Is it possible to relieve pain from contractions? Methods of pain relief for contractions during childbirth. Drug pain relief during contractions

Fear of pain during childbirth is rooted in a woman’s soul from the very beginning, and even after giving birth once, she can continue to be afraid. It is clear why it occurs; everyone says that there is nothing more painful than childbirth. Someone compares the pain of childbirth to breaking 20 bones at once, someone says that it was the greatest pain in his life.

If you are expecting a child, you, of course, try your best to be positive. Thanks to the availability of information, there comes an understanding that this is a natural process that should not cause much pain. By the end of the term, you calm down and the desire to end the pregnancy becomes stronger than these fears. But the question of whether childbirth is easier still remains. Even the most confident person should have hope that if it suddenly hurts too much, they will help him.

Do they take painkillers during childbirth?

Of course, it is possible to make childbirth easy and painless, and almost 90% of women in labor now use analgesics during childbirth in one form or another. You can do it in such a way that the woman will simply oversleep them, and she will have to be woken up at the most crucial moment.

Pain relief during childbirth has even become a source of additional income for maternity hospitals; almost everywhere you can get this service for a fee (we are talking about epidural anesthesia). At the antenatal clinic, you may be given a list of things you need for the maternity hospital; it may still include medications intended to ease contractions.

Now you have plenty of chances to think through childbirth, although from the point of view of what is best for mother and child during physiological childbirth, birth without drugs is, of course, preferable.

How can you relieve pain during childbirth?

There are several options to make childbirth painless. They differ in effectiveness and safety. Another question is whether this is necessary. Sometimes loss of pain sensitivity is vital. For example, if contractions are strong, frequent, but ineffective, and the cervix does not open.

The following methods are used for this process:

Physiological. This includes a relaxing lower back massage, calm music, special breathing techniques and exercises, a bath and shower.
Spinal and - a special injection during childbirth in the spine with the introduction of drugs to the spinal cord. The most reliable and modern method. This injection during childbirth begins to act literally after 5 minutes, completely relieving pain.
Other drugs are also used during childbirth, which are administered intramuscularly, intravenously and in other ways. These are mainly antispasmodics, narcotic analgesics and drugs that affect the central nervous system. Nitrous oxide (an anesthetic) is even used, which the woman breathes through a mask, independently adjusting the degree of pain relief.
Acupuncture and other physiotherapeutic methods of influence. Not used in all maternity hospitals.

It also happens: at the end of the second stage of labor, very intense, frequent contractions occur for about 40 minutes - 1 hour, leading to complete dilatation of the cervix. The fatigue that has accumulated over the past hours makes itself felt, a strong feeling of pressure appears on the bottom, the baby presses his head on the cervix and sacral plexus, the head is pressed tightly against the entrance to the pelvis and there is very little time left before the baby is born.

A woman who says a firm “no” to any medical interventions may simply break down at this time. It is at such moments that a woman in labor most often screams - give me a caesarean section, do at least something, stop this! But right now it’s too late to do anything. If a woman in labor is given a medicine that really relieves pain, the baby may have complications after birth, for example, respiratory depression.

And then the necessary injection is given as a placebo. For example, no-spa is introduced, which generally has no effect on the uterus. This injection is given only to calm the mother while she waits for it to take effect - she will have time to give birth.

How to relieve pain during childbirth yourself

The degree of severity of pain during childbirth largely depends on how the woman in labor perceives the birth act. If you resist contractions and clamp down, then your body quickly gets tired and you begin to feel pain. It often happens that a woman initially expects pain during childbirth and thereby provokes its appearance. It's a vicious circle - the more you resist the contractions, the stronger the pain, the stronger the pain, the more you clamp down. The uterus is working with all its might, but the cervix cannot open - you prevent it from doing this with your fear.

The pain syndrome increases due to the accumulation of lactic acid in the muscles of the uterus and its resistance to itself: some muscles work to open, while others spasm and do not allow it to open. Due to the fact that currently almost all expectant mothers have the opportunity to attend childbirth preparation courses, you have the opportunity to learn in advance how to relieve pain during childbirth yourself.

During the courses you will learn everything about special breathing and relaxation techniques during childbirth, about exercises that help, you will tune in to the fact that giving birth is not painful, and should not be painful. It’s good if your partner, not necessarily your husband, is with you during the birth. Even your mother, aunt or friend can act as an assistant during childbirth. She needs to take these courses with you. Here they will teach you how to do a relaxing massage during childbirth, breathe with the woman in labor, support and guide her at the right moment.

Yes, childbirth cannot be completely painless. Of course, there will be discomfort. You can partly influence how much discomfort and pain you will feel. And remember that if you suddenly can’t cope, there are alternative ways to relieve pain, analgesics are used during childbirth, and if you need it, they will help you.

Childbirth is a natural and painful process. Moreover, every woman feels pain differently. Some people find it tolerable, others find it unbearable. It happens that one woman gives birth to a baby without any intervention from medical staff, while another simply needs this help. In this case we talk about diverse. So what types of pain relief are there and how safe are they?

Psychological pain relief for childbirth

No matter how strange it may seem, a woman’s positive psychological attitude is an excellent way to significantly reduce pain during the birth of a baby. If the expectant mother is psychologically ready for the process itself, if she does not “wind up” herself, does not “squeeze” and wait for pain, then everything will go much easier. It has already been proven that with the onset of contractions, many women begin to feel pain only because they are waiting for it. Instead of getting ready for serious work and helping the baby to be born as soon as possible, they begin to be intensely afraid of pain. Self-hypnosis, you see, is a serious thing. However, we will not deny that many women, due to some individual characteristics, actually experience severe pain.

What can be advised in these cases? Relax. Believe me, wise nature also took care of pain relief during childbirth, but women sometimes harm themselves. A pregnant woman must realize and firmly get it into her head: the more she tightens, the more painful it will be for her. And vice versa: pain will be minimal if the woman can relax. If you become familiar with breathing techniques that promote relaxation before giving birth, master them, and apply the acquired knowledge at the onset of labor, then you can pass this exam with an A plus. After all, in a calm state, a woman in labor produces a sufficient amount of endorphin hormones, which can reduce unpleasant physical sensations, help relax, reduce pain and have a beneficial effect on the course of labor. It is also important to listen to the advice of an obstetrician-gynecologist who “commands the parade”, then you can significantly alleviate the condition.

Many women find massage to cope with the pain of childbirth. It is especially good to stimulate points located in the buttocks and. Moreover, a warm bath can help you relax. This is relevant if the woman is still at home or if the conditions in the maternity hospital allow it. This procedure helps to relax during contractions, relieve tension in the muscles,.

Pain relief during labor with acupuncture

Reflexology is one of the safest methods of pain relief during childbirth. This method is suitable for all women in labor without exception, since it is non-drug and does not affect the whole body, but its specific points. Using this method, you can reduce pain, interrupt the transmission of nerve impulses to the brain, and promote the release of pain-relieving hormones.

To tell the truth, with this method there is not a complete, but a relative effect on pain centers, so special means are often used along with acupuncture.

Drug pain relief for childbirth

Often, medications are used to relieve pain during childbirth. In particular, we are talking about drugs from group A, which includes analgesics. True, they are used in cases of extreme necessity: only when the expectant mother cannot do without their use. In general, pain relief with drugs is used if a woman experiences nausea, vomiting, or if she is too focused on pain and cannot concentrate on the birth process. Analgesics are administered intravenously, intramuscularly, using compresses (applied to certain places), as inhalers.

Sometimes the doctor decides to use Promedol. This is a narcotic substance that is administered intravenously or intramuscularly. Of course, it does not completely relieve pain, but it significantly reduces it. It has already been proven that a single dose of Promedol does not negatively affect the child’s health. However, its use a second time is unacceptable.

In addition to medications included in the group of antispasmodics and narcotics, others are used, for example, anesthetics, antipsychotics, and tranquilizers.

Epidural anesthesia

During this procedure, a painkiller is injected into the space between the lumbar vertebrae in front of the dura mater surrounding the spinal cord. In this case, known anesthetics are used (for example, Lidocaine or Bupivacaine). As a result of this procedure, the roots of large nerves are blocked, and the woman does not feel pain at all. This method of pain relief allows you to “top up” the anesthetic substance from time to time, if necessary. This is done through a thin catheter. But at the same time, the woman should know that after this manipulation she will not be able to move independently for some time.

Unfortunately, this method of pain relief is not suitable for everyone. If a woman has poor blood clotting or an elevated temperature, or if she has neurological diseases, then it will not suit her. It is also not suitable for women who are obese or allergic to local anesthetics.

One of the side effects that often occur as a result of epidural anesthesia is headache. Sometimes it can last up to three weeks. This happens if the needle is inserted a little deeper than it should be. Today doctors know how to deal with such consequences and effectively eliminate this pain.

We looked at the most popular methods of easing or eliminating pain that occurs during the most important event in the life of a pregnant woman - the birth of her child. But you should know that the decision on pain relief during childbirth is made by doctors depending on how severe the pain is, and is applied only on the condition that all manipulations will be safe for the baby.

Especially for- Ksenia Dakhno

Women experience pain differently. For some, special breathing techniques are enough to successfully overcome pain during childbirth; for others, pain management is recommended.

The choice of medications that help overcome pain during childbirth is large. We recommend exploring your options so you can make the right choice: Discuss all your options with your obstetrician well before your due date so you have all the information you need when it comes to delivery.

It should also be remembered that in each individual case, the choice of painkiller depends on certain conditions and characteristics of childbirth and the woman’s health condition. The doctor will assess your condition, comfort and health during childbirth and help you decide on the method of pain relief.

You should not feel guilty about asking your doctor for pain relief. Only you know best how you feel, so only you can make decisions regarding pain relief during childbirth. Moreover, there is no need to worry about the safety of the pain medication. All drugs used for pain relief during childbirth are safe - both for you and for the baby.

Medicines for pain relief during labor and childbirth

There are three ways to relieve pain during labor and childbirth:

Local anesthesia is used during childbirth to numb a specific area or after birth if stitches are needed.

Regional anesthesia (epidural, spinal) is used by an anesthesiologist (a doctor who administers pain medication) during labor to reduce discomfort. With both epidural and spinal anesthesia, a painkiller is injected into the lower back, near the nerves, blocking pain over a large area of the body while keeping you awake. Regional anesthesia significantly reduces discomfort and pain during childbirth. It is also used if a caesarean section is necessary.

General anesthesia means insensitivity to pain with complete loss of consciousness. General anesthesia is safe, however, it is used extremely rarely, only in emergency conditions, since it does not allow the mother to see the child immediately after birth.

In addition, pain medications may be injected into a vein or muscle to numb the pain. In this case, pain sensations are not completely blocked, however, you will feel much less pain. This method is used mainly at the beginning of labor so that you can rest and gain strength before giving birth, since the drugs affect the entire body and can cause drowsiness in you and the baby.

What is the difference between epidural and spinal anesthesia?

Spinal anesthesia involves injecting a drug into the middle of the dura mater, which is located next to the spine. With an epidural, a drug is injected into the spinal column, outside the bursa that surrounds the spinal cord.

Spinal anesthesia requires less drug than epidural; Moreover, spinal anesthesia works faster, however, it is more likely to cause headaches and low blood pressure.

How is regional anesthesia performed?

If you ask for regional anesthesia, you may have an epidural or spinal anesthesia, or a combination of these types of anesthesia. Your doctor will choose the type of regional anesthesia based on your overall health and how labor is progressing.

After the anesthesiologist takes your medical history, he will numb a small area in your lower back with a local anesthetic. The anesthesiologist will then insert a special needle into the numb area to find the desired position and administer an anesthetic. After administering the drug, the anesthesiologist will remove the needle. In most cases, the doctor will leave an epidural catheter—a small plastic tube—at the site where the needle was inserted to administer medications during labor, if needed.

During the procedure, the woman can sit or lie on her side.

At what point during contractions is regional anesthesia performed?

The optimal time for regional anesthesia depends on the progress of labor, your condition, and the condition of the baby. Your OB/GYN will determine the best time to administer anesthesia.

Will anesthesia affect the baby?

Numerous studies have shown that regional anesthesia, both epidural and spinal, is safe for mother and baby.

How quickly will the anesthesia take effect and how long will it last?

Epidural anesthesia begins to take effect 10-20 minutes after administration. The analgesic effect lasts as long as you need it, since the drug can be administered through a catheter at any time.

Spinal anesthesia takes effect immediately after administration. The analgesic effect lasts about 2.5 hours. If labor is expected to last longer than this time, you will have an epidural catheter inserted to continue the drug.

Will you feel anything after the anesthetic is administered?

Although you will feel significant relief from the anesthesia, you may still feel pressure from the contractions. You may also feel pressure when being examined by a doctor.

Will I need to stay in bed after receiving regional anesthesia?

Not necessary. The anesthesiologist can provide pain relief so that you can sit in a chair or walk. Sitting and walking can promote labor. If you want to know more about this, ask your doctor about walking with an epidural. However, it should be remembered that this type of anesthesia is not possible in all cases.

Will regional anesthesia slow down labor?

For some women, contractions and labor slow down a little after regional anesthesia—not for long. Most women, however, find that regional anesthesia helps them relax, improves contractions and allows them to rest.

Unfortunately, none of the currently known methods of drug pain relief for childbirth is perfect. All of them, in one way or another, affect the fetus and the duration of labor and their use is not always possible. However, there are methods of pain relief that have no contraindications for mother and baby.

Methods of non-drug pain relief are absolutely harmless, very simple and effective, and can be used at any stage of childbirth. Self-numbing methods include birth massage, special breathing techniques, relaxing poses and movement techniques, the use of a fitball (gymnastic ball) and aquatherapy during childbirth. In order to master these techniques, only one thing is required - desire!

Active position

The first and most important factor in reducing pain from contractions is active behavior during childbirth. This term refers to the free behavior of a woman in labor, constantly changing positions and moving around the ward, searching for the most comfortable body position. The movements themselves significantly reduce the overall sensation of pain. And not only because any action is distracting.

Firstly, the level of pain depends on blood circulation. During contractions, the muscle fibers of the uterus contract, wasting energy. The main “energy fuel” for the functioning of all cells in our body is oxygen; myometrial cells (uterine muscles) are no exception. As is known, oxygen is contained in arterial blood; therefore, cell respiration depends on the level and speed of arterial blood flow. When the body is stationary, the overall blood flow decreases, the supply of oxygen to the uterine muscle slows down and pain increases. If a woman in labor walks around the room or moves in a comfortable position, as a result of the movement, the level of blood flow increases and the uterine cells are better supplied with oxygen. Therefore, with active behavior during childbirth, the pain from contractions is much weaker than with a stationary position. Even if, for medical reasons, a woman in labor cannot get up, she can behave actively during a contraction - sway, spring on the bed, spread her knees and bring them together. These minor movements significantly reduce the pain from contractions.

Secondly, the feeling of pain depends on the general tension. More precisely, there is a direct proportional relationship between these concepts - pain and tension. That is, the more we strain, the more painful it is for us, and vice versa. During a contraction, when the uterus tenses and painful sensations appear, some women instinctively “freeze,” stopping moving completely. This behavior of a woman in labor is caused by fear of pain. The woman in labor seems to be hiding from the pain and from herself during the contraction. During childbirth, this behavior does not bring relief: “freezing”, the expectant mother unconsciously tenses, which leads to a sharp increase in pain. The main assistant in the fight against excessive tension during contractions is physical activity. After all, when we are in motion, our muscles alternately tense and relax; therefore, hypertonicity (excessive muscle tension) is excluded. And if movement helps you relax, it means it reduces your overall pain level.

Movements during childbirth can be very diverse. If childbirth proceeds without complications, the choice of the type of movements during contractions remains with the woman in labor. In this case, there is one, but very important limitation. At no stage of labor should you make sudden, jerky movements. Here are examples of the most common types of active behavior during a contraction:

walking along the ward or corridor;
bending to the sides and forward;
stretching and turning the whole body;
rocking and rotating movements of the pelvis;
shifting from foot to foot;
transferring body weight from toes to heels and back;
half squats;
flexion and arching of the spine;
in a lying position: swinging the pelvis, turning from side to side, springing movements of the hips, abducting and spreading the legs.

During contractions, you should behave freely, choosing the most comfortable body position. There are many well-known positions that reduce discomfort during contractions and help you relax. The main principle by which a woman in labor chooses a position during labor is the level of comfort, stability and relaxation. Most birthing poses use four points of support and a predominantly vertical body position; There are also “lying” poses. However, in order for the poses to help, you should change your body position as often as possible and remember to move a little within any pose. To reduce pain during labor, try taking the following positions during contractions:

Stand by the bed (sink, window sill, bedside table), with your feet slightly apart. Rest your hands on the bed, relax your back and stomach, as if transferring the weight of your body to your arms and legs. Rock from side to side, back and forth, shift from foot to foot, rock your pelvis.
Stand in the position of a sumo wrestler: legs wide apart and knees bent, body slightly tilted forward, hands resting on the middle of the thighs. Shift from foot to foot or sway from side to side.
Squat down, spreading your legs wide and resting on your full foot. There should be a fixed support behind your back (headboard, bedside table, wall). Place your feet shoulder-width apart and place your hands on your hips. Swing left and right, back and forth. Get on all fours on the bed with your legs slightly apart. Alternately arch and arch your back in your spine.
Stand on the bed in a knee-elbow position, legs slightly apart, and sway from side to side. You can put a pillow under your elbows. Kneel on the bed, lean your hands on the headboard, shift from one knee to the other. Squat down facing the bed. Hands and head can be placed on the bed.
Sit on the vessel, placing it on a chair or a special bench (you cannot sit on the chair itself - this creates unnecessary pressure on the perineum and can harm the baby). Bend your legs at the knees and spread them wide apart (there is always a bedpan and a bench in the room).
Stand at the headboard or bedside table. Place your arms bent at the elbows on it. Squat down, as if hanging from your arms,
If you are tired and want to lie down, lie on your side with your knees and hips bent.

There are so-called “partner positions” for which the woman in labor will need an assistant. Here are some of the simplest and most convenient positions for pain relief from contractions:

Stand facing your partner and clasp your hands around his neck, press your upper body against your partner, turn your head to the side. Bend your legs at the knees, spread them as wide as possible and sway from side to side without lifting your feet from the floor.
Stand like a train in front of your partner. Ask him to put his arms bent at the elbows forward (boxer pose). Spread your legs widely bent at the knees, lean back on your partner and hang on his hands, like on gymnastic rings, without lifting your legs from the floor and swaying (in this position, the woman in labor is fixed with her armpits on her partner’s forearms).
Have your partner sit on the edge of a chair or bed with their legs spread wide apart. Squat down with your back to your partner, legs spread wide and resting on your full feet. Lean back against your partner and sway from side to side.
Lie on your side and ask your partner to sit next to the bed. Bend the leg on top at the knee and rest it on your partner’s shoulder. Try bending and straightening this leg (ask your partner to provide slight resistance to this action).

Recently, many maternity hospitals have allowed women in labor to use a fitball to relieve pain during labor. A fitball is a rubber exercise ball commonly used for aerobics and Pilates. With the help of a fitball, you can take a wide variety of poses, easily changing one to another, guaranteed relaxation and continuous movement, while saving energy. For use during contractions, the fitball is not fully inflated so that it remains soft and springy. You can take all the poses listed above on the ball; In addition, there are special poses with a fitball:

swing, rotate the pelvis, spring, roll from side to side, sitting on the ball;
stand on all fours, leaning your chest, arms and chin on the ball and swinging on it;
lie on your side, placing the ball under your side and arm and springing on it;
lean on the ball with your back in a half-lying, half-sitting position with your legs spread wide;
swing, pushing off your back from the ball; sit or kneel, leaning on the ball with outstretched arms and springing;
lie on your side, placing the ball between your calves and springing them.

As you can see, active behavior during childbirth does not require special physical training. In order to use “active”, you only need the knowledge and desire of the woman in labor to be a participant in the birth, and not a passive patient.

Pain relieving breath

The most effective way to relieve labor pain is with special breathing techniques. The analgesic effect of breathing is based on hyperoxygenation - oversaturation of the blood with oxygen. The respiratory center of the brain, registering excess oxygen in the blood of a woman in labor, sends an impulse to the pituitary gland, the main hormonal gland of the body, responsible for the release of endorphins. These substances, called “pleasure hormones,” regulate a person’s pain sensitivity threshold. The more endorphins are released, the higher the pain threshold; That’s why proper breathing during contractions and pushing relieves pain no worse than analgesics.

Breathing techniques can be used at any stage of labor without restrictions. They are applicable in any position of the body, helping equally effectively both during the normal course of labor and during the development of various deviations of labor.

At the beginning of labor, when contractions are practically painless, it is recommended to use “belly breathing.” At the beginning of the contraction, the woman in labor takes a relaxed, slow breath in through her nose, and then exhales the air through her mouth for a long time (as if blowing on water). This type of breathing helps to relax, relieves nervous excitement and ensures high blood oxygen saturation, stimulating and pain-relieving contractions.

By the middle of the first stage of labor, when contractions increase and become painful, “candle breathing” helps a lot. This is frequent shallow breathing, in which a short inhalation is made through the nose and exhalation through the mouth (as if we are blowing out a candle). As the contractions intensify, breathing becomes more intense, but still remains very rapid. You should only breathe in this way during a contraction; after the pain ends, the woman in labor takes a deep breath and exhales, evening out her breathing, and rests until the next contraction.

At the moment of full dilatation of the cervix, when contractions become especially long and frequent, it is most effective to breathe “locomotive.” This breathing is an alternation of the previous techniques. At the beginning of the contraction, the expectant mother uses belly breathing, saving strength. As the pain intensifies, breathing quickens and at the peak of the contraction becomes as intense as possible. Then, as the contraction “subsides,” the woman in labor calms and evens out her breathing.

In the second stage of labor, when the fetus begins to move along the birth canal, each contraction is accompanied by a false urge to defecate (the desire to empty the intestines). This sensation is caused by the pressure of the fetal head on the rectum, located next to the vagina. At this stage, the woman in labor needs to avoid premature births and relax as much as possible, helping the baby descend through the birth canal. To achieve this goal, you need to breathe “dog” during a contraction. This is frequent shallow breathing through the mouth, really reminiscent of dog breathing. When breathing "dog" the diaphragm - the main abdominal muscle - is in continuous movement, which makes pushing impossible. Breathing has the maximum pain-relieving and relaxing effect.

Magic touches

Another effective way of non-drug pain relief during labor is massage. By stimulating certain points and areas on the body during contractions, the expectant mother can independently regulate the pain impulse, reducing the level of pain and relaxing.

The most “popular” massage area for women in labor is the lower back, or more precisely, the sacral region. The sacrum is the fixed connection of the vertebrae at the bottom of the spine. In this area of the spinal cord is located the sacral nerve plexus: a nerve node that innervates the uterus and other pelvic organs. By stimulating the sacral area (lower back in the middle) during contractions, the woman in labor blocks the transmission of nerve impulses, thus reducing pain. Massage can be performed with one or two hands, massaging the area with the pads and knuckles of the fingers, the base of the fist, the base of the palm, the inside of the palm or a hand massager. Movements during a massage can be stroking, pressing, patting, pinching and even lightly tapping the area to be treated. To prevent irritation from occurring on the skin of the sacral area, you can periodically lubricate it with cream or oil. If you haven’t stocked up on massage oil, don’t worry: ask your midwife for liquid Vaseline oil, which is always available in the maternity hospital.

During contractions, you can stimulate the protrusions of the pelvic bones on the sides of the abdomen. These bones should be treated in the same way as the sacral area. You can try different methods: squeezing, pressing and releasing, stroking, pinching. Choose the type of massage stimulation that most effectively reduces pain for you. This method is a kind of distracting maneuver that transfers the source of pain.

Periodically during the contraction, gently stroke the lower abdomen and the area of the fundus of the uterus (the uppermost part) in a semicircle. The same stroking movements can be made by moving your hands from the lateral protrusions of the pelvic bones along the inguinal fold towards the perineum and back. These movements calm the woman in labor, help relax and improve blood circulation in the uterine area,

The next massage option is most convenient to use while lying on your side or sitting on a ball. Press the insides of your palms against your inner thighs. During a contraction, move your hands with pressure, without lifting your palms, from the groin to the knees and back. The recurrent nerve, which innervates the pelvic organs, passes through this area. Massaging the inner thigh helps reduce pain and maximize relaxation.

In partner childbirth, the assistant can constantly perform a light relaxing massage of the whole body, avoiding only the chest, perineum and abdomen of the woman in labor. The touch of a loved one's hands calms the expectant mother and helps her relax better.

Water as a helper

The main advantage of aquatherapy is the relaxing and pain-relieving properties of water. In warm water, contractions feel softer, blood circulation improves, the woman in labor has the opportunity to relax and take a comfortable body position, and gets less tired. Water eliminates the occurrence of such side factors of discomfort during childbirth as dry skin, increased sweating, chills or a feeling of heat,

Recently, many maternity hospitals have begun to use non-drug pain relief from contractions using water. For childbirth with aquatherapy, special showers and a hydromassage tank are used, located in the maternity ward. The rooms for water procedures in the maternity block are disinfected in a special way. Of course, staying in water during childbirth without risk to the health of the mother and fetus is possible only under the supervision of a qualified medical specialist. When using a special bathtub, the expectant mother should fit entirely in it, being able to turn and change her body position. The water temperature should not exceed normal body temperature (36.0°C-37.0°C) and should not fall below 30.0°C. A birth partner or a maternity hospital specialist should always be near the woman in labor (in the shower or near the massage bath).

Unfortunately, this wonderful method of pain relief cannot always be used. Staying in a water tank during childbirth can be considered absolutely safe only as long as the baby and the uterine cavity are protected by the wall. After the rupture of the membranes, the last barrier between the sterile uterus and the non-sterile vagina disappears. After all, water through the vagina can penetrate into the uterine cavity and cause infection. There are fewer restrictions on the use of a shower during childbirth: this method will have to be abandoned only if the doctor recommends bed rest to the mother in labor.

If childbirth proceeds without complications, you can visit the shower quite often throughout the first stage of labor. For this, two conditions are necessary: the presence in the maternity unit of a shower equipped for women in labor, and the ability to observe the expectant mother during water procedures. Shower stalls for women in labor are made open (without doors - to allow medical observation), trays with a “non-slip” coating are used, and comfortable handrails are installed on the walls. During the entire stay in the shower, a midwife or doctor must remain with the expectant mother. Of course, this is only possible in the case of individual management of childbirth; however, during a partner birth, the spouse of the woman in labor can become an “observer” and assistant.

The optimal analgesic and relaxing effect can be achieved by using a stream of water like an aqua massager. To do this, you need to take the shower head in your hand and, changing the water pressure from weak to medium and even strong, water your stomach in a circular motion throughout the contraction. If you have an assistant, you can ask him to massage the lower back and sacral area with a stream of water. Between contractions, it is worth reducing the water pressure and directing the stream to the face, shoulders, chest and legs, achieving complete relaxation. The ideal water temperature for pain relief during childbirth is 36-40°C; lower temperatures have a stimulating effect on the nervous system, and too hot water can cause bleeding.

The birth of a child is the most wonderful event in a woman’s life. Of course, the process preceding this event requires a lot of strength and patience from the expectant mother. But you shouldn’t expect pain and unbearable pain from childbirth; childbirth is rewarding work. And if a woman has prepared for childbirth, knows how to help herself and goes into labor with a smile, this exciting event becomes a real holiday. And pain has no place at the holiday!

Elizaveta Novoselova, obstetrician-gynecologist, Moscow

Childbirth is very rarely painless. However, pain was developed in the process of evolution as a protective reaction of the body, and we can control it.

For the birth to be easy, the woman must feel safe, and the birth of the baby must take place in a calm and friendly environment. In addition, there are a wide variety of methods that are used to relieve pain during childbirth.

There are medicinal and non-medicinal pain relief for childbirth. Undoubtedly, the latter option has several important advantages: the absence of side effects and influence on the child and ease of use.

Physiological (non-drug) methods of labor pain relief include relaxation, breathing exercises, active behavior, massage and water treatments. In order to be able to use the entire arsenal of these methods, you need to master them in advance - even during pregnancy.

Learning to relax during childbirth

When preparing for childbirth, it is very important to learn to relax. The fact is that tension quickly depletes strength, and hormones produced in response to stress, which, as a rule, inevitably arises when a woman is very tired during childbirth, reduce the effectiveness of uterine contractions.

Prolonged stress reduces the supply of oxygen to the baby, and also affects the heart rate, impairs blood circulation, and causes headaches for the expectant mother. By learning to consciously relax, a woman is able to manage her stress level and avoid many unwanted complications.

What do you need to learn? You can master the relaxation technique by following these recommendations. Sit comfortably. Try to relax your facial muscles first: they are connected to the internal organs. Unclench your jaw and let your chin drop. Then focus your attention on the muscles in your neck and upper back. You can turn your head a little without straining your muscles, as if rolling your head from side to side. Relax parts of your body, causing a feeling of warmth in them and accompanying this process with positive thoughts: “Everything is going as it should,” “I feel easy and calm.” Imagine some pleasant image that evokes a feeling of inner peace and joy: warm rays of the sun, swimming in warm water. Then proceed to relaxing your right hand, left, then the muscles of your legs and perineum, while imagining your arms and legs hanging freely. Remember how you feel. During the contraction, it is advisable to remain in a relaxed state. But this relaxation is not passive, but an active conscious process that requires concentration.

With the increase in regular labor, a woman’s positive attitude towards a favorable completion of childbirth should not weaken. It is important to switch your attention from pain to something else, for example, focus on proper breathing, which is very helpful during childbirth.

Correct breathing during childbirth

Special breathing techniques are rightfully recognized as one of the most effective ways to relieve pain in childbirth.

What is the effect based on? It turns out that when certain types of breathing are used during childbirth, the blood becomes oversaturated with oxygen (hyperoxygenation), which causes the release of endorphins into the blood. These substances are also called hormones of joy or happiness. They influence a person’s pain sensitivity threshold. The more endorphins are released into the blood, the higher the pain threshold, that is, for the expectant mother, contractions become less painful and she tolerates them much easier. This explains the pain-relieving effect of breathing. In addition, the uterus is a muscular organ, and for its effective functioning it requires oxygenated blood.

What do you need to learn? Breathing techniques are good because they can be used at any stage of labor without restrictions, in any position of the body, during normal labor and even during the development of various labor abnormalities.

However, each stage of labor has its own way of breathing.

At the beginning of labor When contractions are practically painless, abdominal breathing is recommended. When the contraction begins, the woman inhales slowly and relaxedly through her nose, and then exhales through her mouth for a long time, trying to stretch out the exhalation as much as possible (as if blowing on water). This technique helps to relax, relieves nervous excitement and saturates the blood with oxygen, stimulating and pain-relieving contractions.
When contractions intensify and become painful, you can use “candle breathing”: in this case, you need to breathe frequently and shallowly, taking short breaths through the nose and exhaling through the mouth (as when blowing out a candle). As the contractions intensify, you need to breathe more intensely, but also very often. You should only breathe this way during a contraction. In between, it is recommended to take a deep breath and exhale, calm your breathing and rest until the next contraction. You can also use a “tired exhalation” - this is breathing with a so-called voiced exhalation, which will help relieve tension accumulated during childbirth and replenish your strength. Remember how we breathe when we are very tired and want to throw a heavy burden off our shoulders.
When the cervix is already fully dilated and contractions become especially long and frequent, the strongest pain-relieving effect is exerted by “train” breathing. At the beginning of the contraction, you need to breathe with your stomach, which allows you to save energy. As the pain increases, it is recommended to breathe more often, and at the peak of the contraction, the most intense. As soon as the pain begins to subside, breathing needs to be evened out and calmed down.
In the second stage of labor, when the fetus begins to move along the birth canal, pushing begins. They are accompanied by a feeling as if you want to empty the intestines (due to the fact that the fetal head is pressing on the rectum, located next to the vagina). At this stage, it is important for the woman in labor to avoid premature pushing and relax as much as possible, helping the baby move down the birth canal. Dog breathing helps to restrain efforts - in this case, you need to take frequent and shallow inhalations and exhalations through your mouth, which resembles the breathing of a dog. In addition, it has a strong analgesic and relaxing effect.

Pain relief for childbirth: active movement

Another option for natural pain relief is active labor. It lies in the fact that a woman can behave freely during childbirth: constantly change positions, move around the ward or corridor, looking for the most comfortable position for herself.

What is the effect based on? Firstly, movements allow you to take your mind off the pain, which in itself significantly reduces pain. Secondly, if a woman does not move, the overall blood flow decreases, less oxygen reaches the muscles of the uterus, which is their energy fuel, and because This makes the pain intensify. And with active movement, blood flow increases, more oxygen is delivered to the muscle tissue of the uterus and pain is not felt as much. Thirdly, as noted above, the feeling of pain depends on whether a woman is tense or relaxed: the more she tenses, the more painful she becomes, and vice versa. Quite often, women completely stop moving during a contraction - they seem to freeze out of fear of pain. But such behavior will not allow you to hide from pain, but will only intensify it. So, in addition to the techniques of conscious relaxation, in such situations, constant physical activity will come in very handy, because during movement the muscles naturally tense and then relax, so their excessive overstrain is excluded. It becomes easier for a woman to relax, which means the pain will be felt less.

What do you need to learn? It is important to know what movements are acceptable during childbirth. They are very diverse. And if childbirth proceeds without complications, then there are no special restrictions, except that you cannot sit on a hard surface and make sudden and impetuous movements. You are allowed to walk calmly around the hall and ward, lean to the sides and forward, sway and rotate your hips, make turns and stretches with your whole body, step from foot to foot, squat shallowly, arch your back, squat with your knees apart, kneel with your knees apart, them to the sides, stand on all fours, etc. Often relief during childbirth is brought by poses using a large gymnastic ball (fitball) - you can swing on it, spring, rotate the pelvis, etc.

If, for medical reasons, you have to give birth in a lying position, then you should move here too: you can bring your legs together and spread them, rock your pelvis, turn from side to side, and make springy movements with your hips.

Pain-relieving massage during childbirth

Massage is an excellent help for reducing pain during childbirth.

What is the effect based on? The use of massage techniques allows you to switch attention from the pain during a contraction to the tactile sensations from the massage effect. Impact on certain points and areas on the body during contractions allows the expectant mother to reduce pain and relax better. For example, massage of the sacral region (lower back) has a fairly strong analgesic effect. In this zone there are nerve nodes that innervate the uterus and other pelvic organs. Massaging the sacral area during a contraction stops the transmission of the nerve impulse, and the pain decreases.

What do you need to learn? A woman can perform a massage on her own, but if her husband or someone else close to her is present at the birth, then it is more convenient to entrust it to him. Massage of the sacral area can be done with one or both hands, the pads and knuckles of the fingers, the base of the fist, the base of the palm, the inside of the palm, or a hand massager. Movements during a massage can be stroking, pressing, patting, pinching and even lightly tapping.

Massaging the protrusions of the pelvic bones on the sides in the lower abdomen will also help to take your mind off the pain and make it easier to survive contractions. These bones should be treated in the same way as the sacral area: press and release, stroke, pinch. Experiment and choose the effect that will be most effective.

During the contraction, you can gently stroke the bottom and top of the abdomen in a semicircle. These movements calm and help the woman relax.

Massaging the inner thigh helps reduce pain and maximize relaxation (the recurrent nerve, which innervates the pelvic organs, passes through this area). It is more convenient to do it lying on your side or sitting on a ball. Press the insides of your palms against your inner thighs at your groin. During the contraction, move your hands with pressure, without lifting your palms, to your knees and back to your groin.

If you are planning a birth with your husband, then he should learn the simplest massage techniques.

Eight: take a large pillow and ask the expectant mother to kneel down, spread them gently to the sides, sit on her heels and rest her forehead on her hands crossed on the pillow. This position is quite often used during contractions; it is convenient to massage the back. Putting our hands on the woman’s shoulders, we draw a figure eight – the palms meet on the lower back and tailbone. Then, with the backs of your hands, move your hands along the spine from bottom to top and draw a figure eight again.
Screwing: clench your hands into fists and very lightly twist them into the lumbar region, without pressing on the spine itself. Gradually increase the pressure, but do not forget to focus on the sensations of the expectant mother. It should tell you the strength and area of pressure.
Acupressure: With your thumbs, press on points along the spine from bottom to top, stepping back two centimeters from the protruding processes, and go from the sacrum to the cervical region. You can stay longer on more sensitive points.
Foot, neck and shoulder massage often brings relief and helps to relax. First, the foot needs to be rubbed up and down with quick but light movements, on both sides. The heel and pads of the toes should be massaged in a circular motion separately and with effort, paying attention to each, then press on the hollows between the toes. This massage should be completed by stroking the foot. Start your neck massage by stroking, performing smooth, light movements with your palms from top to bottom. Then start rubbing, moving 2 cm to the left and right from the protruding bone processes of the vertebrae (while grasping the back half of the neck with your thumb and forefinger). Next, we gently knead the neck muscles, including vibration techniques, patting and tapping. The massage ends with stroking.

Water procedures for pain relief during childbirth

Water is an accessible, safe and pleasant remedy. Using water for healing purposes is an ancient method that has proven its effectiveness. In the absence of contraindications (premature rupture of amniotic fluid, high blood pressure), it is allowed to take a warm bath or shower in the first stage of labor.

What is the effect based on? Warm water reduces pain during contractions, relieves muscle and emotional tension, and helps to relax in the intervals between contractions of the uterus. In addition, the body weight in water is less, and often a woman giving birth feels more comfortable. You can also wash your hands from elbows to wrists in cool water, thereby activating blood circulation and relieving fatigue.

As you can see, pain during childbirth can be overcome. Tension and anticipation of pain slow down the birth process, and proper breathing, relaxation, comfortable body position and massage help move the baby’s head along the birth canal and make birth easier.