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Pain Management during labor... that is the question.

Updated: Sep 6, 2023




When the average woman in the United States talks about labor and birth, sadly, words like empowering, amazing and relationship enhancing are typically far from their vocabulary. More commonly used phrases or words such as "Epidural" or "C-section" and even the catch phrase, "When they start that Pitocin, you're gonna want those drugs" are frequently shared by well meaning friends, complete strangers, and even our own family members.


LABOR is the most athletic event a woman will ever do. So, why do so few train their body? What if you took time to prepare your body for such an event as your birth marathon?


What if your husband/partner was trained to help you alleviate unnecessary pain and did their job when you had a weak moment at the peak of a contraction?


What if you complimented your training with a doula? Not just any doula, but a doula willing to actually step up and do the work needed to help you through rough contractions drug-free, if that is your goal and one who empowers you to do everything RIGHT during your contractions and helps your husband/ partner best support you, as well. Do you still think PAIN MEDICINE would be warranted?  



Take a moment to examine your own thoughts on this controversial subject. Birth can look good either way. Women do not have to fear natural birth when they know how to respond to contractions and help progress labor naturally. Look closely at the two photos above... precious moments captured just seconds and minutes after giving birth epidural free.


Jasmine accomplished what we call #SymbioticBirth (low intervention/ natural birth) by choice. It can be done with education, preparation, training and proper support even when giving birth in a hospital. Second trimester is the best time to begin training for labor, because it allows couples the time needed to put into practice what they have learned. In addition, women should learn ways to stay healthy and low risk to avoid poor outcomes and improve chances of meeting their own target birth experience.


Consider this, what if you knew when you were experiencing that weak moment in hard labor that you were actually experiencing a normal part of the birth process? If you knew it was supposed to happen, would it alter your thoughts in regards to "needing or wanting meds?" If you were breathing and sinking and doing all the things you were supposed to be doing to progress labor, even though you were working HARD, would there be a difference in how you perceive pain with a purpose and the use of medicine? Would it still be a NEED or simply a WANT?


Mom Jasmine would share during a weak moment, she asked for IV medication. She wants you to know she realized it wasn't a need, she was enduring the muscle squeeze, but in that weak moment she WANTED it. Her "want" also lowered her blood pressure and following her dose of Stadol, a common side effect it also affected her baby's heart rate, which then turned into a fetal monitoring concern. The nurse had to constantly chase baby with the electronic fetal monitor for about 40 minutes or so until the baby's heart rate began returning to normal. Women should understand IV meds, for a good portion of the population are very short lived. They might distract mom and make the laboring woman drowsy for approximately 20 minutes to maybe an hour and then mom is right back to hard labor and her former labor discomfort returns, not to add often narcotics can be problematic to baby's heart rate, as well. CHOOSE WISELY as to not create a new medical concern. Always weigh the risks and benefits of any drug or medical intervention and make the decision best for you and your baby.


Yes, it's true, at some point in time, the laboring mother will experience discomfort and pain. The question then to ask is, "WHEN as a laboring woman will I choose to be uncomfortable... before, during or after I give birth?"

Toilet sitting can be very beneficial to laboring women
Namaste on top of my contractions

Some choose to remain drug-free during labor and once the baby is born, the labor pains have ended. The bible shares, "When a woman is in labor, she is full of sorrow, but as soon as the baby is born her heart is filled with JOY and she can remember the pain no more. John 16:21


Others choose elective surgery or choose to end labor at some point, especially when tired and now will be in pain and discomfort for 6 plus weeks post surgery.


Some want to medicate as soon as the first pain hits them and insist upon epidural as early as possible. Sadly, this situation only increases the odds of labor ending in what the medical world calls "failure to progress," which also increases your risk of labor ending in surgery. Epidurals are best utilized for women truly in active labor around 6cm or beyond who can not bring themselves into a relaxed state of being with emotional, mental and physical support. 


We know RELAXATION equals PROGRESS during labor. Therefore, did you know with training and practice, it is possible to bring yourself into a relaxed state, and avoid often unnecessary pain management drugs such as narcotics, nitrous oxide gas, epidural, and other commonly used respiratory depressant drugs during labor?

Mom trained with Your Birth Helper to avoid epidural
Side lie relaxation has many benefits during late first stage / transition

If the first thing you want your baby to do is BREATHE, why wouldn't you give some thought to a different way to do business? In late pregnancy, Jasmine's husband David was greatly concerned about safety of their baby especially when she carried beyond her due date. A valid concern as doctors always share the 41 week higher incidence of still born baby speech, but very few couples bother to inquire, "What is the higher % of stillborn babies beyond 41 weeks pregnant?" And, most would be even more shocked to learn if they are healthy and low risk, the odds are in their favor that their baby has a 99.5% or more chance their baby is just fine. But, because doctors are required to share risks, it is typically phrased in a negative way. Of course, we should listen to the information being shared with an open mind, weigh the risks and benefits of induction vs. remaining pregnant. Consider alternative options such as possible membrane sweep, or ask about NST testing, once or twice a week for the weeks carrying overdue, if she is not comfortable with moving forward with induction. Mom should also listen to her intuition, does she have concerns? And, if remaining pregnant, keep close tabs on her baby monitoring kick counts, etc. However, an error of due date alone is not a medical complication, but it certainly could turn into one and more frequently can when what could have been spontaneous labor with natural progression, now turns into a medical induction with added risks. All chemical agents/ drugs like Cervadil, Cytotec, and Pitocin, all carry a separate increased risks and various side effects, even higher billing rates at most hospitals, and if that isn't enough, all require IV and constant fetal monitoring. In addition, they may still want to break the bag of water which equalizes pressure and further serves to protect baby during labor. Just be mindful, the use of induction medications could possibly be used to remedy an issue during the labor process such as a tired uterus from long labor, sometimes they may also increase pain levels making the goal of low intervention or natural childbirth further challenged. Weigh the risks of being "overdue" and the risks of medical induction, side effects of drugs, etc. and take all into consideration and make the decision best for you and your baby. Take ownership of your decision making! What is not fair to doctors, midwives and labor nurses is being blamed for negative birth outcomes, when you as a laboring mom/ coach have failed to properly prepare, and can not manage labor without such interventions.


Jasmine and David's OBGYN practice even went as far as to try to schedule her for a medical induction she had already declined simply because she was beyond 40wks pregnant. It is called an estimated due date after all. She received a phone call from a practitioner at 10:30 p.m. advising her she had been added to the induction calendar. She was like wait... what, No thank you. Imagine to an over due mom how frustrating. Stress alone causes pregnant women to release adrenaline which further perpetuates the problem of spontaneous labor not happening. If I may speak plain, doctors must have serious conversations we get that, but how about an occasional positive reinforcement for those who have made GOOD DECISIONS and do NOT have a medical complication.


HOW EMPOWERING would it have been at her last office visit the doctor had said...

look I have to review this form with you, but know this in advance, YOU have done an amazing job taking care of yourself! Your blood pressure is GREAT! Your weight gain is GREAT! You have educated yourself, ate right and exercised and I am so impressed! It would have changed the whole context of the visit and in reading aloud all the potential risks of childbearing (re: the doctor's office consent form), they wouldn't have left the office fearing DEATH. They would have left knowing they should be proud of themselves and all they have done up to this point. Of course, there are always parts of pregnancy, labor and birth in which we can not control, but what if the focus was on what we can control? What if the conversation was educational, they actually received proper informed consent at the time the problem was occurring not in advance in the context of birth being a death sentence, they were informed of all their options and not just what the doctor wanted them to choose, and then were ENCOURAGED to make the decision they felt best for MOM & BABY. They may have still elected induction, but they would also take ownership and accountability not feeling pressured or bullied into a fear based decision which causes even more tension and increases pain... then we could have eliminated the unnecessary pain associated with the fear - pain cycle.


Also, couples need to be aware of what is known as aggressive management of labor, and how it can further increase risks of labor ending in major surgery or other poor outcomes. With black moms statistically being 3 to 4 times more likely to die from such medical complications and various negative outcomes while in labor, giving birth or postpartum, why aren't more black women and couples seeking PREVENTATIVE EFFORTS? Why not try to avoid such negative outcomes all together, if all possible? We as individuals must do what we can to lower our own risks.





WHAT IF YOUR STORY COULD LOOK LIKE THE ABOVE AND READ LIKE THIS...


I MADE HEALTHY PREGNANCY A NEW PRIORITY


I INTENTIONALLY AVOIDED HARMFUL THINGS, ATE CLEAN & EXERCISED DAILY


I MADE CHILDBIRTH TRAINING A PRIORITY


I PUT MY FAITH TO WORK, PRAYED OVER & FOR MY BABY & BIRTH OUTCOME


I CONTINUED TO MAKE POSITIVE CHANGES AND PRACTICED WHAT I LEARNED


I HAD A TRAINED COACH AND HIRED A DOULA TO BETTER ADVOCATE FOR ME


I EDUCATED MYSELF IN REGARDS TO INFORMED CONSENT AND MY BIRTH RIGHTS


WOULDN'T THAT BE GREAT?

Instead of... a doctor saved me and my baby, thank God for that hospital. After all, even doctors would rather laboring women show up healthy and avoid medical complications altogether!


Moms, what if you could say:


I TOOK CARE OF MYSELF!

Your Birth Helper mom Jasmine trains in Athens, Ga to give birth naturally
Don't settle for just any birth experience, Train to meet your goals!

I PUT IN THE WORK!

I PRACTICED MY JOB FOR LABOR & BIRTH!

Your Birth Helper Athens, Ga Labor Role Play workshop
Practice makes perfect and ice cubes make great practice contractions

MY LABOR COACH PRACTICED HIS/HER JOB FOR LABOR & BIRTH!

Pamela Sauls of Your Birth Helper®, LLC poses with mom Jasmine after helping her give birth epidural-free in Conyers, Ga
New mom Jasmine is all smiles with Doula Your Birth Helper®

MY DOULA CAME ALONGSIDE AND EMPOWERED ME!

LDR nurses that assisted couple with a low intervention birth
Rockdale Medical Center LDR Staff

AS A HEALTHY MOM, MY LABOR NURSE ENCOURAGED ME TO AVOID ROUTINE INTERVENTIONS, because THE SAFEST ROUTE OF PASSAGE INTO THE WORLD FOR MY BABY IS A DRUG-FREE NATURAL BIRTH.

Rockdale county Georgia OBGYN with new parents
Couple gives birth without epidural... #symbioticbirth

MY DOCTOR & MIDWIFE CHEERED ME ON AND ONLY NEEDED TO CATCH MY BABY & EVEN LET MY HUSBAND HELP!


We are all super thankful for our medical professionals in situations of which we have zero control over, but the good news is a vast majority of such outcomes are, in fact, avoidable by making good health and positive changes a priority.


#SymbioticBirth is defined as both sides, Medical (as in medically necessary-not routine interventions) and Normality (the natural process) working together to help create happier "BIRTH" days!

Together, WE CAN ACHIEVE THIS!

Overdue mom gets active to help bring on labor
Putting in the work to help avoid induction or raise her bishop score

Q & A Real Talk with Jasmine

1. What if more black women knew there were ways to lessen their own risks during childbirth by applying a proactive approach to birthing? Would more black women/ couples make childbirth education and preparation a priority?

-I can only speak from my experience and perspective. I feel that this is a multifaceted issue. Education and access to resources are a great introduction to having this conversation. We, as black women, understand that healthy pregnancies require certain lifestyle changes. I believe the change has to start with both us AND our providers. We can choose to exercise and adopt a cleaner diet while pregnant—absolutely! However, our providers and partners can also give us tangible support and accountability for those changes. Education is necessary for all: women, providers, partners, etc. The expectation of doing whatever is easiest shouldn’t be the justification for all medical decisions. Meaning: epidurals, while easy, is not the only option for delivery although, it’s typically the only one mentioned to women for delivery.


2. How would you say your faith played a role?

⁃Faith played a significant role in my birthing experience. As a Christian, I knew that God had uniquely created our bodies to do the (birthing) work. With my trust in Him, I wanted to give my body the opportunity to do what God designed it to do first. Having faith provided me the strength to focus on His word and His promises to us as His children. My husband and I prayed continuously about this birthing experience, and God honored our prayers.


3. Also, what if anything would you have done differently?

⁃ (1) Found our doula and get the education much sooner. My husband and I were about 31 weeks when we began our classes with YBH. Getting the education sooner would have allowed us the time to practice more and retain more information better.

⁃ (2) Not shared the due date with anyone! The pressure and anxiety of “is she here yet?” became an unexpected weight and stressor while trying to remain “unbothered” and calm especially towards the end.

⁃ (3) Exercised more and sooner: me exercising was met with much concern and hesitation at first. But once I explained the benefits, I gained support. Exercising regularly gave my body the flexibility and endurance needed to sustain labor. (I was placed in all kinds of positions to maximize each contraction. They weren’t all comfortable, but they all worked.)

4. Advice to other moms?

⁃My advice to other moms is trust your body. You were wonderfully made and designed to do this the way God intended. Also know that you are stronger than you think! Natural birth was a desire of mine for years, and when the opportunity came, I began to doubt my ability to do it. Through prayer, meditation, and affirmations, I was able to build my confidence.

⁃Also, make sure you have a supportive partner. I’m thankful for the support of my husband and parents. Having the right voices in your ear make all the difference!!! In transition phase, I called for Pam to lean in and I did my best to convince her privately that I needed IV medicine. Pam told me I was about to start pushing and with my lower BP it wasn't good timing, because I needed to be alert during second stage. She spoke confidence into and over me telling me I could do this, it's just a contraction and it's pushing my baby down like it's supposed to. I am so glad I listened! Turns out, I only wanted medicine in that weak moment, I didn't actually need it at all.

baby placed on mom's chest immediately after birth
Emotions overflow as mom meets her baby for the first time

Real talk with Labor Coach David


Initially, I felt a c-section was a guaranteed safety net.. as I saw it.. I just wanted to ensure my wife and baby's safety in case of any blood pressure or other medical issue arose and thought surgery was a safer route. Turns out a c-section is considered major surgery and comes with a lot of additional risks and when not medically necessary, it's best to avoid, if all possible.

OBGYN releases newborn to father's hands to help catch baby
BABY emerges and doctor releases baby into dad's hands

I am so grateful my wife did not need, nor desire a surgical birth, because there was no better feeling then catching my own daughter!

Father helps birth baby at Rockdale Medical Center
Dad David helps catch his baby and bring her to mom's chest

I learned a lot doing the homework and classes with Pam. Prior, with my sons caesarean birth, I had limited knowledge of natural birth heck even my mom brought me into the world via c-section. Therefore, it just seemed a normal way to birth and safe especially if things went upside down. I would say to all the fathers...allow your wife to work with her body and listen to her body. It’s amazing what their body can do.

Couple poses for maternity photo by Desiree Greenwood
Together, we brought forth LIFE (photo credit @desireedanie11e)

As the song states, "I can see clearly now the rain is gone”. It took a lot of work mentally to support my wife and to be less head strong about what I thought our birth should look like.



Would I do it again with her? YES! And, with the right preparation and practice. We were blessed this time around. I know Jasmine will do her part to take good care of herself again, I will do my best to support her and GOD WILL DO IT AGAIN!


Congratulations again Jasmine & David! The pleasure to both train you at the farm (M2b Family Farm Colbert, Ga) and assist your birth in Rockdale was all mine!


Author Tip: WE CAN NOT PREVENT ALL NECESSITY FOR DRUGS & C-SECTION WITH GOOD NUTRITION, DAILY EXERCISE & AVOIDANCE OF HARMFUL THINGS, BUT WITH EDUCATION, TRAINING & GOOD CHOICES, WE SURE CAN REDUCE THE LIKELIHOOD YOUR STORY ENDS IN A MEDICAL COMPLICATION. And, that is a huge win - pain management or not?

Don't allow your decision to take a quality childbirth class or hire a doula to be based solely on a decision to medicate or not. Some would suggest you may need even more education and training if you are planning to be induced, use pain management drugs or you are a high risk pregnant mom, not less training. There is a lot of information to be made aware of before contractions begin. I would agree.


BABY EMERIE,

Our Ga, Sc, Nc, Tn and virtual Your Birth Helper teams would like to shout out your parents Jasmine & David for putting in the time to educate, the daily energy to best prepare and enduring the hard work during labor to bring you into the world with as few medical interventions as possible! We call this a happier "BIRTH" day! Your parents agreed! Your life will be forever blessed! I am looking forward to seeing you grow, and what specific talents God bestows upon you and how you will use them to make the world a better place!

P.S. Your mama has a great singing voice!

xoxoxox Ms. Pam


In closing, Alabama moms, Jasmine would suggest you check out www.desireedanielle.com for gorgeous maternity photos or check out her work on social @desireedanie11e



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