Transcript: Tips For Natural Pain Relief During Birth and Labour

This is a text transcript from The First Time Mum’s Chat podcast. The episode is called Tips For Natural Pain Relief During Birth and Labour and you can click on the link to view the full episode page, listen to the episode and view the show notes.

Helen Thompson: This week on First Time Mum’s Chat I’m talking about comfort and pain relief in births with birth and postpartum doula, Janet Purcell. We’re not going to be talking about the drug etc. side since these are readily available via hospitals, but rather comfort measures that a hospital won’t necessarily offer.

Janet shares some excellent tips from her wealth of experience and if you are pregnant or in the family planning stages, then I highly recommend listening. You’ll hear Janet share how devices such as TENS machines, birthing combs and acupressure balls help trigger non painful stimuli to help distract your brain away from focusing on your uterus. How to use the force of gravity to make the whole birthing process easier and more comfortable. Suggestions on what your birth environment should look like and why it is so crucial to get this right. The importance of choosing the right birth partner to ensure you get that all important 100% unconditional support when you’re giving birth.

And so, so much more.

Hi Janet and welcome to First Time Mum’s Chat. I’m delighted to have you here and I’m looking forward to chatting with you about comfort and pain relief during birth. Can you please start by telling us a bit about yourself and your background?

Janet Purcell: Oh, thank you so much for having me Helen. I’m very passionate about my job. So I’ll tell you a little bit how I got there. My name is Janet Purcell. I am most importantly, a mother of 2. I happen to be a registered nurse and after a couple of wonderful birth experiences myself, I decided to become a doula.

So I’m a birth and postpartum doula, which means I spend a lot of time in the postpartum perinatal space with new families and existing families that are just getting bigger and people that have experienced traumatic births. I do a lot of support, give a lot of support to those families too. So that’s kind of where I’m happiest within that realm.

Helen Thompson: So you’ve got a lot of experience there with the nursing background as well, which is always good when you’re a doula to have that nursing background too.

Janet Purcell: Well, it’s nice to know it, but I don’t apply it because of course douling is very non-medical, but I feel like it’s nice to understand the situation.

Helen Thompson: Yeah, definitely. If you’re dealing with trauma, it does help to have a bit of that medical background, although you don’t use it, it gives you extra support and confidence, I guess.

Janet Purcell: Absolutely and you’re aware of the resources that are there as well.

Helen Thompson: So you mentioned when we chatted how you help first time mums with comfort methods. So what sort of comfort methods do you add to your practice?

Janet Purcell: Right. So I think this is one of the things that most people Google when they’re pregnant and that’s, pain relief in labor and birth. I’m not going to talk about the pharmacological side of things, because they’re very much available to everyone. There’ll be things like gas and air, epidurals, morphine, even panadol, things like that. If you’re within the hospital system, you have access to all of those things. There is a lot of comfort measures that a hospital won’t necessarily offer you that you don’t need to have very much practice in, that are really valuable to know that you and your birth partner can do together to really reduce discomfort for labor.

So obviously, because that’s part of my job, it’s something that’s very much second nature to me. I mean, while I’m looking at somebody laboring I can tell where she’s feeling her pain, I can tell where she’s uncomfortable and how she’s moving. Then normally what I would do is, is I would gently prompt the birth partner, whether that’s a husband or other, to maybe apply some pressure, to maybe offer to change positions and things like that.

So doulas definitely don’t take over in any respect, we’re very much a support. So there’s lots of things that a hospital would never really mention that we have to kind of fall upon if we travel in the right circle. So nothing I say to you today would be new information to anybody that’s had a home birth or a doula before. If you’ve had a couple of hospital births or if you’re preparing for a hospital birth, you’re not likely to come across these things unless you’re down the same rabbit holes as what I am.

So one of the most important things for the physiology of birth is being upright and active. So pretty much the hardest way to get a baby out would be to be hanging upside down. In a way, if you’re reclined on a bed and you can’t move, you’re making things difficult to get that baby out. So gravity is definitely your friend. Now obviously, different births and different birth plans, it’s very personal and I support all kinds of birthing. If you want to make it easier for yourself, then gravity is definitely your friend. So you’ll be looking at staying upright. So whether that’s standing or whether it’s a supported stand against a wall or on a bed table. You can get your partner to support you while standing. You can use a birth ball, like those yoga balls. You can use those to kind of move the pelvis and get a bit of mobility into your whole pelvic girdle, and then you’re still upright so baby’s moving downward.

You could also do something like getting on all fours and swaying that’s still considered upright. So getting gravity on your side is a really simple thing and moving. A lot of the time that we will find that birth, if it slows a little bit, sometimes that can be because baby’s in a position that it needs a little bit of adjustment.

Helen Thompson: Would that be like a breech?

Janet Purcell: Well, no, not necessarily breech. They tend to get very complicated in the healthcare system because we don’t see enough of them. Sometimes a baby can be in like a posterior position. If you’re looking at a side on view of a woman with her bump, then where the woman’s belly button is, the baby’s spine should be behind that. That’s the correct position for a baby to be in, but sometimes the baby’s spine can be behind the mother’s spine and their legs and hands can be behind the mother’s belly button, so that’s posterior.

Helen Thompson: Right, okay.

Janet Purcell: Yes, and babies can often move into posterior positions at any stage. Your best chance of shifting a baby out of a not ideal position would be to be upright. Sometimes we find that there’s a little bit of a pause and when we change positionings and when we get upright and start moving and doing things like lunging and squatting, baby will find that position and then things pick up again and baby arrives. So being active and upright is really important. Then the environment that you’re in is really important. I know that kind of sounds a bit silly.

Helen Thompson: No, it doesn’t. You’ve got to be calm and relaxed. If you’re not calm and relaxed, and your environment’s not calm and relaxed, your baby’s not going to be relaxed, and you’re not going to be relaxed.

Janet Purcell: Exactly, I like to say this as a kind of a shortest way to explain what your birth space should look like. It should look like the most romantic thing you’ve ever witnessed. It should be low lights, comfortable, warm, intimate. There shouldn’t be a cascade of people sticking their head through the door. It should be really romantic and intimate because we know that we need oxytocin to birth our baby. Feeling loved and safe and supported is how we get oxytocin. Low lights is how we boost our melatonin, and melatonin and oxytocin work together, so it’s really important.

I always empower people, once they get into their hospital birth space, you are the master of your destiny in there. Turn off all the lights, close all the doors, put a sign on the door that says, knock and wait for us to answer. Really make it feel like this is your space because if your body feels like it’s in an unsafe environment, it’s not going to work in the way that it should. Environment is really important.

Most people would know about aromatherapy in birthing but there’s definitely a lot to be said for the application of aromatherapy, via massage, for example, and you’d be well versed in this. Certainly when we apply rhythmic movements to any muscle set, even if it’s thighs, buttocks, or lower back, you’re going to increase the blood flow.

You’re going to soften and lengthen the muscles. All of that is important for the pelvis to widen and the baby to come down. So aromatherapy is beautiful, but you don’t have to know heaps about aromatherapy, like all the information is there. What I would say is that sometimes in labor people can be very sensitive to smells, so don’t be surprised if that beautiful lavender you were hanging on to is too overpowering.

So rather than applying it to the skin you can put a drop on it like a tissue and have a little sniff and then you can put it away if it gets too much. Certainly aromatherapy is something that I implement in most of the births I go to. I enjoy it myself too. I think it sets a lovely environment too, as well as it’s good for pain relief. Things that kind of fall under the similar kind of acupressure and the pain gateway theory.

So if I talk about the pain gateway theory a bit, but if you haven’t heard of it, you probably think that’s an odd thing to be talking about. Essentially your body has a process called the pain gateway theory and if your body’s experiencing pain, and your brain is identifying that your body is experiencing pain, if you introduce another non painful stimuli, it can trick your brain out of paying full attention to the pain.

So when we talk about pain, I’m talking about contractions, really. So things like TENS (Transcutaneous electrical nerve stimulation) machines, if you’ve heard of birthing combs, so you squeeze them in your hand and it triggers this non painful stimuli to distract the brain away from focusing everything on it, on the uterus. You can use things like acupressure balls, which are like little spiky balls, and you just squeeze them. Sometimes you see people using them in pairs. That’s another non painful stimuli. Then acupressure is something I don’t do myself, but I see a lot of families, especially families that have done hypnobirthing courses, are familiar with acupressure points and they apply them during labor to provide that. Essentially it kind of distracts the brain away from focusing everything on the uterus.

The TENS machine works on a couple of different levels, but really what a TENS machine does is it causes numbness in an area, reduces pain, but also it overwhelms the brain really into kind of paying less attention to contractions so they all work and you can use them all together.

Now, I will say, the greatest comfort measure of all is not anything that anybody else can do for you, but it’s information and education. I always recommend my clients to do independent birth classes, not the ones at the hospital, because they’ll generally give you the options that they provide, rather than what’s available to you. So I always suggest that. The way births kind of unfold, you can see the families and the couples that have spent a lot of time with gaining knowledge and making informed decisions.

You can actually tell that by how it unfolds because they never feel overwhelmed or they never feel out of control. Doulas generally don’t have clients that say, Oh, I’m just going to go with the flow, because that’s literally the opposite of what a doula would do!

Helen Thompson: Yes, you mentioned also the calmness, to do with the aromatherapy. Very briefly, without going into too much detail, what’s your take on homeopathy?

Janet Purcell: Whatever works. I have a lot of women actually that would bring homeopathic products. You’d see more on home birthing because hospitals sometimes are a little bit scared of homeopathic remedies. That’s not to say you can’t have them and and use them discreetly, but you certainly won’t get permission from a hospital to use them.

So we often have people that would have tea blends. If you think about it, most pregnant women are drinking raspberry tea now anyway, raspberry leaf tea towards the end. So yeah, I, I see a lot of it and I think I certainly wouldn’t poo poo anything that somebody valued as part of their birth journey. I’m there for all of it.

Helen Thompson: Yeah, I think, as you said, you can use all of them, aromatherapy and homeopathy and I think that’s also a pain relief as well. I mean, you can use both of those natural therapies for pain relief. I think it’s much more relaxing for the baby and for the mother.

Janet Purcell: It can be just the most incredible thing and I often say to my clients, I wish you could see you how I see you now, because there are moments in a birth and to be honest, most of it is like this, that she just looks like she’s connected to some other place.

Helen Thompson: Yes.

Janet Purcell: It’s most magical thing and it’s such an honor to witness and I cry at most of the births, but I do warn them because it’s just the most incredible thing to witness a woman coming into her full power and literally creating life in front of you. It is amazing! There is a period during most births, sometimes I don’t really pick it, but there’s a period called transition. How I would recognize it in women would be, it’s quite common for a woman to say, that’s enough, I don’t want to do this anymore, I’m going home. We think, well, you’re not going home, though you can leave at any time because your baby is really close. The transition is just that part before we know baby is coming, but it can be very overwhelming and I think depending on who you have surrounding you, it’s really important for them to know what your planned outcomes were because as well with birth partners, if couples are in a relationship for a long time, despite the length of time they’re together, it can often be that this is the first really difficult and hard and painful thing that has ever occurred in their relationship. So, if your idea of birth is that it is to be endured, rather than to be an active participant in you’re going to feel sorry for the birthing woman. If you feel sorry for her, if she asks you for an epidural, you’ll, you’ll make it happen but that’s not necessarily what she wants, because even In the most educated and in the most naturally planned birth we have, there is always a point where the mother will say, is it too late for the epidural?

They’re just having a confidence crisis and they just need maybe a change of position, a bit of reassurance, knowledge to know where you are, even identifying, this is what we talked about, this is transition. Then knowing that, Oh yeah, I knew I’d feel like this. They can move on and they know their baby is so close.

Helen Thompson: Give them that boost to push through the pain.

Janet Purcell: Absolutely and to be honest, pushing is very satisfying. It’s a very satisfying feeling. It’s a bit like scratching an itch. When you get to the pushing, you think this is it. It can be very satisfying.

Helen Thompson: I think it’s an amazing thing how women can carry that baby for so long inside and then it comes out of such a small area. I just think it’s absolutely amazing and I can appreciate how painful it is too.

Janet Purcell: Yeah, it really does depend on what your kind of outlook on birth is. I have had two children and I wouldn’t describe any of them as unbearable. It’s pain with a purpose. It’s not like a broken bone or it’s not like a disease process. The reason we feel this is because our body is shifting and stretching and moving and softening. So it’s pain with a purpose. So once you kind of respect that it’s happening because we’re making way for the baby, it’s not necessarily something that you’ve sustained, so to speak.

Helen Thompson: Yeah, that’s a very interesting point.

Janet Purcell: Yeah, and that’s where I’ll be truthful. I struggled with that a little bit in the beginning because most of the pain I’ve seen in my career as a nurse is because of disease or infection or injury and to witness a woman displaying similar symptoms or at least, you know, reactions, I did have to really reframe the purpose of this. I will say that there are even like in some of the birth education courses, they don’t refer to pain at all. If they call it surges, they call it like waves because technically speaking, we call it pain because I suppose it’s probably historically been kind of labeled that rather than it being kind of appreciated for its purpose.

Helen Thompson: Yeah, I think that’s a really nice way of putting it, and if you feel that way at the very beginning, and you’re encouraged to feel, to be more natural, it, it would make you feel much more relaxed, as you say. I love the idea of what you do, because although you’re a doula, you’re also bringing in that relaxing aspect as well of the aromatherapy, especially the calmness and bringing in the environment and the oxytocin.

Janet Purcell: Sometimes the best place for a doula to be is outside the door and that’s something that I’ll always mention in birth planning. Sometimes couples need to reconnect, have a little snuggle, maybe have a little kiss because we got to get that oxytocin happening and to do all of that, you need privacy.

So sometimes I will say, do you guys just want some time together and I’ll wait outside and just snuggle down and these are your last moments as two, you’re about to be three! So soak it in and just hold each other because it’s important that you feel safe.

Helen Thompson: I think doing that would also relax your abdomen. It would relax you completely because you’re with the person you want to be with.

Janet Purcell: Absolutely and it doesn’t have to be a partner, as in like a sexual partner. I see the most beautiful trusting, supportive, connected relationships between sisters and best friends and a mother and yeah, it’s incredible. It just has to be the right person. This is something that comes up a lot, is that unless now everybody’s afraid to poo during birth and they shouldn’t be because everybody’s delighted when they see poo because that means the baby is making their way down. So the only person that might not be delighted to see poo is the person doing it, maybe, but it’s very much a normal and natural part of birthing is poo. Unless you know the person well enough to poo in front of them, and I’m talking strictly about birth partners, don’t bring them in. So sometimes people will say, oh, my mother in law wants to be in the room. I say, well, would you poo in front of your mother in law and, and, and things like that? Oh, no, no, no. I say, well, even if you try and talk yourself out of it, if there is someone in the room that you don’t feel wholly comfortable, your body is going to react in a way that doesn’t allow for complete relaxation.

Helen Thompson: Yeah, that could even be the partner too.

Janet Purcell: It can be the partner. That’s also something that we talk about because sometimes the doula comes in because either it might be a second birth where the partner might have been completely overwhelmed by the first birth and found it traumatic and ended up feeling anxious through the whole time. Unfortunately, that’s not the best person, but that’s why I kind of say my role is to support the partner too and actually the research shows that if there’s a doula there, the partner actually spends more time in the room because they don’t become burnt out and overwhelmed because they’re supported. So I’m often offering drinks to both people and wiping brows on both people and making sure everybody’s eaten. So I want to protect their unity and the intimacy between them as well.

Helen Thompson: I love that idea because I think that’s what they need. That’s what mums need, they need that loving support from whoever it is that’s there, whether it’s a doula, whether it’s a midwife, whether it’s a mother, whether it’s a sister, whoever it is. So is there anything else that you want to mention?

Janet Purcell: Two things. One, don’t be worried about making noise. You’re supposed to make noise. We know that if we look at the anatomy of the throat and the anatomy of the vagina and the uterus and the cervix, very similar. And there is definitely trains of thought around vocalizing and groaning and getting really down deep and low into your voice through contractions, that that can help to soften and relax your pelvic floor, which allows baby to move down. So don’t be afraid to make noise. I had a client once who told me that her mother, every time she made a noise in her first birth, her mother said, shh don’t do that, shh, you’re being embarrassing and I think it was culturally that they weren’t allowed to make noise during birth. As a result of that, she never really relaxed and she ended up having quite a traumatic cesarean at the end of that. I’m not saying they’re completely related, but she had someone in the room who was kind of chastising her and yeah, it could have been very different.

So don’t be afraid to ask questions, get rid of people you don’t like in the room. You can ask for someone else, you’re the boss. You can leave anytime. You can ask for a different doctor. So protect your space and ask all the questions.

The other one that I’m seeing more and more of is the rebozo. Rebozo is and I hope I do this justice because I am sensitive for the cultural significance to this. So in South America some women would often have like a cotton woven, like a cloth really, but it’s like a large scarf and it’s something that becomes part of their lifestyle really. So they wear it, they carry their babies in it, but they also use it during birth to help with positioning and softening down the muscles and things.

So most midwives and doulas would know about rebozo now and people have access to the information about it. I want to be very careful about not claiming it culturally as my own because it most certainly is not, but a lot of people now will be using something like, you’ll see it being called like a scarf or a sling, but it essentially is the technique of rebozo, which I’ll just try and kind of visualize it for you.

So If all the muscles around the buttocks and the legs were really tight, something that I do myself and I’ve seen lots of other doulas and families know about is they’ll get the birthing person on fours and then they’ll stretch the piece of fabric across their buttocks, lower back, and they’ll bunch it at either side of the hips so that all the fabric is spread across but nice and firm around it. Then by holding either of the end, you give it a little shake. So what happens is then that the buttocks and the bum does this lovely kind of a wobble and a shake and then you keep that going. Yeah. So you’ll hear it called shaking the apple tree as well.

So you get this lovely wobble going, and it’s nearly hypnotic to be fair, because what happens is, is that the mother’s not actively doing anything but literally you can see all the tension and stress and kind of holding of the legs and the bottom, it melts away.

It’s beautiful, it’s well worth having and if you can find somebody who culturally practices rebozo, it’s well worth your audience knowing about it because it’s fantastic. You can also use it in other ways, like if the mother was on fours you can pop it across the belly underneath and then you stand overhead and just give a beautiful soft little jiggle to the belly and that can help with repositioning the baby inside the belly.

Helen Thompson: What a nice natural way of doing it. It sounds beautiful.

Janet Purcell: Yeah, fabulous. Now, you need to know, have an idea of what it’s purpose is, and I certainly wouldn’t feel confident in teaching it to anybody, but a lot of my clients know about it well before they meet me, because a lot of the birth education classes are teaching it now. So we’re very lucky to have such a wide variety of comfort measures, but definitely your environment and your knowledge are the top two.

Helen Thompson: Wow, I love that. I love that rebozo idea. So how can people find out about you?

Janet Purcell: So my first toe dip into the birth world was through a store called Birthplace. So I’ve had Birthplace, which is my shop where I sell all birth and pregnancy things, including combs and acupressure and aromatherapy and all that. Then as you’ll see on there, my doula name is the Birthplace doula. So you’ll find me.

Helen Thompson: Okay, so, well, thank you so much. I can talk to you forever on this.

Janet Purcell: I know. I’m very passionate.

Helen Thompson: It shows in what you do. I’ve interviewed a number of doulas who’ve talked generally about how they support mothers but you’ve gone into more depth on topics such as comforting, aromatherapy, and all of those lovely things. So I really appreciate you talking to me today, and thank you so much for being here.

Janet Purcell: Thank you for the opportunity, Helen. Thank you so much.

Helen Thompson: Wow, Janet shared some great tips and suggestions around childbirth and I find her passion for what she does highly contagious. I highly encourage you to check out Janet’s website and social media and I’ve included links in the show notes which can be found at MyBabyMassage.net/podcast/138.

Next week, I will be chatting with Occupational Therapist, Munira Adenwalla. We will be talking about how to build your little one’s strength and coordination through their own movement.

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