This blog post is all about how to get through painful labor before an epidural. This blog post isn’t about whether or not a woman should get an epidural. Maybe you definitely know you want an epidural, maybe you’re taking the “wait and see” approach or maybe you just want the epidural during transition, one of the more difficult parts of labor.
For whatever reason, if an epidural may be in your future, this blog post is for you. I hope that by reading this post you will feel more confident in your ability to cope with whatever comes your way.
Knowing how to cope through painful labor before an epidural requires an understanding about what labor is and how it works. To get started, let’s have a brief conversation about the stages of labor.
There are three stages of labor:
First Stage of Labor
The first stage of labor is where you will spend the bulk of your time. The goal of the first stage of labor is to have contractions long and strong enough that they efface (soften) and dilate (open) the cervix to allow the baby to come through. Because it’s long and its symptoms are varied, the first stage of labor is broken down into three parts.
In early labor contractions may be a bit irregular, perhaps 5-7 minutes apart and only lasting for 30 seconds. Women are able to walk and talk through contractions and are generally feeling positive about what lies ahead. At this point women are usually still laboring at home.
In active labor contractions become longer, stronger and closer together, around 3-5 minutes apart. The average length of an active labor contraction is around 60 seconds. At this point women can no longer walk and talk through contractions, but need to use a pain coping practice learned during pregnancy, perhaps breath awareness.
Transition is the most challenging part of labor and when many women request epidurals. Contractions are around 90 seconds long and 2-3 minutes apart.
Second Stage of Labor
The second stage of labor is pushing and birth of the baby.
Third Stage of Labor
The third stage of labor is the delivery of the placenta, the unsung hero. After this you’re no longer pregnant. Congratulations!
How to Get Through Painful Labor Before an Epidural
Whether you’re at home or hospital, in early, active or even the transition stage of labor, there will be a period of time where you must cope through painful labor before getting an epidural.
Even when planning for an epidural, women still have to cope…
- before arriving to the hospital
- throughout triage
- during the admission process
- after the initial request for pain relief
- during the placing of the epidural
- while the epidural is taking effect
Even when the epidural is working most women still feel lots of pressure and discomfort. Some women even report an epidural working only on one side. Or not at all! If that’s the case, you will need to know how to cope through a “re-do” of an epidural (or it never working at all).
It is imperative to learn coping mechanisms no matter what type of birth is planned – natural, epidural, cesarean, whatever. The following are proven ways to get through painful labor before an epidural.
1. Eliminate Fear
Many women choose an epidural because they are afraid of the pain of labor. In my experience, making fear-based choices does not eliminate fear. Face your fears head on and work through them during pregnancy in order to approach the unknowns of birth with peace and confidence.
Eliminating fear before birth will also decrease your experience of pain during labor. The fear –> tension –> pain cycle teaches us that the more fear we have, the more tense our bodies will be. When our bodies are tense, our experiences of pain are heightened. When we are experiencing higher levels of pain, we react in fear and the cycle starts all over again.
Check out my post about eliminating anxiety during pregnancy for some practical ideas on embracing peace and calm throughout pregnancy, birth and postpartum.
2. Hire a Doula
Just because you’re planning for an epidural doesn’t make you exempt from receiving high quality support throughout the entire birth process. Hiring a doula has many benefits, even for those planning on an epidural.
A doula can provide tailored childbirth education prenatally, reduce fear about what’s to come, facilitate communication with care providers, assist navigating the unknowns of birth, help determine when to go to the hospital, and so much more.
3. Build a Birth Team
Another way to get through painful labor before an epidural is to build a supportive birth team that is familiar with medicated and unmedicated birth. If your partner is afraid of the pain of labor before an epidural they will be the opposite of helpful. It would be better if they had just stayed home!
Sometimes it can be helpful for fathers and other birth partners to work through their fears about birth. If fear is holding your partner back from being the support you need for your upcoming birth, have them read my post about 7 Fears Fathers Have About Labor and Delivery. In that post I give some great practical tips for working through fears before birth begins.
Once birth partners work through their fears, it will boost their self confidence and effectiveness to learn what to NEVER SAY to a woman in labor and what to say instead. The words said to a woman in labor may make or break her experience!
4. Learn a Labor Breathing Technique
Another way to get through painful labor before an epidural is to learn the labor breathing technique I teach in my childbirth classes – breath awareness.
Sure, breath awareness is mainly learned by those women hoping to have a natural childbirth, but I firmly believe it is useful for all births, unmedicated and medicated.
What breath awareness does is it encourages us to stay connected to our bodies and stay in the present moment – both of which help reduce suffering during labor.
Breath awareness will be vital during the placement of the epidural, let alone during labor before an epidural.
Breath awareness is helpful when staying focused waiting for the epidural to kick in, when it only partially works, during a “re-do” to fix what’s not working, or heaven forbid when it doesn’t work at all. Breath awareness is helpful during pushing, and insanely helpful even in the event of a cesarean birth.
No matter what type of birth a woman is planning for, it is helpful to learn breath awareness.
5. Understand the Hormones of Birth
Another way to minimize the pain of labor before getting an epidural is to understand the hormones of birth and how the application of this knowledge can reduce pain (and hopefully speed up labor!).
Maximize Oxytocin and Endorphins
Oxytocin is an important hormone, especially during labor. Many people refer to it as “the hormone of love” as it encourages bonding and feelings of altruism. Oxytocin is secreted when you feel safe and connected and it feels GOOOOOD. It makes you feel all warm and fuzzy!
During labor, oxytocin is the hormone that causes contractions, which also brings with it some pain.
Endorphins are our body’s natural opiates. In labor, our body secretes them as a response to the pain from contractions. The more pain, the more endorphins. It’s truly amazing! Our bodies help us cope through labor.
Adrenaline in the laboring mama is the body’s way of saying “it’s not safe to birth here” or “that’s ok, I’ll wait to find a more comfortable space to have this baby”.
But get this.
It doesn’t matter if she’s truly in danger or not. If her brain THINKS she’s in danger, her body will respond the same either way.
Put it Together
In a nut shell we need to give birth with people and in a space that increases oxytocin (and therefore endorphins) and decreases adrenaline. For every woman, this will look a little different.
Dim lights, warm water, massage, and essential oils for labor may all help reduce the pain of labor before an epidural.
Spend a little time and think to yourself…
What do I need to give birth?
Who needs to be present for me to give birth?
6. Avoid Induction and Augmentation
Despite popular belief, a labor stimulated by Pitocin (the synthetic of oxytocin) is much more painful than a labor stimulated by oxytocin.
I’ve had an exasperated nurse tell my “struggling through a Pitocin induction” doula client that, “this is labor” (meaning that they need to buckle down and start coping better).
This is simply not true. A pitocin labor is not normal labor.
Pitocin is not oxytocin and feels VERY DIFFERENT. None of the warm fuzzies are there – just long, hard and close together contractions (similar to transition contractions, but for the entire portion of labor not just the tail end).
My third birth was augmented by pitocin and I experienced this first hand. It was very difficult. (If you want the dirty details, read my story here.)
If you want to decrease the pain of labor before an epidural, avoid medically unnecessary inductions and augmentations. Pitocin contractions are worse than being pregnant longer than one hoped.
For tips on working with your care provider and making hard decisions like these, use the brain acronym tool.
7. Pain with A Purpose
Another aspect to consider when gearing up to cope through painful labor before an epidural is the purpose of labor contractions. Unlike other sorts of pain, the pains of childbirth have a different purpose. Knowing and remembering this during labor can ease tension and eliminate fear, therefore allowing for a less painful labor.
Once upon a time I had kidney stones, and boy was that a painful experience. It was so bad I even went to the ER! I went to the hospital to see a doctor because there was something seriously wrong with me and I was in incredible amounts of pain. This pain was a signal to my body that there was something seriously wrong. It was bad!
Compared to kidney stones, the pains of childbirth do not mean that something is wrong. In fact, the opposite is true!
You Get a Baby
Also, the outcome of kidney stones is… perhaps passing a kidney stone? With childbirth you get a baby, which is truly one of the most miraculous things you will ever be a participant of. The pains of labor bring with them great rewards, whereas normal pains just suck.
8. Affirmations and Encouragement
One of the ways women prepare for the intensity of birth is to use positive birth affirmations. Birth affirmations are a way to infuse your positive intentions into your daily life while pregnant and remind oneself during labor.
The words we speak, especially to ourselves, are powerful. So powerful, in fact, that our words can change our lives and the lives of those around us.
Having a baby is not a separate event from life. If faith and spirituality is part of a woman’s every day, normal life, it would make sense that it would be an important part of birth as well.
9. Change Positions
Another way to reduce the pain of labor before an epidural is to get out of bed and change positions frequently.
When a woman instinctually changes birthing positions throughout labor she will likely choose positions that encourage labor progress but that also decrease her pain. Here are 5 popular birthing positions for reduced pain and length.
TIP: Don’t forget to try a birthing ball! It’s so helpful.
10. Labor at Home as Long as Possible
I realize that to labor at home as long as possible seems illogical to those wanting an epidural, however, hear me out before scrolling on by.
The first reason you should consider laboring at home as long as possible is because women are generally more comfortable and relaxed at home when in labor. Because of that, and because of how labor works (remember the hormones of birth?), labor is generally less painful and moves more quickly when at home.
In my experience by spending a good bit of time at home in labor you will increase your chances of being further along when arriving at the hospital. Which means…
- You will be less likely to be sent home (which can be super upsetting and frustrating).
- You will be less likely to need Pitocin (which can happen if you go to the hospital too early).
- You may have a shorter labor.
11. Narcotics or Gas and Air
Another way to get through painful labor before an epidural is to use an IV narcotic or breathe “gas and air”.
Gas and Air
“Gas and Air” is colorless, odorless and comprised of 50% oxygen and 50% nitrous oxide. This mixture is called Entonox and is manufactured by BOC Healthcare.
Gas and air is given through a mask or mouthpiece. During labor, before and during each contraction, a woman breaths Entonox to cope with the pain of contractions. As a contraction begins, a woman simultaneously breaths slowly and deeply into the mask to get the full effect of the medication.
Gas and air does not eliminate the pain of labor but helps women feel more relaxed and less uptight about the sensations of labor.
If a woman is fearful about childbirth she will begin to feel tense and uptight. The more tense and uptight she feels, the more painful her labor will be. The more painful her labor is, the more fearful she will be… and so on. This cyclical behavior is called the “fear tension pain cycle”.
Gas and air is helpful to short circuit the “fear tension pain cycle”.
IV narcotics, like gas and air, can be administered faster than an epidural because there is no “procedure” and does not require an anesthesiologist.
Some women find an IV narcotic to be helpful as it helps them to relax between contractions and it “takes the edge off” during contractions. Some women may find themselves even falling asleep between contractions.
Other women find IV narcotics to be frustrating because they now have to cope through contractions while feeling drunk. The contractions are not gone like they would be with an epidural and now their mental clarity affected making it difficult to cope.
It’s important to know that IV narcotics absolutely get in the baby’s system too. Care providers prefer narcotics to be administered no closer than three hours prior to delivery, which can be difficult to predict. Side affects of IV narcotics in baby may be breathing problems, sleepiness and a disinterest in breastfeeding.
How to Get Through Painful Labor Before an Epidural
I hope this blog post has been helpful to those considering or planning for an epidural during labor. To recap, here are 11 ways to get through painful labor before an epidural.
- Eliminate Fear
- Hire a Doula
- Build a Birth Team
- Learn a Labor Breathing Technique
- Understand the Hormones of Birth
- Avoid Induction and Augmentation
- Pain with a Purpose
- Affirmations and Encouragement
- Change Positions
- Labor at Home as Long as Possible
- Narcotics or Gas and Air
What do you think?
Leave a comment and let us know your best advice for coping through painful labor before an epidural. I’d love to hear from you!