Ep 136. How to Decrease Pain in Labor for a Natural Birth

How to work with your body for ultimate comfort in labor:

• How to support the natural hormone cascade of physiologic labor
• Our number one coping tool, that happens months before the birth
• Why mental fortitude and preparation helps you cope physically
• Practical tools to fill your labor comfort measures bag with

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Transcript

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Welcome back to at home with Kelly and Tiffany I'm Tiffany and I'm Kelly. And we are two licensed midwives and sunny San Diego. Enjoying the best of the tail end of summer. Yeah. And you know what? We had a really random. Kind of drizzle. I was going to say rainstorm wasn't really, it was like some slight drizzle this morning. But I'm looking out and it is, it is sunny. San Diego. Again. We're doing something a little bit different today in which we have been a little bit more creative in how to get some work stuff done without. Abandoning our family is. And so today the concept was. Come over for lunch, the kids can swim and we'll sneak into the office and record a few episodes. But so far it's included. Hurry up and eat. Go outside and be quiet. Please. This is your magical childhood. Together. Go do all the things together. I can hear them and they sound like they're having fun. They're screaming and splashing. They're having the time of their lives. They're together. And our husbands are hanging out. And that's good for them. It's good. Okay. So on this beautiful Saturday afternoon, Which will be. Monday when these people hear it. Yes. These people. You people we get to talk about understanding the physiology of labor, how to work with it, how to work with your body, to get more comfortable that is actually available to you in labor. There are things you can do in order to increase comfort. Yeah. And I mean, right. We think about when you break your arm or something, right. You're like owl, this sucks. And there's no point to this. It just hurts. Right. This is not helpful whatsoever. But then we start understanding what's. Going on in labor and the discomforts and the pains that you feel during that you realize one, this is purposeful. And write it has a reason it's bringing you towards something it's your body is wanting to do this thing in order to get you to the other side, it's supposed to be doing this. It's not like breaking something. But that in. In recognizing that, then you can lean into that idea of that. We talk about in so many other ways, right? Your body wants to do a thing. How can we support it in the thing that it's doing? So that's what this is all about. And that is what we're going to talk about today. Yep. It's one of the Babel we're going to talk about before we jump in Kelly, we are wrapping up an entire month long course on metabolic health inside of our membership. And you kind of. Captained vet ship. Yeah, this was a, this was a topic that we knew we wanted to bring into the membership for months, because it was probably the most, one of the most common suggestions from our members from the get-go just about understanding metabolic health, metabolic disease, the issues that come up with. Higher risks when only 12% of adult Americans are actually considered metabolically healthy, like that is a PERAB limb. And so. Being able to explain, not only what is, what is really metabolic health, what does that mean? And what is it? Like, what does that actually entail? But also to what's what can help that, what can hurt that understanding the choices that you make daily, what is supporting and what is kind of taking away from that w protocols for, at home use of what you can do if you're noticing some of these flags in your metabolic health and taking you along for an entire day of like a metabolically healthy. Kind of trophy day, right? This is generally speaking what that would look like and some of our favorite tools and tricks and all kinds of stuff that are involved in that. So we walked through this entire thing and it's super cool for me to, to be able to put it together. And I we've said this and in different spaces, but we create this content for our membership and we get encouraged by it too. And so, it was, it was helpful and I see it being such a need. I mean, for everybody, but for women. In particular. I was blessed by it. By what you created. It changed things for me. And so thank you. Anytime. We have another listener question today. This is a good one. She says, Hey ladies, I just found out I'm pregnant with our second child. And I would love to have a home birth. Good job. In my first pregnancy, I developed preeclampsia and Cola stasis around 36 to 38 weeks pregnant. Ruff. So rough. I know that I wasn't staying properly hydrated, consuming enough protein or exercising as I should. I have educated myself since my first birth and will be able to go into this pregnancy, focusing on detoxing, my body properly. I loved your episode on detoxing our bodies, by the way. And thank you. I was wondering if there was any advice that you could give me on avoiding these health, health complications. And if I do have to be transferred to a hospital, what would be your best advice on maintaining a peaceful environment for my birth? Unfortunately, I don't believe we'll be able to afford a doula. I'm currently trying to train my husband though. Haha. Aha. Yes. A hundred percent. These are all things that are very worthy of consideration and thoughtfulness coming into another pregnancy. Yeah. And even recognizing, oh, there's things that I can do differently. This go round that may have a huge impact on my actual health and outcomes of this pregnancy. Is massive because I think a lot of people are like, oh, I developed preeclampsia. Right? I guess that's, I just got the bum end of the stick. Right. And sometimes we don't have a reason for why certain things come up. But. With your foresight and your desire to be as proactive as possible, which is really what midwifery care is about, is being able to sit and know and just be proactive. And the way that we're. Supporting. Women and their bodies and what they're doing. I think you hit on some of the biggest things though. You knew in your last pregnancy, you weren't staying properly hydrated, consuming enough protein. Or exercising, right. Even just simply moving your body. Those are three huge things, especially that protein, especially moving your body. Well, and especially staying hydrated. So all three. Those are towards the very top, like tippity, top of the list, this go round worthy of leaning into, even if it feels like. Gosh, I really feel like I can't do this, or I keep missing my protein mark. That is worth it to lean into and, and work towards that goal. Yeah. Preeclampsia and Cola stasis. Are both thought to kind of have like a, a founding disease process in the liver. Or at least liver support in general tends to improve the outcomes for women who may be already predisposed to have risk factors for developing these maternal diseases. And so eating plenty of protein, high injury eating, but then taking special care of your liver health in general, with some really gentle detoxing that is safe for pregnancy, like. Consuming dandy, lion, consuming nettles dry brushing. Lemon water. First thing in the morning, those types of things, as well as like, you know, potentially getting additional or both support on board would be super helpful. And then also for anybody else who's listening, who finds himself in this same particular situation. And even the listener who asked this question, knowing what your MTHFR statuses can change things for you too, because if you have a methylation issue that is related to this gene mutation, Called MTHFR. You're going to need to make some lifestyle adaptations in order to prevent some complications in your whole entire life from coming to the surface. And so we see a lot of preeclampsia and MTHFR positives together. And so having that information can really change the outcome of your pregnancy, but let's talk real briefly on. What she should do to maintain a peaceful environment in her birth if she has to transfer to the hospital. Yeah. I mean, certainly, you know, recognizing that if there is a transfer, you know, you know, you need it. That is like the number one, like kind of wrapping your brain around. Okay. This isn't what I wanted, but here's what I, here's what I need. But one of my favorite things as a doula simply was to turn the lights down. You can hang your own, like little fairy lights or, you know, lights, whatever in there, but keeping the lights down. And either your music up in a speaker or your music and in your earbuds. All, all that does is not only it calms things down for you because those no fluorescent lights are good for no one. But anybody coming into the room immediately is sort of like shocked at the difference between the fluorescent bright outside and this dark quiet space inside with like, whatever music you want or whatever kind of vibe you want to set up in there. I think those. It sounds so simple, but those two things can make a big difference just in your assessment of maintaining peace. And then it checks the nurses when they walk in. They're usually not as like gregarious and outgoing. When, when they see that the lights are down. Absolutely. I love that advice and I wouldn't rule out having a doula with you necessarily for financial reasons, because there's plenty of doulas who are just getting started, who will have a reduced fee. There's a lot of programs out there that can assist with find matching you with a doula. If it's not an affordable option for you, you can find women who are just passionate about birth and just want to be there to help. That would be ideal so that your husband can just be also one of the other parents experiencing birth that day. But if he is going to be your number one sole support person in that environment, I would have him, or you guys read together the birth partner by penny sinkin and just kind of have that on hand as a handbook for him so that he's not expected to remember all the ways that you want to be advocated for or comforted physically, and kind of have a little bit of extra tool in your back pocket with that one. I like it. I love the things that she's thinking about though. Even just that huge she's got it. Yes. Yeah. You've got a lot of pieces in place already. Mama. Okay. So let's talk about this idea of like, I wanted a natural birth, but I didn't get one. It is such a prevailing message out in the natural birth or unnatural birth world. So, what did you say to someone to keep them. From sharing their negative story about bursts. When you share that you're hoping to have a natural birth and then they say, oh yeah, I wanted that too. But listen to what happened to me. Yeah. Which is like stories from real life, every pregnant woman. Has probably experienced this. I know I did. My first two times, for sure. I don't think anybody really said anything after that, but I think some of the things just to kind of keep in your back pocket while it's not a bad thing, too. Here, like the many different ways that birth can go. I'm not somebody that thinks that you should just like close your ears and be like, there's nothing. There's nothing negative that could ever happen to me. Right. Kind of person. But when you're pregnant and you're planning something and somebody's response is all about their experience that went haywire. Most likely because not because birth went haywire because the support, the pieces around their birth kind of went haywire. One of the most helpful things that sort of shuts that down without being aggressive, I guess, is thank you for wanting to share your experience. Like, I really appreciate that, but I'm really working hard to kind of stay positive, looking forward. And that's all you really have to say, right? You don't necessarily have to go into an entire. Explanation. Yeah. Or I would love to hear more about this after I have my own birth experience and just being really honest, that like I've noticed other people's stories happen effect on me. Yeah, and you can you can also just remind them that you are pregnant and feeling kind of vulnerable. And you can just sort of, you know, if you're in a conversation you're sitting down with some friends or something, You can just be like, you know what? I think I'm going to get up right now. I'm going to excuse myself for a minute. I've just realized since I've become pregnant. I'm just really overthinking labor. And I don't want to lose confidence that I am, that I have right now that I'm bringing into my labor. And that's what I fear might happen. If I continue in this part of the conversation, which are then that'll. That if, especially for women who haven't, don't really understand, maybe. The importance of birth, they haven't really accepted that, like their own traumatic experience, why they want to process it, why they want to talk about it so much is their own actual, emotional. Processes and healing from it. That'll make them think twice of how they share. Yeah. And I think that's really important. Also like you can just stop and just say, I'm sorry that happened to you. Can we talk about something else? You don't have to let them finish the conversation. You don't have to give them an explanation for why you don't want to continue to hear it. Yes, you can just say, I think we should talk about something else or I have to stop you there. Sorry, not sorry. I made a boundary about hearing other people's birth stories for now and let them think whatever they want to think about you being a weirdo who has to stop them from hearing stories, but you distill your job to protect your mental space. This is bringing up thoughts of when my fairy. Different family members get together. And politics comes up. And there are some very different feelings about. And I pull some of these out where I'm just like, I have to stop you. I like where I'm going to divert the conversation elsewhere. I need to share my boundary that like, this is actually not good for me. We should not keep talking about this. It's not good for. Everyone in this conversation wants to raise your hand. If you want to keep talking about this. Oh, it's not everyone. Okay. Okay. Or even if it's everybody wants to, I cannot. It's not good for me. Yeah. I can accept that. Good, good. Conversational boundaries is important and not something that is exercised enough because we're so worried about being polite and. And you can, you can be polite and say, this conversation's not working for me, right? Yes, absolutely. So take that with you in your pregnancy. You absolutely are. More vulnerable and emotional. Okay. Like just subject to more emotional kind of heaviness in pregnancy and in postpartum. And so being able to lean into that and be okay, protecting that is a good thing to work on. Physiological birth is all about what happens in your body without intervention. So when we use the term physiological over natural or unmedicated, the physiological piece of it actually points to what it is designed to do. And it's a really important part of looking at quote unquote, natural birth, because we can learn from it. We can see what the body is naturally trying to do and work with it instead. Of trying to do any of the things that might. Seem helpful, but actually be working against the process. Yeah, absolutely. And so understanding what physiological birth actually means as in like, if, if somebody was out in the woods and gave birth, right. What, what would the, what would actually play out. Right. Nobody was there meddling with anything. How, how would birth go? Right. And so understanding more about what, how, like, how that body actually is designed to work. Then you can take that information and make a plan for how to work with it. And I think planning on those pieces. Is a pretty foundational, vital, important, whatever word you want to use aspect of your goal as you look forward to your, your birthday. So in episode one thirty four, we talked about what's missing from your birth plan. And I don't think people really recognize that it really is about the choices that you have of who you're surrounding yourself with what the support actually looks like. What. Th those people's belief in physiological birth and what they believe about this entire process, I would venture to say, that's the number one coping tool is who you have on your side. When it comes time. Yeah. Is that person going to encourage with a physiological process and encourage you in accepting the physiological process? Or does that person have their own agenda or their own idea for what that process should look like for you? Yeah, absolutely. And so, Right. You're understanding what's going on physiologically in your body. You're surrounding yourself with people who actually believe that that is a good and trustworthy and worthy thing to lean into. And then you can start to Understand. Okay. Physiologically. Here's sort of this cascade of hormones, that's normal and natural, and this is how it was designed to be, how can I support that? We talk about hormone. Support and balancing all of the time. Right. And we recognize they're actually our friends they're talking to us though. Right. They let us know some things that are going on and we have to listen to it. Right. And so understanding what actually supports those natural hormones and how to lean into that rather than what is interrupting it. And so I think a lot of people are like, oh yeah, that oxytocin, those endorphins. That sounds so nice. Why does labor suck so bad for me? Why, why does it hurt so bad? Or why is this? Whatever, it's not necessarily the pain that is interrupting the hormone flow, right? It could be. Other people's response to it. It could be your own fear about what your body is doing. Could be just getting into something like this feels unfamiliar. Maybe you don't have somebody who you really can trust as your support person, maybe. You're being given like 10 different options of things to do or decisions to make. And that's not where your brain is in that hormonal flow. Right. And so your body is set up to. Release endorphins. It's set up to encourage you along in this journey, but being able to actually. Lean into those things, allowing that flow to happen. Is vital. Yeah. And I think that like, Realizing that you were actually in charge of many of those pieces can feel kind of terrifying because that means that you act on the idea that these, these pieces really matter. So there's three main methods for physiological coping. One is the central nervous system control method. And we'll dive into that. The next is the gate control theory. And then third is diffuse noxious inhibitory control. So let's talk about the central nervous system control method. It is essentially learning and practicing. So this happens before labor. Okay. Learning and practicing. Techniques that help you to perceive birth differently? You can control the unpleasantness of pain by controlling what you let yourself think about it. And it's not. Woo. It is science. How do you control your thoughts about birth though? Truly. How were we raised to think about birth, who is telling us about their negative birth stories? What do our own. Thoughts and feelings about our ability, our sense of accomplishment in life, how we deal with stress, our own sense of, you know, self-confidence all those pieces. And so controlling your thoughts about birth starts with educating. Maybe re-educating or uneducated yourself in certain places. It has to do with having continuous support around you. That is actually meaningful and has the same goals for birth that you do. And it also can be done with attention deviation. So in the moment recognizing, oh, I'm thinking a lot about how much this sucks right now. This happens to me a lot when I'm doing a really hard workout or when I'm at the very end of my sauna bag session where I'm like, I hate this so much. When is this going to be over? My body is screaming at me that I, I don't want to do this. I just want to quit. It is almost that same place mentally. What do you do when you start to have those thoughts that you can divert your intention? Yeah. When I used to teach childbirth education and when I first kind of got into it, I was really struck with this quote that the lady who started hypnobirthing said. When she said the way you think when the way you think about birth changes, the way you birth will change. And so that's that idea, right? Of like, the, before, where you're essentially learning and practicing all of these pieces. And all of that's going to help you perceive birth differently. So. Yeah. And then it plays out, not that. Not that birth necessarily is. Easier. Yeah, easy, I guess, but it helps alleviate so much. And I would not say that this counts for all of the people that we have worked with before, but. Kelly. And I have been able to pretty reliably. Be able to say, no matter on what the circumstances are and taking care of some particular woman. We can predict. For the most part because of her mindset around how she's framing her birth experience. If she is going to struggle in that space or not. Yes. Yeah, absolutely. And I think that's, that's more so because. Of that first foundational piece that we talked about, the support, we know that she's entering into labor. With the full support of midwifery care. I didn't always feel that way when I was a doula working in the hospital and just being like, this is somewhat of a crap shoot of like who's on call and how the nurses are feeling that night. And like so many pieces felt more out of. Control, I guess. But I definitely agree. Yeah. And so we can do, we can put every single supportive piece in. Line with someone, but we can't. Change the wave. They will trust the process that they're about to go through. And so I would say that might be one of the most important pieces for women to just even recognize if there's parts of birth where you feel really unsure or afraid or right. Like that is going to come out in your experience more than likely. Yeah, absolutely. And then when those do come out, who do you have around you and what tools do you have to kind of. We get you back on the path. Yes. Because the majority of women are going to have some kind of struggle a hundred percent. Yes, absolutely. Yeah. And because we know, especially first time, you've never done this before it is going to feel really unfamiliar. It is going to feel really challenging. And there's nothing wrong with needing an extra amount of support. But I think for the women who say I wanted a natural birth, but then I got this, they're essentially saying, oh yeah, I had that desire to, and I did all the things that everybody's said that I was supposed to do. And then I ended up with this outcome. Not that our outcome says anything about who we are, the kind of moms we are or whatever, but we know that birth is really important experience and women who want to have a natural birth deserve to know what is going to increase their chances for actually doing that. And this is a piece of that. Yes, absolutely. Well said. The second method for physiological coping is called the geek control theory, and that is the concept that your brain can only interpret so many nerve signals at once. So, although you may be perceiving pain in birth, you can intentionally flood your brain with pleasure signals to decrease the experience of pain. Because the five senses are an easy way to get ideas for extra stimulus. We usually brainstorm from those categories. So like sight, smell, touch, hear taste. And how can you overload those sensory pieces in order to decrease the perception of the discomfort? Yeah, absolutely. And so this comes in things like music, right? Or essential oils going, what kind of touch you want? Some people like really respond well to lighter touch, but some people are like, give me, like push on my back as hard as you possibly can. Or let me put my hands, those Like birth Combs. Right. So that they feel something different. Or I had one client once who had flick herself during her entire right. Because she was just like, that is what is making my brain think about this weird feeling of being flicked on my leg. Right. And so it just helped her. Recalibrate, of course she was still like, yep. Still feeling. What's happening in my belly. But also, my brain is thinking about this other thing that's happening too. Yeah. And so, as you compile your actual real life coping kit, like the toolbox of things that you are going to have at your birth, Get as many of these items in these five senses categories as possible. From massage for smell, for things that you can suck or chew on for visuals for all of those things. Got. A lot. Yeah, absolutely. The third method for physiological coping is called diffuse noxious inhibitory control. And that is a method of using a secondary. But intentional pain stimulus like heat. Pressure or electrical pulses to modulate the primary pain stimulus. It's also known as the pain inhibits pain pathway. So it's basically like. All the time. I joke with my kids, like when they fall down and get hurt or something, and they're like, oh, my knee just hurts so much. And I'm like, well, give me a hammer and I'll hit your other knee. And then that me won't hurt so much. You. You know, it's like that isn't scientific coping mechanism. And great parenting. Thank you. Thank you. This one in particular, I have seen women really enjoy the tens unit in particular. Like this is like a little unit that you attached to. You know, your back or wherever you need to, and you actually are in control of these, like a little electric pulses that are coming in. And that is, you're like, oh, it's sort of like a. It's not hurting you, but it is zing enough that it'll get your attention, which is the point. Yeah. It's like a little jolt. And at the time that we recorded this, this particular tens unit that we love is on sale for $17. It's usually a little bit over 30, like 32 or something. So I put that in the show notes, just in case it's still on sale, or it goes on sale again, or you just don't mind paying $32 for something that can help you. You guys can grab that. We had, we had a client who used it even postpartum. That's right. Yeah. Where her back was really bothering her after she had her baby and she reattached and was very happy. You know, we keep one around our house just for like when my husband and I pull her back out or have some awful like muscle recovery from a workout situation. It's a great household staple. But the other things that you can use this. Control method for, would it be acupressure? Acupuncture. Or sterile water injections, which can be really helpful. That's something that we use in particular for back labor women who just have like all of the sensation in their back. We normally hear women. Express that type of labor pain as like, I didn't have a contraction anywhere except for my back. And that's not true. She has the contraction in her entire uterus, but it was this same concept of like, it just was so severe in the back that you couldn't feel it any place else. And so those sterile water injections. Our like little sterile water injections. Yes, they are. They put them the water that gets injected. Basically it puts pressure on sort of some of the nerves that are back there and can help. Ease discomfort. When I learned how to do them in midwifery school, we did the money each other. As a, like with somebody like to try this so that we can show you what to do and whatever. And I was like, yeah, sure. And I got it done to myself. Not in labor. And I was the only one because nobody else volunteered after I did it because it was so uncomfortable. Yeah. I was like, I'm trying to like be cool. And I was like, I'm not cool. I'm not cool. Yeah. And it's, it's like a stinging sensation. It was like a major zing sting, but when we have done it for women in labor, when they needed it, right, I'm like, okay, count down from like 10 or something. Right. And they're just like zing, easing, easing. But then they're like, oh gosh, that actually I do feel like whether it's complete relief, not necessarily usually, but. Right. It's like taking the edge off. Yeah. And that zinging in comparison. To the other labor sensation is preferred. And so it's so cool that our brains and nervous systems can actually help with some of these pieces. Yeah. So understanding that and then using it to your advantage. That's the idea behind all of this is understanding what's going on and then use all of these pieces about how our brains work. And about how you physiologically are like how your body wants to go through labor and marry those two things. And that's great. Yeah. I mean, in an event that can be rather unpredictable, like birth. Take it from us. You actually have so much within your control. And one of those tools that we can send you guys off with is our free guide on foundations to natural birth, which is basically. Dive into three areas that help you work with the intensity of labor and feel confident about your future birth plan. Just from our own experience, walking through this with various. Women in so many different environments and what we feel like really sets midwifery care apart and how you can bring that into whatever birth experience you're about to have. You can grab that free guide. In our show notes. I hope you feel encouraged the whole desire behind wanting to make an episode just about this was that you people want. And desire natural birth. I think that that is like a heart's desire of a lot of women that have, you know, that we have seen and that who interact with us all of the time. And. We don't always get to, you know, share all of these pieces with them directly, if they're not our clients or whatever. And so being able to plant some of the seeds for you, whoever you are, as you're planning your labor and design, like. Wanting to lean into these desires, but not quite sure how to go about doing that. Hopefully you feel encouraged. That you really do have control. Over some of these pieces. Wonderful. All right, ladies, that is it. For today. We will catch you next week with a whole nother episode.