Doctors and nurses often ask their patients to rate their pain on a scale of 1 to 10 with 1 being little pain and 10 being the worst pain ever – like labor pain. While this may not be reassuring to an expectant mom, there are many pain relief options during labour that can make the process significantly more comfortable for the mom-to-be. When you’re creating your birth plan for labor, it’s important to consider the possible options for pain relief.
Epidural and spinal analgesia can both make you numb from the ribcage and/or waist down, but they aren’t the same thing. Epidural anesthesia involves inserting a thin, flexible catheter through the ligaments between your spinal bones in the spinal canal. A common misconception is that the epidural is placed in your spinal cord, but this isn’t true. Instead, the catheter is placed in the area near where your spinal nerves are. When medication is delivered to the area, it can numb the nerves so you won’t feel pain. An epidural catheter can stay in for several days if your labor is prolonged.
Pros: Epidural anesthesia provides pain relief, most often for women who deliver their babies vaginally. It is possible to “dose up” an epidural should a mother require an emergent C-section if labor doesn’t progress. A mother is much more comfortable throughout the delivery experience than through natural childbirth.
Cons: Epidural anesthesia can result in side effects although the risks are relatively small, including severe headaches and infection risk. Sometimes an epidural doesn’t work. Epidural anesthesia may also prolong the second stage of labor where a mother is “pushing” her baby through the birth canal, according to Live Science.
Spinal anesthesia is similar to administering a “shot” of pain medicine into a deeper area in the spinal canal than an epidural does. The pain relief is often faster and sometimes more potent than an epidural. However, spinal anesthesia is a one-time dose. This method is most often used for C-section deliveries. However, it’s possible to offer a combined epidural that delivers immediate relief and the long-lasting effects of epidural anesthesia.
Pros: Spinal anesthesia can effectively reduce pain for mothers delivering vaginally or surgically. The effects usually last about two hours.
Cons: Like an epidural, a spinal anesthesia technique may not work. Numbing the nerves quickly also can cause a woman to experience very low blood pressure. She may need medications to treat this.
General anesthesia is similar to surgical anesthesia. It involves putting an expectant mom completely asleep during the delivery process. This may be indicated for emergency procedures or procedures where complications could occur.
Pros: Advantageous for mothers who can’t receive epidural or spinal analgesia, yet still require a C-section.
Cons: Typically used only in emergencies. Medications given could cross the placenta. Also, a new mother doesn’t get to see or hold her baby immediately after it’s born because she is waking up from anesthesia.
Doctors must be careful about what medications you’re given during labor because the medicines can cross the placenta and affect your baby’s heart rate and breathing. However, there are some medications you can receive during labor to dull or diminish your pain experience. It’s unlikely they will remove all pain.
Pros: You don’t have to have an invasive procedure to receive anesthesia. This reduces risks for potential side effects. In some cases, spinal or epidural anesthesia can also prolong the birthing process, but not usually to a great extent.
Cons: The small doses of medications aren’t usually enough for total pain control. They also have their own side effects, such as nausea, itching, dizziness, and drowsiness. Medications can also potentially affect your baby.
Sharp Abdominal Pain
Pregnancy can bring its own unique sets of aches and pains. From back pains as your baby grows to abdominal gas pains, it’s tough to know what pains are part of pregnancy and what you should worry more about. This is true for abdominal pains that can cause you an unexpected amount of pain and discomfort.
When you experience sharp abdominal pain, there are a few questions to ask yourself about the nature and particular causes of the pain. However, there are some “absolute” symptoms that indicate you need to call you obstetrician and possible seek emergency medical care. These symptoms include:
- Feeling faint
- Losing consciousness
- Pain that is getting worse instead of better with rest
- Uncontrolled nausea and/or vomiting
Possible Causes of Sharp Abdominal Pain During Pregnancy
Sharp abdominal pain can indicate several different conditions while you’re pregnant. Some of them are mild and will likely quickly subside while others are severe and could constitute a medical emergency. Here are some examples:
Gas and Bloating
Hormones associated with pregnancy and your growing uterus can place extra pressure on your stomach and intestines, slowing digestion time. This can increase the incidence of gas and bloating. Unfortunately, this can result in gas and bloating, even if you’ve never experienced these symptoms before. This can become serious if you haven’t had a bowel movement in several days. Talk to your doctor about extreme gas and bloating.
If you are less than 20 weeks pregnant, sharp abdominal pain could potentially indicate a miscarriage. Additional symptoms could include vaginal bleeding and pressure in the pelvis.
Preeclampsia is a serious medical condition that causes your blood pressure to be very high, and can lead to severe and potentially deadly consequences, including seizures. Pain and tenderness in the upper abdomen is a symptom as is swelling in the face or around the eyes, swelling in the feet or ankles, difficulty seeing well, nausea, and/or vomiting.
If you are before 37 weeks of pregnancy, sharp abdominal pains could indicate preterm labor. This means your body is attempting to deliver your baby. Additional symptoms include bleeding and/or vaginal discharge, low back pain, menstrual-like cramping, and more than five contractions in an hour. Always call your obstetrician if you think you may be experiencing pre-term labor.
Round Ligament Pain
The round ligaments are located in your pelvis and will start to stretch in your second trimester and beyond to accommodate your growing baby. Round ligament pain can cause sharp, jabbing pains, most often when you’re changing positions. This can include rolling over in bed, getting out of the car, or getting up from a chair. They can also result in dull, aching pains after a long day of activity.
Urinary Tract Infection
Pregnancy can increase the likelihood you’ll experience a urinary tract infection (UTI). This causes abdominal and pelvic pain. Other symptoms include frequent urge to urinate (which is also a pregnancy symptom), foul-smelling urine, or blood in the urine. Because a UTI can worsen and potentially cause premature labor, it’s important to treat a UTI as quickly as possible.
Appendicitis, food poisoning, kidney stones, and gallbladder disease are also potential causes of sharp abdominal pains during pregnancy. If you have concerns or questions about abdominal pain, it’s a safe plan to go ahead and call your physician to ensure you shouldn’t seek medical care.
Migraines During Pregnancy
If you had migraine headaches before becoming pregnant, you might experience more of these sometimes disabling headaches during pregnancy. On the other hand, you might experience fewer. The hormonal changes that go along with pregnancy can trigger more migraines or calm them, depending on your individual sensitivities. Some women even have their FIRST migraine headache during pregnancy. If you suddenly develop a migraine headache during pregnancy and you’ve never had one before, check with your doctor. A headache can also be a sign of a pregnancy-related condition called pre-eclampsia that needs close monitoring and treatment.
If migraines are “old hat” for you, it’s still nice to know what to expect when you’re pregnant. Unfortunately, whether you experience more or fewer headaches is hard to predict. It depends on how your body responds to the hormonal changes taking place in your body. It also depends on factors like stress and fatigue that commonly trigger migraines. Other factors that can bring on a migraine for some women include sudden changes in temperature, a drop in blood sugar, bright lights, loud noises, and certain foods. Avoiding known migraine triggers may help ward them off these headaches or reduce their frequency.
If you don’t know what’s triggering your headaches, keep a headache journal. In your journal, write down what you eat at meals and your level of stress. Also, document any migraines you experience and how long they last. If you do this for a few weeks, you’ll notice patterns such as certain foods trigger the symptoms. If you can identify them, take steps to avoid them.
What should you watch out for?
Some common migraine triggers, although they don’t apply to everyone, include caffeine, food additives (particularly MSG and nitrates) in processed foods, artificial sweeteners, chocolate, smoked fish, and some fruits, beans, and nuts.
Can You Take Something for the Pain?
It’s best to consult with your doctor before taking any medication for a migraine. Acetaminophen is an option, although most doctors don’t recommend taking ibuprofen or aspirin. Most medications that prevent migraines are also off-limits if you’re pregnant. Most of these medications are not documented to be safe during pregnancy. A mild sedative combined with acetaminophen may be appropriate for severe pain. Talk to your doctor about this. Otherwise, don’t take the risk. One of the best strategies for easing the pain is to lie in a cool, dark room and practice breathing deeply. How about prevention?
Ways to lower your risk of migraine headaches:
- Know your triggers and avoid them as much as possible.
- Get at least seven hours of sleep a night.
- Eat a balanced diet and avoid skipping meals. Stay away from processed and packaged foods as much as possible.
- Have a stress management strategy. This might include yoga, meditation, message, or deep breathing.
- Stay hydrated by drinking water throughout the day.
- Take a brisk walk for 30 minutes each day.
- Dress appropriately for the temperature outside. Try to avoid getting too hot or too cold.
The Bottom Line
Hopefully, you’ll be one of the lucky ones who has fewer migraines during pregnancy. If not, give these strategies a try.
American Pregnancy Association. “Migraines During Pregnancy”
WebMD. “Migraine Headaches and Pregnancy”
IBS Symptoms During Pregnancy: What Can You Expect?
As if your body isn’t changing enough, some women have to deal with another problem during pregnancy – IBS symptoms. IBS, also known as irritable bowel syndrome, is characterized by bowels that are exquisitely sensitive. Although not considered a disease, irritable bowel syndrome can be a source of unpleasant symptoms that make pregnancy more challenging. If you have IBS, you may also be concerned about how having it will affect your pregnancy.
What is IBS?
IBS is a “functional” condition marked by symptoms involving the digestive tract, particularly the bowels. No one knows what exactly causes it but stress seems to play a role. People who have this syndrome have a digestive tract that’s unusually sensitive to stress.
IBS Is surprisingly common. In fact, about 10 to 15% of the population reporting symptoms at some point over a lifetime. IBS symptoms you might experience, if you have the disorder, include abdominal cramping, diarrhea, bloating, constipation, or alternating bouts of constipation and diarrhea. One caveat – don’t assume you have irritable bowel syndrome until you’ve been medically evaluated and other causes of your symptoms have been ruled out. Similar symptoms can arise from a variety of intestinal problems. IBS is mainly a diagnosis of exclusion, meaning other potential causes for the symptoms have been ruled out.
IBS During Pregnancy
If you were diagnosed with IBS before becoming pregnant, you may find your symptoms worsen during pregnancy. There’s some evidence that hormones influence irritable bowel syndrome, including some that your body produces more of when you’re pregnant. On the other hand, every woman is different. You may find that your IBS symptoms either don’t change or improve during pregnancy. So, don’t assume your symptoms will get worse, just be aware that they can.
Taming IBS Symptoms
There’s no cure for IBS but there are some things you can do to tame the symptoms. Some studies suggest that imbalances in gut bacteria are a factor in irritable bowel syndrome. Talk to your doctor about whether a probiotic would be right for you. Another way to get probiotics is to eat a serving of yogurt with active cultures every day.
Another approach, especially if you’re having mainly constipation, is to add more fiber to your diet. Be careful, though. Some foods high in fiber, particularly cauliflower, broccoli, Brussels sprouts, cabbage, and beans, are rich in sugars called FODMAPs. If you’re sensitive to FODMAPs, eating these foods could make your IBS symptoms worse. Add more fiber to your diet, but avoid foods high in FODMAPs. You can find a list of these foods online.
Since stress seems to worsen IBS symptoms, your symptoms may improve once you find ways to better deal with stress. Self-hypnosis, meditation, and deep breathing are all approaches to relieving stress that may be helpful.
Signs of Contractions: How Do You Know When You’re Ready to Deliver?
Contractions – they’re uncomfortable, in fact, downright painful. On the other hand, if they are true contractions, they’re a sign that your baby is on the way – and that’s a good thing! Contractions come in two varieties – true contractions and false contractions. It’s important to differentiate between the two so you’re aware of what you’re experiencing and when it’s time to call the doctor. What are signs of contractions and how do true ones differ from false ones?
Signs of Contractions: False versus True
False contractions are sometimes referred to as Braxton Hicks contractions. Unlike true contractions that you feel as labor approaches, Braxton Hicks, or false, contractions have certain characteristics that help you identify them.
Real contractions are those you feel right before giving birth. In contrast, you can experience Braxton Hicks contractions as early as your second trimester. True contractions that usher in labor are often strong, painful, and are characterized by tightening of your entire abdomen and your back. In fact, they often start in the back and move to the abdomen. In contrast, Braxton Hicks contractions are usually confined to your abdomen and don’t involve the back.
These aren’t the only ways true and false contractions differ. Real contractions that happen with labor gradually become closer and closer together. They also increase in duration, meaning they last longer and longer. False contractions do neither of these things. Braxton Hicks contractions usually happen at irregular time intervals and don’t become lengthier in duration. Another distinguishing feature is false contractions are often relieved by changing position or standing up and walking around. Real contractions are not.
When Should You Head to the Hospital?
Knowing the characteristics of your contractions, whether they’re occurring closer together and becoming longer in length, gives you a better idea of what you’re dealing with – true or false contractions. But you probably have another question: When should you call the doctor or go to the hospital?
Most doctors will encourage you to call when your contractions occur every five minutes and have been doing so for an hour. You should also reach for the phone if you think your water has broken, you’re spotting/bleeding, or you aren’t feeling the baby move as much as before.
If this isn’t your first pregnancy, your doctor may ask you to call when your contractions are every 10 or 15 minutes apart since delivery moves faster when you’ve delivered before. Be sure to keep track of things. Once the contractions start, begin timing them. Write down when each contraction occurs and how long it lasts. Be sure to have your doctor’s phone number on speed dial and a hospital bag packed and ready to go. You want to be able to make a quick getaway, if necessary.
The Bottom Line
Hopefully, you now have a better idea of signs of contractions and how false, or Braxton Hicks, contractions differ from the real ones you experience with impending labor. When in doubt, always err on the side of safety and call.
WebMD. “Pregnancy and Signs of Labor”
Fit Pregnancy. “Different Types of Contractions and What They Mean”
Why You Need a Pregnant Pillow
What’s a pregnant pillow and what can it do for you? If you’re lying awake, tossing and turning and sleep just won’t come, you’re not alone. Over three-quarters of all women have problems sleeping at some point during the nine months of pregnancy. One reason you might not be able to sleep is because you can’t get comfortable! As your belly grows, assuming a comfy position that lets you sleep peacefully is challenging. Fortunately, there are pillows made especially for you.
Get Extra Support with a Pregnant Pillow
The safest position to sleep in when you’re pregnant is on your left side. Sleeping on your tummy as you grow in size is uncomfortable, if not impossible, and sleeping on your back reduces blood flow to your growing baby. So, slumbering on your left side is the best bet. If you’re not accustomed to sleeping on your side, a pregnant or pregnancy pillow can help.
What is a pregnancy pillow? It’s a special type of pillow that gives you extra support while you’re sleeping. Although you can use regular pillows, pregnancy pillows offer some advantages over standard pillows. Most are specially designed to give your body support during pregnancy.
Types of Pregnancy Pillows
Pregnancy pillows come in several varieties. Available are models that wrap around your neck and your back to ensure these areas are adequately supported while you sleep. Then there are wedge pillows designed to support your growing tummy and the baby you’re carrying. As the name implies, they’re shaped like a wedge. You simply place the lower end of the wedge underneath your “bump” to support it while you sleep.
You might also prefer the support a full pregnant pillow offers. These large pillows extend the length of your body. They’re sometimes straight but more often curved in shape. The advantage of the curved shape is you can twist it to conform to whatever shape you like. To make the experience of sleeping on your side more comfortable, place a full-body pregnancy pillow between your legs to relieve pressure on your joints. Then, hug the top of it to support your head and neck. Having one of these generously sized pillows means you don’t need a separate pillow for your head.
Another variation is a full-length pregnancy pillow in the shape of a C. To use this pillow, place one end of the C-shape between your legs and place your head on the other end. The curve in between supports your spine.
Choose a Quality Pregnant Pillow
Don’t be tempted to buy the least expensive pregnancy pillow you can find. Pregnancy pillows are filled with different types of material. Whichever material you choose, make sure it offers firm support. Look for one with a removable cover that you can wash.
The Bottom Line
You can get by with a stash of regular pillows but why not maximize your chances of getting a good night’s sleep? Sleeping is more challenging when you’re pregnant. A pregnancy pillow could be just what you need to make the time you spend dreaming more pleasant. You might just discover that you want a pregnancy pillow around even after you deliver – so choose a quality one that will last. You won’t regret it.
National Sleep Foundation “Pregnancy and Sleep”
Parent.Guide. “Best PregnancyPpillow: An Expert Buyers Guide”