Pain During Childbirth

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As you've already heard in the previous videos, the contractions are getting stronger. That means they're becoming more effective, but also more intense—or more painful.

Because the intensity of the WW increases gradually, you can slowly get used to the pain. It starts at one level, and you get used to that. Then it goes up a notch… You get used to that, too… and so on.

The sensation of pain you feel can vary. There are several ways to make the pain more manageable.

• Provide a distraction; The initial phase can take a while. Don't focus too much on how you're feeling—find a distraction! Don't start timing them too soon. You'll know when the contractions start coming closer together.
• Breathing: One way to cope with contractions is to focus on your breathing. By focusing on your breath, you can go with the flow of the contraction and not let it catch you off guard. For example, breathe in deeply and out deeply, or breathe in deeply and out in small puffs.  Through practices such as mindfulness, yoga, or hypnobirthing classes, you can explore the different breathing techniques in greater depth.
• By positively and with confidence
  If you can cope with the contraction, you’ll be better able to handle it. You won’t think, “Oh no, oh no, there it is again,” but rather, “Okay, bring it on—I can do this. I’ve prepared for this, and because of it, I’ll get to see my baby soon.” For example, visualize a beautiful scene as you deal with the contraction. Imagine lying in bed after giving birth with the baby on your belly. The courses mentioned earlier can help with this, too.
• Postures: You may feel a contraction more in one position than in another. That’s why it’s a good idea to try different positions to find the one that works best for you. You can find more information in the video about positions.
• Massage It can also help reduce pain in a specific area. For example, by applying continuous pressure to the lower back, you can reduce the sensation of pain caused by back labor.
• Heat helps you relax. Relaxation reduces pain. So a hot water bottle, shower, or bath is a great natural pain reliever!
• A tens device It delivers weak electrical currents that help reduce the sensation of pain. You attach two electrodes to your back. This can make the pain more bearable, especially for those with lower back pain. You can purchase or borrow the device yourself. Insurance sometimes covers the cost.

Sometimes the above measures won't be enough, and more will be needed. In that case, there are other pain relief options available. These aren't automatically offered right away because they can also have side effects. But if needed, it's good to know they're there!

The type of pain relief available depends on the stage of labor. We will, of course, provide you with more information about this.

• Nitrous Oxide It can be administered at the Amersfoort Birth Center. This is a method that has no negative effects on the mother or the baby. You inhale nitrous oxide through a mask. It helps you relax and takes the edge off the pain. Once you start using this pain relief, we can continue to support you through labor, and you won’t need to be transferred to another location.

 For the following two pain relief options, you’ll need to go to the hospital, and we’ll have to transfer your care. Before you can receive this pain relief, you’ll need to undergo a CTG for at least 20 minutes. A CTG is a fetal heart monitor, used as an additional check on the baby’s condition. After the CTG, another internal exam will be performed to assess how far dilated you are. If you’re ready to push at that point, you will no longer be able to receive pain relief. Otherwise, based on how far dilated you are, the doctor or midwife will advise you on which pain relief option seems best for you at that moment. You may choose which pain relief option you prefer.

• Remifentanil is an option. This is a form of morphine administered through an IV. You can decide when it enters your body by pressing a button. It works quickly and wears off just as fast. It cannot be administered while you’re pushing. It takes the edge off the pain and helps you relax between contractions.

It is effective for 2 to 4 hours. If they don't expect you to be ready to push by then, they won't choose this medication.

One side effect is that your breathing may slow down. This requires additional monitoring.

Remifentanil can therefore only be administered in a medical setting. Not at home or at the birthing center.

• The most effective form of pain relief is the epidural, also known as a spinal block. Medication is administered through a small tube in the back. The epidural is often administered within an hour of you requesting it and arriving at the hospital. You’ll feel much less pain—and sometimes none at all. It can be administered for an extended period of time.

Complications or side effects may occur. These can include headaches, fever, a drop in blood pressure, loss of bladder function, and itching.

For this reason, you will be given an IV and a catheter, and you and your baby will be monitored more closely using a CTG. This also requires a transfer.

More information, including videos, about the various forms of pain management can be found at www.deverloskundige.nl. The pros and cons of the different types of pain relief are listed here; it’s a good idea to take a moment to review them.