risks and side effects to mother and baby Conclusion Hearing the words “pain medication” and “epidural” usually prompts a lot of emotional reactions. Some women feel that it is an achievement to give birth without using pain medication at all, and get disappointed in themselves and feel that they are giving up if they end up asking for pain relief.  I personally feel that pain medications, including epidural, are simply tools. The decision to use or not use them should be made after reviewing and considering all the information. Also, I feel that women are allowed to change their minds during birth (in either direction) without being judged or criticized. It’s important to remember that labor pain is a natural and normal part of the childbirth process. Each woman’s experience of pain during labor is unique, and there is no right or wrong way to manage it. The intensity of labor pain can vary greatly from woman to woman — and even from one labor to another. One of the most effective and widely used forms of pain relief during childbirth is an epidural, which involves the administration of a local anesthetic into the epidural space of the spine. This results in numbness in the lower body and can significantly reduce the intensity of pain during labor. However, epidural has some potential risks and side effects, so it should be discussed with a healthcare provider and considered carefully before use. Also, it is important to note that an epidural may not be appropriate or effective for every woman. Some women may have medical conditions or complications that make an epidural contraindicated. Let’s explore the different questions that might come up when considering an epidural during childbirth. How is an epidural administered? Most people refer to epidural as a medication, but, in fact, the epidural space is the area between the spine and the outermost layer of the spinal canal, located in the lower back, aka lumbar spine region. It contains the nerves that transmit pain signals from the uterus and birth canal to the brain. The actual medication contains a combination of an anesthetic and an opioid.The procedure for administering an epidural begins with the woman sitting up and leaning forward or lying on her side. The anesthesiologist will clean the skin on the lower back and inject a small amount of local anesthetic to numb the area. They will then insert a needle into the epidural space and thread a tiny, flexible catheter through the needle. The needle is then removed, leaving the catheter in place. The medication is delivered through the catheter using a pump, which allows the woman to receive a continuous dose of pain relief. Some women are concerned about the size of the needle or the pain involved in inserting the catheter. The needle is a normal-size needle and once the skin is numb, you should not feel pain when the epidural is placed. It is normal to feel some light pressure in the back as the doctor inserts the needle and catheter, and sometimes a small zing in one of the legs. The epidural usually takes effect within 15 to 20 minutes, and the level of pain relief can be adjusted by the anesthesiologist. The epidural medication typically lasts for the duration of labor and delivery, although some women may require additional doses. At what stage of labor is an epidural given? An epidural is typically administered during active labor, which is the stage of labor when the cervix is dilated to at least 4 to 5 centimeters, and regular contractions have begun. Some women may choose to have an epidural early on in labor, while others may wait until the contractions become more intense and frequent. When using it earlier, there is a risk of contractions spacing out, which could require a need to start adding Pitocin to encourage contractions to become regular. Also Read: Knowing when it’s time: when to head to the hospital for labor I’m a doula: this is what a doula does How long does labor with an epidural last? On average, labor with an epidural can last longer than without an epidural.However, the impact of an epidural on labor length can vary depending on individual circumstances and medical practices, including the individual woman’s labor progress and the stage of labor in which it was administered.  Some studies have suggested that the use of an epidural may increase the likelihood of needing interventions such as vacuum-assisted delivery or cesarean section, which can also impact the length of labor. There are instances where an epidural may have a positive effect on labor and help relax the pelvis, which may prompt quicker progress.  Sometimes an epidural may be turned off when it is time to push to help the mother regain sensation and push more effectively. Does an epidural make you dilate faster? There is no clear consensus on whether an epidural makes you dilate faster during labor. Some studies have suggested that an epidural can slow down the process of cervical dilation, while others have found no significant impact on dilation. One possible reason for the conflicting results is that an epidural can affect the body in different ways, depending on the dosage of

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