During labour there are various ways to maximise your comfort, and ease the pain of contractions, including:
Have you thought about attending an antenatal class?
Most birth preparation classes cover coping techniques for dealing with the discomfort of labour and birth. Many of these techniques are based on the idea that staying calm can facilitate the flow of birth hormones - including oxytocin (the hormone that causes the uterus to contract) and endorphins (the body's natural painkillers) - making for a smoother, easier birth.
Depending on the class, these techniques may include:
breathing and relaxation techniques - these can help the mother stay calm and relieve tension in her body so that blood and oxygen are diverted not to the mother's tense muscles, but instead to her baby and to the contracting uterus. They can also provide a focus to help the mother cope with the discomfort of contractions, and can help her make the most of the rest periods between contractions
- massage - the birth partner can learn and practice techniques that help release tension in the mother's body, encourage hormone release and provide general comfort and reassurance
- positions for labour and birth - freedom of movement can bring great comfort during contractions, and movements such as rocking and swaying can even help labour progress.
Learning and practicing positions during pregnancy can help you identify positions that are comfortable for you, and lets you think in advance about how you want to use e.g. a birth ball, or birth sling, or how you can use things like chairs or furniture for support during contractions etc.
Water can also bring comfort in labour. Most hospital labour wards (and some labour rooms) have baths which you can use during labour - although most hospitals will not willingly let you give birth in water. Read more about waterbirth in Belgium.
Having an independent midwife (in a support capacity), physiotherapist or doula at your birth can offer wonderful support for both the mother and her partner. Physiotherapists in particular can offer a wealth of practical support in terms of positions, massage and breathing techniques.
A TENS (Transcuteaneous Electrical Nerve Stimulation) machine is a small electronic device that offers pain relief by giving small electrical pulses to the muscles on the back using - this helps block the pain signals coming from your uterus as it contracts.
Although it does not mask the pain entirely, it often helps women cope better with contractions. This pain relief method is most effective when started in early labour, and as it is non-invasive, has no side-effects for mother or baby.
TENS machines are battery-operated, and usually come with a belt clip or neck, so do not limit your movement in labour. They are widely available in the UK (e.g. in Boots), should you feel like buying one and have the opportunity to visit the UK. Alternatively, TENS machines can be rented from the BCT or Antenatal and Baby.
'Gas and air' - entonox, which is made up of half oxygen and half nitrous oxide, and administered via a mask/single-use mouthpiece - has a calming effect, and takes the edge off pain, rather than blocking it out completely. Some of the advantages are that the mum controls when to use it, it is fast-acting and easy to use, it doesn't stay in your system, and won't directly interfere with your labour as e.g. an epidural would.
As this is very new development in Brussels hospitals, make sure to express your interest early on to discuss availability and ability of staff to support you in its use. Some gynaecologists and midwives still seem to be resisting its introduction, but demand from expectant mums is growing! Also, while entonox is most commonly administered using a mouthpiece, Brussels hospitals tend to have masks - best to specifically ask in advance of the birth if you are inquiring about using entonox with a mouthpiece.
Have you thought about attending an antenatal class?
Until mid-2015, epidural analgesia was the only kind of pharmacological pain relief available during labour, which may help explain its popularity - in 2010, over 72% of labouring women in Belgium opted for an epidural, with some hospitals reporting rates of closer to 90% (1, 2, 3).
During an epidural, powerful pain-killing drugs are injected into your lower back using a hollow needle. A fine catheter is then passed through the needle, and this catheter is taped up your back and over your shoulder to allow the drugs to be topped up as necessary. The pain relief from an epidural is very effective, and you shouldn't be able to feel any pain. How much you can still feel your legs will depend on the dose of drugs used.
'Mobile epidurals' (where you have enough feeling in your legs to be able to walk around) are not typically available in Belgian hospitals, though it may be worth asking your gynaecologist about this, or asking when you do a hospital tour.
Many hospitals also organise special information sessions on epidurals, given by anaesthetists, where you can ask any questions you have.
Read more about epidurals (external link).
- Cammu, H., Martens, E., Van Mol, C., Jacquemyn, Y. (2013) Perinatale activiteiten in Vlaanderen 2012. Brussels: Studiecentrum voor Perinatale Epidemiologie (SPE)
Leroy, C., Van Leeuw, V., Minsart, A-F., Englert, Y. (2012) Données périnatales en Région bruxelloise – Année 2010. Brussels: Centre d’Épidémiologie Périnatale
- Leroy, C., Van Leeuw, V., Minsart, A-F., Englert, Y. (2012) Données périnatales en Wallonie – Année 2010. Brussels: Centre d’Épidémiologie Périnatale