Philomenia Jabour wrote:"Our maternity unit has been instructed by the
>powers that be  that we are no longer allowed to use hotpacks/wheat
>packs. This is frustrating, as they are a  very  effective form of pain
>relief for labouring women, eg, posterior position and also in the post
>natal  period. Has this occured in any other maternity units? Any
>suggestions besides hot showers and/or an increase in pain >medication
for there has been a definate increase in pain medication >since we have
ceased using ther packs.

The most effective method for pain relief during labor in
a normal birth is the discharge of strong feelings, particularly
if there has been a release of adrenaline into the system.

I would suggest that you check the mother for fight or
flight arousal symptoms. This is most common in my
experience, particularly if the mother is giving birth in
a hospital or birth center. It has also been my experience,
that even in the comforting environment of the mother's home,
if there are unresolved hidden hostilities, fears, and anxieties
concerning anyone present, the primal needs of the birthing
mother to feel safe will arouse this instinctive reaction.

Because this reaction is an instinctive one, and largely
unconscious it does not always respond well to conscious
learned methods of stress control. For that reason I always
try to prep the mother before labor begins, on how to recognise
the symptoms, and how to discharge the adrenaline.

The most benign method IMHO without going more deeply
in issues which neither the mother or attending staff may feel
they wish to address, is to get the mother to release repressed
feelings by making deep, guttural sounds deep from the gut.
I usually recommend that the mother get on her hands and
knees and start making noise from the back of her throat.
This will usually help to access the strong feelings which are
often rageful. This of course will vary but for most of the
mothers I have used this method on, rage is the first emotion
that arises. This rage is ideal, because the fight or flight reaction
requires strenuous physical exertion to discharge the adrenaline
which provides the mother with the energy to either run or fight
off a real or imagined predator. Of course fleeing is not an option!
But fighting is!

When the rage appears push some pillows forward for the mother
to beat on or the mattress. Quite often mothers will be inhibited
from releasing these feelings in this unorthodox manner. Not to
mention other staff or relatives or friends of the birthing mother!
The noise and fury is sometimes quite spectacular!  I have on
occasion got down on my hands and knees myself and started
roaring to demonstrate to the mother, and convince her that it
is OK to do this and to lessen the embarrassment. My embarrassment
however I am sad to say, is quite acute still to this day!

You may find that it is impossible to use this method in the
environment that you are working in. Every case is of course
individual and must be intuitively assessed as too it's "rightness"
for that individual mother. It has also been my experience that
some mothers because of other issues, sex abuse, past birth
trauma, particularly if their own birth was traumatic, and their
mother was inhibited from expressing her feelings, do not want
to ventilate their unconscious in this manner. This of course
must be honored. I always try to give mothers the knowledge
that their instinctive, intuitive feelings are right for them, and to
follow them as much as possible.

If and when a mother has been able to discharge the adrenaline in this
manner the results have been quite spectacular. Labor rapidly proceeds,
the mother is relaxed compared to her previous state, and her state
of arousal has changed from fear to pleasure. Usually the mother can
tolerate the presence of people that formerly aroused fear and
aversive reactions. The bonding that usually occurs between the family
present in the room and the mother and infant is heartwarming.

I think that there exists a great need for birthing attendants and
mothers
to have access to training that will deal with these issues. Midwives
are
ideally placed to be able to give mothers the simple training that
is needed. In conjunction with every midwives own loving care and
specliased knowledge,
IMHO such training could transform the birthing experience for everybody

including reducing the need for interventions and lowering the C-rate.

The physiology for the fight or flight manifestation, if you are not
familiar
with it I can post, or you can read about it in Grantly Dick-Reed's book

Natural Childbirth which describes this mechanism in relation to birth
physiology.

The idea for discharging the emotions to reduce physical
pain came from my experience in using deep body work techniques to
improve pelvic configurations that may inhibit birth. I found that
direct
manipulation however sensitively carried out would cause extreme pain.
If however techniques were used in conjunction with the manipulation
that stimulated the release of strong feelings triggered by pressing on
those
areas, the pain would transform into feelings of stretching and
releasing.
Often these feelings after the discharge were interpreted as pleasure.
Please don't hesitate to contact me, directly if you wish if further
clarification is required.
Rayner Garner





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