Tiffany Araura Rose, CMD, LMT, RYT 


    


    
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                                                           Birth With Less Pain
   What every woman wants for their birth is to feel as little discomfort as possible. But can birth really be a painless experience? That would depend on the person, the choices they make for pain management, and there thought processes about birth. With all the options available today, a woman can be empowered to create a birth that is perfect for her. There is no "right" or "wrong" method of pain magagement. The choice is a very personal one; and no one can tell a mother what she should do for her birth. 

There are women who have said that they had little pain, only minor discomfort with their births. Some women even reported having an orgasmic birth experience. In order to have similar types of experiences, fear about the birth process and even about your ability to be a parent must be erased. I can talk further about this during our monthly meetings.


FORWARDING LINKS:

Epidurals


Anaesthetic drugs


Spinal analgesia


Birth Hypnotherapy


Visualization 



From Wikipedia, the free encyclopedia

1.    Epidurals   
The term epidural is often short for epidural anesthesia, a form of regional anesthesia involving injection of drugs through a catheter placed into the epidural space. The injection can cause both a loss of sensation (anaesthesia) and a loss of pain (analgesia), by blocking the transmission of signals through nerves in or near the spinal cord.

Injecting medication into the epidural space is primarily performed for analgesia. When a catheter is placed into the epidural space a continuous infusion can be maintained for several days, if needed. Epidural analgesia may be used:
  • For analgesia alone, where surgery is not contemplated. An epidural for pain relief (e.g. in childbirth) is unlikely to cause loss of muscle power, but is not usually sufficient for surgery.
  • As an adjunct to general anaesthesia. The anaesthetist may use epidural analgesia in addition to general anaesthesia. This may reduce the patient's requirement for opioid analgesics.
  • As a sole technique for surgical anaesthesia. Some operations, most frequently Caesarean section, may be performed using an epidural anaesthetic as the sole technique. Typically the patient would remain awake during the operation. The dose required for anaesthesia is much higher than that required for analgesia.

The epidural space is more difficult and risky to access as one ascends the spine, so epidural techniques are most suitable for analgesia for the chest, abdomen, pelvis or legs. They are much less suitable for analgesia for the neck, or arms and are not possible for the head (since sensory innervation for the head arises directly from the brain via cranial nerves rather than from the spinal cord via the epidural space.)

  

Side effects

In addition to blocking the nerves which carry pain, local anaesthetic drugs in the epidural space will block other types of nerves as well, in a dose-dependent manner. Depending on the drug and dose used, the effects may last only a few minutes or up to several hours. This results in three main effects:

  • Loss of other modalities of sensation (including touch, and proprioception)
  • Loss of muscle power (hence, a risk of falling)
  • Loss of function of the sympathetic nervous system, which controls blood pressure

Pain nerves are most sensitive to the effects of the epidural. This means that a good epidural can provide analgesia without affecting muscle power or other types of sensation. The larger the dose used, the more likely it is that the side-effects will be problematic.

For example, a laboring woman may have a continuous epidural during labor that provides good analgesia without impairing her ability to move around in bed. She requires a Caesarean section, and is given a large dose of epidural bupivacaine. After a few minutes, she can no longer move her legs, or feel her abdomen. Her blood pressure is noted to be lower and she is given an intravenous bolus of ephedrine or phenylephrine infusion to compensate. During the operation, she feels no pain.

Very large doses of epidural anaesthetic can cause paralysis of the intercostal muscles and diaphragm (which are responsible for breathing), and loss of sympathetic function to the heart itself, causing a profound drop in heart rate and blood pressure. This requires emergency treatment, and in severe cases may require airway support. This happens because the epidural is blocking the heart's sympathetic nerves, as well as the phrenic nerves, which supply the diaphragm.

The sensation of needing to urinate is diminished, which often requires the placement of a urinary catheter for the duration of the epidural.

Opioid drugs in very large doses may cause troublesome itch, and rarely, delayed respiratory depression.



2.    Anaesthetic drugs

A patient receiving an epidural for pain relief typically receives a combination of local anesthetics and opioids. This combination works better than either type of drug used alone. Common local anesthetics include lidocaine, bupivacaine, ropivacaine, and chloroprocaine. Common opioids include morphine, fentanyl, sufentanil, and pethidine (known as meperidine in the U.S.). These are injected in relatively small doses.

Occasionally other agents may be used, such as clonidine or ketamine.




3.    Spinal analgesia  
Commonly called spinal anesthesia or sub-arachnoid block (S.A.B.) is a form of regional anaesthesia involving injection of a local anaesthetic into the cerebrospinal fluid (CSF), generally through a fine needle. The desired effect is to block the transmission of nerve signals to and from the affected area. Sensory signals from the site are blocked, thereby eliminating pain, and motor signals to the area eliminate movement. In effect, the result is total numbness of the area and paralysis. This allows surgical procedures to be performed with little or no sensation whatsoever to the person undergoing the procedure, and provides a still patient or area for the surgeon to work on.

Some sedation is sometimes provided to help the patient relax and pass the time during the procedure, but with a successful spinal anaesthetic the surgery can be performed with the patient wide awake. Spinal anaesthetics are limited to procedures involving most structures below the upper abdomen. 

Complications

  • Spinal shock
  • Cauda equina injury
  • Cardiac arrest
  • Hypothermia
  • Broken needle
  • Bleeding resulting in hematoma, with or without subsequent neurological sequelae due to compression of the spinal nerves
  • Infection: immediate within six hours of the spinl anaesthetic manifesting as meningism or meningitis or late, at the site of injection, in the form of pus discharge, due to improper sterilization of the LP set.

 

4.    Birth Hypnotherapy 
    Would it surprise you to know that birth doesn't have to be a long, arduous and agonizing experience? Women in many countries around the world give birth without the drama and screaming that we in the West associate with childbirth. When you use visualization and hypnosis in the process of birthing you stand to gain so much.

    Many people hear the word "hypnosis" and think of people acting foolish on stage or on television shows. Hypnosis for childbirth is not like this at all; it is more like a type of meditation. It puts the woman in a very relaxed state, but she is still herself and still very aware of everything that is happening around her and within her body. She is able to take herself out of the relaxed state, or out of hypnosis, any time she wishes, and will never do anything that she doesn't want to do while in a state of hypnosis.


Research has shown that birthing with hypnosis can help to achieve the following:
• Faster labour
• Efficient labor
• Less pain relief
• Less interventions
• A relaxed and healthy baby/less chance of distress
• Faster recovery
• Reduced incidence of post-natal depression
• Breast-feeding success 


So how does hypnosis help birth?
1. Relaxation. The state of hypnosis is highly relaxing for the mind and body. In this state the entire body relaxes and so do the blood vessels. This relaxing or dilation of the blood vessels ensures a better blood flow throughout the body and especially to the womb.

2. Efficient Birth. During labor, a relaxed body will ensure that blood is diverted to the uterus in order that it can contract efficiently and progress labour smoothly and swiftly. A relaxed mind and body will ensure that the womb has the blood supply it needs. Post-natally a better milk supply is encouraged through good blood flow.

3. Calm the Emotions. The effect on the mind and emotions is profound. With hypnotherapy a woman can relieve stress and anxiety. This relief can help to achieve a calm birthing experience and later calm the emotions during the post-natal period.

4. Overcome Fear. Fear is the single greatest factor that you can change about your labour. Fear inhibits labour, constricts the blood supply and increases the perception of pain. This leads to the Fear-Tension-Pain cycle, where fear creates tension, which creates pain, which creates more fear of pain and so it goes on. If you can remove fear then you can aid your own body to do what comes naturally and that is to birth a baby comfortably and easily.

5. Stress Relief. When we are stressed or fearful we release adrenaline and other stress hormones into the blood stream. This tenses our bodies and a tense body feels pain and creates its own pain. Blood rushes to the arms and legs ready to fight or run, taking blood away from the uterus where it is needed to help the uterus to contract. If there is not enough blood flow to the uterus, it works less efficiently and slower and blood flow to the baby can be disrupted, resulting eventually in distress. Other blood vessels can be constricted, again stopping the uterus from working well. You can see that when hypnosis removes stress from the experience of childbirth, then a swift, comfortable birth of a relaxed baby will normally result.

6. Relaxed Baby. A tense mother will release stress hormones, adrenaline and cortisol into the blood stream. These can in turn stress the baby, who then appears distressed to medical staff and interventions can result in order to speed up labour or bring the baby out quickly. Babies are designed to withstand many hours of labour and a relaxed baby will cope well even if labour does not progress as smoothly or quickly as hoped.

7. Post-Natal Recovery. A relaxed mother will have good blood flow around the body. This blood flow will assist soft tissues in recovery and promote a good milk supply. Stress is known to have an adverse effect on milk production so the relaxed mother has a head start.



                                                                    Hypnobabies Program
    There are several home study birth hynotherapy courses on the market. The three that are most popular are Hypnobabies, Hypnobirthing, & Hypnobabies. These courses are a wonderful adjunct to Childbirth and Labor preparation classes. I am trained as  hypno-doulas using the Hypnobabies techniques.


    Hypnobabies is the only childbirth hypnosis program that teaches "Eyes Open Childbirth Hypnosis", allowing the birthing mother to walk and talk & move around during labor, and yet remain deeply in hypnosis, relaxed and physically comfortable throughout. This is a very important feature for labor- to enable you to use upright positions for descent and positioning of your baby. You must be prepared to learn the self-hypnosis techniques that you will practice on a daily basis until your baby is born.

    You will use the Hypnobabies workbook, CD's and hypnosis scripts to train the inner mind- that contractions in labor will be felt only as pressure, tightening, pushing and baby movement sensations. Hypnobabies uses the same kind of hypnosis techniques that people employ when preparing for surgery without any medications. The course also teaches the birth partners how to fully support the hypno-moms. But be aware that not every mom will experience a pain-free birth.

                                                                                           Visit http://www.hypnobabies.com/

                                                               or  Sacredbirthsdoulablogspot.com    for more information about Birth Hypnotherapy
                                                                 and about research supporting the use of Birth Hypnotherapy
                                         

 

 

 


5.    Guided Visualization   
Guided imagery is the conscious use of the imagination and the mind to create positive images ("healing visualizations") or a setting in order to bring about healthful changes in both the body and the mind. It has many utilizations. Creating mental images is nothing new for most people. Everyone has daydreams, perhaps of a set of new clothes or of winning the lottery. Guided imagery takes this natural process a step further. Most people most likely use it without even realizing they are doing it. By working with your midwife, a doula, a trained therapist, or using special audiotapes, you can learn to communicate more effectively with your unconscious mind, requesting that your body function in an optimal and healthy way.

The early stage of labor can be difficult for a birthing mother. She may not be sure that she is experiencing real labor. Or her contractions might be mild and spaced out, but the anticipation of what is ahead may prevent her from getting rest before more difficult labor begins. A midwife, a doula, or anyone else experienced with guided imagery can verbally guide her mind to an image of her unborn baby, sleeping and floating inside of her, while the mother gently strokes her own abdomen.

 

 

 

 

 

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