Pain in the early stages of labour

You’re in labour, but you’ve been told it’s best to stay home for as long as you can. That’s all very well in theory, but how will you cope with the pain without a health professional in sight?   

When you’re in the early stages of labour, going into hospital too soon can actually set you back and slow down your contractions. ‘Most women will tense up and it takes a while to settle down again, so their labour slows down,’ says M&B expert and midwife, Helen O’Dell. ‘You may even end up being sent straight back home again.’

If you can manage to stay at home for as long as possible, you’ve got comfort and privacy and there’s more to keep you occupied, but how do you actually cope when the pain is getting worse, you’re counting the minutes and all you can think about is an epidural? Never fear, M&B is here with the best ways to stay calm and manage the pain…

Strap on a TENS machine

A TENS machine emits electrical pulses that block pain signals. You’ll need to hire one in advance, which costs around £20 for a period of 4–6 weeks. (Try Boots, the NCT, ask your midwife or log on to preciouslittleone.com/links/tensmachines.asp).

The effect takes time to build up, so use it as soon as you start to get contractions. ‘I used a TENS machine while I was waiting for my sister to arrive to look after my son, and it was a lifesaver,’ says Kelly Wild, mum to Seth, two, and Martha, six months.

‘It feels like a tingling sensation, which, at the beginning, just gave me something to concentrate on, and, as the contractions got stronger, really took the edge off the pain.’

Keep moving

Staying upright and active makes contractions more efficient and helps your baby move into the best position for delivery. One study found that women who stayed mobile in the first stage of labour used less pain relief and had fewer ventouse or forceps deliveries.

‘The thing that worked best for me was keeping moving,’ says Sharon Smith, mum to Caspar, three, and Constanze, 10 months. ‘I walked around the house, then, when I had a contraction, I leaned on the kitchen worktop, which was the perfect height, and rocked my hips from side to side.’

Eat and drink

You probably won’t feel like a large meal, so snack to keep your energy levels up. ‘Choose high-calorie foods for energy,’ says Helen O’Dell. ‘Energy bars or cereal bars are good, but even sucking on a sweet will provide you with some sugar.’ Aim to drink a glass of water every hour or, if you prefer, take a few sips after each contraction – dehydration will make your labour harder and longer.

Get wet

Having a bath or shower can be soothing and help you feel more comfortable, as being in water encourages your body to release endorphins (the body’s natural feel-good pain relief hormones). Fill the bath as full as you can without flooding the bathroom and keep the water at body temperature. Add a couple of drops of calming lavender oil to help relax you.

‘Having a bath at home made me feel so much more comfortable,’ says Alison McQuail, mum to Chaia, three, and Anarosa, 21 months. ‘I had been having contractions since 1am and it was about 7.30am when I had a bath. I went to the hospital straight afterwards and found I was already 10cms dilated!’

Take painkillers

If your contractions are painful, but still not strong or regular enough to send you running to the hospital, and particularly if you have back pain, it’s okay to take paracetamol.

Or you could try something slightly stronger, like co-codamol (a mixture of paracetamol and codeine). ‘Painkillers are fine, but make sure you follow the dosage instructions carefully, and when you get to hospital, tell your midwife exactly what you’ve taken,’ says Helen.

Distract yourself

‘I was in total denial that I was in labour,’ says Katrina Alford, mum to Alex, three, and four months pregnant. ‘I had my hair cut, went for coffee and had a big trek around the shops. The, back at home, we watched several hours of Trinny and Susannah on video to distract us! I’m glad I did, as I had a 27-hour labour.’

Whether it’s knitting, watching TV or your favourite DVD, calling up friends or even doing the washing up, anything that takes your mind off your labour will help.

Get some rest

The excitement of knowing that things are moving at last, and you’re finally going to meet your baby, may give you a rush of adrenaline, and you’ll feel you want to be active. That’s great, but don’t overdo it; if you’re in early labour, the birth may be some time away and you need to conserve your energy.

Have sex!

Why? It may be the last thing on your mind, but it’ll be distracting, you may not get another chance for quite a while, and it could tip labour from tentative to full-on contractions. Semen contains substances called prostaglandins, which can help to ripen your cervix so it can start to dilate.

Nipple stimulation will cause your body to release oxytocin, a hormone that stimulates contractions, and best of all, orgasm will stimulate your uterus. What are you waiting for?! ‘Don’t have penetrative sex if your waters have broken though,’ warns Helen, ‘as there is a risk of infection to your baby.’

Enjoy a relaxing massage

Massage stimulates your body to release pain-killing endorphins. It’s also very comforting and supportive, as it makes you feel cared for and being touched will help calm and relax you.

Get your birth partner to stroke down the side of your spine using the flat of their hand (not just the heel), alternating hands in a rhythmical movement and using long, slow strokes.

Don’t panic! Discovering that you’re in labour can be quite shocking, even though you’ve been anticipating it for the past nine months! If you’ve never had a contraction before, or your waters break, it can feel quite scary – but rest assured your body’s only doing what comes naturally – it’s how we all came into the world! Stay calm, and call someone who’s done it or who you know can reassure you.

Remember you’re not alone

Every labour is different and the symptoms and coping strategies here are just a guide. If you have any worries, day or night, remember there is always a midwife on the end of the phone and you can go to the hospital as soon as you feel you need to.

Should I stay or should I go?

Labour builds up gradually, and it can be hard to decide when it’s really time to go to hospital. A show (a discharge of mucus tinged with blood) is a sign that something’s happening, but labour may still be several days away. You may also vomit a little and empty your bowels, or have mild diarrhoea, as your body ‘clears out’ in preparation for labour.

Call for help

It’s definitely time to call someone if:

• You are less than 37 weeks pregnant.

• Your waters have broken. This is when the membranes that surround your baby in the uterus break and amniotic fluid leaks or gushes out. Labour may still be some way off, but you should contact your midwife or maternity ward even if you don’t have contractions yet, as there is a risk of infection and you will need to be monitored.

‘You’ll be asked what colour the waters are,’ says Helen O’Dell. ‘If they’re clear, that’s good, but if they’re greenish brown that means the baby has passed meconium and may be in distress, so you’ll probably be asked to go to the hospital.’

• Your contractions are painful, regular and last for longer than 30 seconds. Early contractions can feel like bad period pains – each one starts gradually, builds to a peak and fades away, and they may stop and start.

You may also have an achy back. When the contractions are coming every five minutes or more often, and they last for 30 seconds or more, then it’s the real thing. ‘Strong contractions will take your breath away,’ says Helen O’Dell. ‘If you can talk through them, you probably still have a way to go yet.’

• You have had any bleeding, or you have had symptoms of pre-eclampsia such as high blood pressure or protein in your urine.

Help – the baby’s coming!

Whatever you may have seen on TV, in real life, a first-time labour takes an average 12 to 15 hours, so sudden births are very rare. ‘A sudden birth can be a shock, but there’s very rarely a problem,’ says Helen O’Dell. ‘Babies are more robust than you think.’

If you do think your baby is going to arrive very soon, here’s what to do:

• Stay as calm as you can.

• If you’re alone, phone for help: get a friend or neighbour to come immediately, then call your midwife and an ambulance. Leave the front door open so they can get in when they arrive.

• Grab some old towels, go to a warm room, take off your knickers and lie down. If you can kneel on the floor with your head down and bottom up this may help slow things down.

• Try not to push – just let the birth take its course. If you have someone with you, they can phone the labour ward and get someone to talk them through the birth.

• When the baby’s head is born, your helper can gently support it until the body comes out – if you have no helper, keep your bottom close to the floor so that the baby doesn’t fall. You should now push with the contractions.

• Once your baby is born, wrap him in a dry towel and gently dry him all over, especially his head. Then wrap him in a fresh dry towel and keep him warm with skin-to-skin contact.

• Don't cut or pull on the umbilical cord

• The placenta will come out when it is ready – don’t worry about it.

• Cuddle and feed your baby, and stay lying or sitting until help arrives.