Conference moira::parenting_v3

    Sarah,
    
    I'm currently working in England and am pregnant with my second so I'm
    very interested in knowing this type of info. My views might be
    "tainted" a little after going through a fantastic birth experience
    in the States and the now trying to understand the process here. 
    
    As for the pain relievers...
    
    I've heard the TENS works great, especially if you are having back
    labor. It might be a wonderful choice because you get to determine the
    amount of "shocks" you need to handle the pain.
    
    About the gas and air, I assume you mean "laughing gas". I'm not real
    comfortable with this. I have never heard of it as an option in the
    States and since I had it for the removal of my wisdom teeth, I know
    what it felt like and I was not in control.
    
    The pethadine sounds like all it is going to do is make you and your
    baby very sleepy and you won't be able to do what you need to do.
    
    The epidural you describe sounds like what is termed a "spinal".
    A true epidural isn't injected into the spinal fluid but into the
    epidural casing outside it. The epidural will numb pain but will not
    hinder your motor coordination. Therefore , you can still push and move
    your own legs. The spinal on the other hand numbs both pain (sensory)
    and physical coordination so you can't push effectively; hence the need
    for more forcep deliveries. Do check with your mid-wife and nurse
    practitioner as to which one you will really get. Everyone I know who
    has had an epidural said they were the best!! 
    
    As for staying upright...why fight gravity?!?! Walk around until they
    either confine you to the bed or you are ready to push. When I was
    walking the contractions began to get closer together but they found
    the baby was laying on the cord and being upright could cause the cord
    to slip under his head. I was confined to the bed on my side and
    thought I'd go nuts. Contractions stayed 3 mintues apart through the
    whole labor and only quickened to about 2 mintues (a couple
    one-minuters even now and then) when it came time to push. While 
    walking they immediately quickened. I highly recommend it!! If it's a 
    long labor you will know such facts as how many steps it takes to cover 
    the area you are allowed to walk, how many ceiling panels there are 
    during that walk, how many floor tiles there are in area, etc!!
    
    If you want, I have some of my books from home with me. I'll be glad to 
    photocopy the pages about "pain relievers" for you so you can read about
    other options that just might be available here. I know I was offered
    a combination during my delivery that wasn't discussed. You may have more
    options then just 4 and I have quickly learned that you have to ask for
    everything here in order to get all you need. Just let me know
    your location if you would like a copy. I'm in DECpark.
    
    Andrea      

    
    Congratulations, Sarah, and congratulations to Andrea too!  I'm
    expecting my first in November.
    
    The only pain relievers I've learnt about are the four suggested
    by Sarah.  I was also wondering about taking a course of hynotherapy
    beforehand so help with relaxation .... and don't forget massage with
    help from your partner.  I intend taking the epidural if it gets
    too bad - I don't believe there's any great virtue in suffering
    pain when you perhaps don't need to.  Would you have a tooth out
    at the dentist without anaesthetic, just because it's 'natural'?!
    
    I would be very interested to hear any more about hiring a TENS
    system.  Does anyone know where to go to do this?
    
    Also, Andrea, I'd be really grateful if you could send me a copy
    of the pages from your book too - Alison Lyng @WLC (Winnersh). 
    Thanks a lot!
    
    Best of Luck!
    
    Alison  

    Hi Alison,
    
    Congrats to you too!
    
    You can hire the TENS from a company called Splemby and their
    telephone number is 0264 65749 (this is a UK number).  They will
    then send you an application form.
    
    It costs 25 pounds for 4 weeks, and they send it to you two weeks
    before the baby is due.  Each extra week you keep it costs an
    additional 6 pounds.
    
    My midwife told me that for best effect you need to start using
    it as soon as you are fairly sure you are in labour, it doesn't
    work if you leave it till things get bad!  Also, you can travel
    to the hospital with it on and carry on there for as long as you
    want to.  It is also in your control and your hubby can help if
    you get to the point that you can't manage the controls yourself.
    
    I have just got my application form, so I'll be filling it in
    this weekend!
    
    Good luck!
    Sarah

    
    Thanks for the info., Sarah.  I've just telephoned them and they're
    sending me an application form too.
    
    I've been reading Parenting for a few months now and it seems sad
    that maternity care seems so much more advanced in the USA than
    here in the UK. Something to do with NHS versus private medical cover, 
    I suspect!
    
    Something I've often seen mention of is Lamaze ante-natal classes.
    I'm intrigued - is this anything to do with pain relief?  We don't
    have them in the UK ...... do we?
        
    Alison
    

    From what we've seen between the UK and Canada (which is similar to the
    USA), it is the difference between a lot of doctor involvement and
    little doctor involvement.  I have seen two sides to this:  it becomes
    hard here for some women to have a straight forward pregnancy and delivery
    which is what they wanted and could and should have had while in the
    UK, I have seen inadequate care of the mother because the doctor still
    believes that natuire should run its course and we'll deal with any
    problems after the delivery.
    
    Here, test after test is performed most of which come up negative.  
    Caesareans are extremely common at more than 20% in some hospitals because
    the dotors feel happier coping with what is a straight forward surgical
    procedure than coping with say a breach birth.  The fact that it is
    major surgery is irrelevant.  They seem to want to force questionable
    procedures upon you, such as the amniocentesis.  We, for example went
    through a genetic screening because for our last child my wife was 37
    (past that magic age of 35) ... the counsellor took great care to
    explain what it was about and that from our family's history the
    chances of problems, including Downs (mongolism) was low.  The Doctor
    in charge of the department looked at the front page of the form
    which had Name, Age, EDC, dates and results of previous pregnancies
    and asked when we would schedule the amnio.  He did not look at the
    counsellor's recommendations.  He did not explain what use we might
    put the amnio's results to (primarily if we wanted to terminate the
    pregnancy if it turned up something horrible).  He did not explain that 
    the risk of miscarriage from the procedure was greater than the risk
    of Downs syndrome due to age.
    
    Here, the doctors insisted on weekly visits near the end, that multi-
    vitamins be taken (never mind that they cost some exhorbitant amount
    more than regular vitamins and aren't available on prescription). 
    
    They often insist on inserting gizmos like fetal monitors to measure
    fetal stress... never mind that the monitor often increases the
    stress of mother and baby.
    
    In the UK, on the other hand, the dr we had for our first was very
    nonchalant about the whole thing ...  My sister in law developed an
    infection during pregnancy that they left untreated ... she ended
    up with Bell's Palsy as a result, which eased after the delivery.
    A lot of things get untreated or dismissed in much the same way as
    a normal visit to the Dr.  Most times I visited the Dr in England,
    the biggest challenge was actually getting past the dragons at the
    reception desk.  They would usually a) put you off ... b) give you
    the run-around ... c) give you quasi-medical advice.  So you avoid
    the Dr unless it's essential.
    
    Lamaze is one of the names given to a form of Natural Childbirth
    preparation techniques to help make it easier to control / bear the
    pain.  It is named after a french dr.  I believe you have such classes,
    but they may not go by the Lamaze name.
    
    Stuart
    

A little more on Lamaze.  Our instructor was quick to point out
that it is not the same as "natural" childbirth in that "natural"
means no artificial pain relief whereas Lamaze doesn't have this
restriction.  I'm sure that definitions vary.

In essence, you learn several levels of breathing patterns that
help you cope with the discomforts of labor.  In addition, you
learn a lot about the physical and emotional aspects of pregnancy
and childbirth.  We took it as a group and really enjoyed it.
A few weeks after all of us delivered we held a reunion.

    Do see if you can find a prepared childbirth class.  It helps
    immensely to learn what you can expect during labor and delivery. 
    If the hospital, birth center, midwife, or whoever/wherever you're
    going to deliver offers a course, that's usually good because
    they'll show you around the facilities and explain their policies
    and procedures, so you can either argue ahead of time or at least
    know what you're going to have to put up with. 
    
    Lamaze is only one of the available techniques.  It's based on
    conditioned reflexes.  The idea is that you train yourself to
    respond to the pain of labor with the trained response of
    breathing rather than the natural response of panic.  I think
    there's something called the Howard Technique that depends on the
    father's participation (Lamaze is perfectly happy with anyone from
    your mother to the night nurse as coach).  Other courses emphasize
    things like massage therapy, relaxation techniques, and different
    kinds of breathing.  
    
    The best way to find one that will suit you is to ask around.  Ask
    other mothers in the waiting room when you go in for your
    checkups, ask the nurses or whoever, call the hospital and ask
    what they have -- not sure what all the British sources would be,
    but anyone who deals with pregnant women would be good.  The woman
    who runs the maternity clothing store near this facility was one
    of my best sources . . . 
    
    --bonnie

    .4
    
    Alison,
    
    We are having NCT (National Childbirth Trust) classes that are
    really good.  And I will get the NHS antenatal classes soon as
    well.
    
    The NCT classes are in the evening and are for you both.  They
    are for a small group (in our case 5 couples) and are quite
    personal.  You also get to know the other attendees very well
    which is nice!  They cost 35 pounds for the classes and a 
    further 18 pounds if you chose to join the NCT.  If you join
    you get other services, like post natal advice and support,
    breatfeeding support etc...  The antenatal classes are run
    by a midwife, most other services are run by volunteer
    NCT trained mothers.
    
    If you are interested, mail me and let me know you location
    and I will try and put you in touch with a person in your
    area.  It was at these classes that I learnt about TENS etc...
    
    Cheers,
    Sarah

    (Hello Sarah, glad to hear everything is going well...)
    
    In answer to .0, Sarah, I think you have summed up the UK pain relief
    options pretty well.  The only one I have had practical experience of
    is Entonox (gas and air).  It was wonderful!  I think it is a mixture
    of nitrous oxide and air, but the mixture is set so that it doesn't
    knock you out, like the stuff dentists used to use, (although I've
    never had nitrous oxide at the dentist) it just helps to deaden the
    labour pains.  
    
    Reasons why I liked it:  I coped OK with first stage labour pains, between
    being 0 cm dilated and 6 cm  dilated (this took about 9 hours), by 
    breathing, concentrating, relaxing and walking about (I am also a great
    believer in gravity!!).  After about 6cm dilated I felt I needed 
    something more, but didn't feel bad enough to want an epidural, and
    didn't want pethidine.  The gas and air I could use just when I needed
    it, I could use it in conjunction with the breathing exercises, and it
    wore off between contractions, so I didn't feel woosy.  My midwife told
    me that you can't take too much, because you are in control of it, you
    hold the mask yourself, so if you start getting woosy, you
    automatically drop the mask, and stop breathing it.  It didn't take the
    pain away, but it did make it much more managable.  However I did reach
    a point when even with gas and air, and breathing exercises, the pain
    was too much to cope with.  I realise now that this was the transitions
    stage between the first (cervix dilating) and second (pushing) stage of
    labour.  I told the midwife that I could not cope and she suggested an
    epidural, but when she examined me, I was 9cm dilated - nearly ready to
    push, and it was too late for an epidural.  I only remember having a
    few excruciating contractions before the pushing stage, and I don't
    remember the pushing contractions as being painful, but I didn't have
    to do much pushing - my daughter got into distress and had to be
    delivered by forceps.
    
    Reasons why some people don't like gas and air:  you have to breath 
    it though a mask, which makes some people feel uneasy, it smells a 
    bit odd, it doesn't completely take the pain away, just makes it 
    more manageable, and it takes a few seconds to work, so you have to 
    start breathing it at the very beginning of a contraction.  Some 
    people never get the hang of this, breath it too late when they're 
    well into a contraction, and the by the time it's taking effect, 
    the contraction is over.
    
    If your're thinking of using gas and air, try "practising" using it in
    the early stages of labour, before you actually need it.  Then you can
    see the effect that it has, and you can get the hang of it before the
    going gets to tough.  The secret is to breathe it in IMMEDIATELY you
    feel a contraction coming on, take three or four deep breaths (this can
    be part of the breathing exercises), then as the gas and air takes
    effect carry on coping with the labour pains by breathing and relaxing.
    (yes I know that that is MUCH easier said than done!).
    
    I've got some other comments about TENS and UK Ante-Natal classes but I
    think I shall put those in another reply.
    
    Good luck to all you ladies-in-waiting.
    
    - Janet
    

    Re: childbirth classes in the UK - I was going to describe National
    Childbirth Trust classes, but Sarah got in there first!  
    
    
    Steve and I attended these classes and I can really recommend them. 
    We found them a really good preparation for labour and the early days
    of parenthood, and we have made some good friends through the classes -
    we still have regular re-unions with the other parents.  
    
    
    In addition I think all Area Health Authorities offer Parentcraft
    classes (West Berkshire and Hampshire certainly do).  These take the
    form of six two hour courses and are free.  Your midwife/GP should 
    give you details of how to entrol.  The ones I went to were taught 
    be a midwife/health visitor  and an obstetric physiotherapist.  
    They discussed pregnacy, labour, breathing and relaxing techniques, 
    breast feeding and care of newborns.  They were really good, and
    reinforced what I learnt in NCT classes, and I still see the other Mums
    from these classes.  The only "problem" with these classes is that they
    are held during the day, so it is more difficult for a partner to
    attend (although the classes usually have one evening session for both
    partners).
    
    Re:  TENS  
    
    There is a clinic in Reading (England) that rents out TENS machines. 
    They have a initial session where you learn how to use the TENS, then
    you can rent it out on a weekly basis.  If anyone is interested, please 
    mail me and I will send you the address and phone number.  I never had 
    time to hire one because my daughter was born two weeks early, but I 
    would definately try one if there is ever a next time.
    
    Cheers
    
    - Janet
    

    
    Sarah,
    
    Yes, I have enrolled on the NCT classes.  My midwife said I could
    have either these classes or those run by the NHS, but I wasn't
    told I could have both.  She seemed to try and put me off of using
    the NCT as she said they were very pro-natural childbirth and she
    felt they tried to discourage women from using epidural, drugs etc.
    She expressed an opinion that if a woman is all geared up to going
    for a natural child-birth and then finds she really cannot cope
    with this, she can come out feeling a bit of a failure and this
    can add to post-natal depression.
    
    Anyway, I opted for the NCT classes as they were the only ones I
    was offered where my partner could attend too.  I feel strongly
    that partners should be included in all pre and post-natal activity
    wherever possible and was disappointed that the NHS classes didn't
    seem to encourage this.  Also, no-one's going to talk me into a
    natural childbirth - I've already decided to leave my options open
    and take anything on offer if I need to!  I'd like to try the gas
    and air and TENS way of doing things, with the epidural etc on standby.
    
    By the way, my TENS information and order form arrived in this
    morning's post!  I'm definitely giving it strong consideration.
    
    Thanks & take care.                                            
    
    Alison

    I think Alison has the correct attitude - keep all your options open.
    The "trend" in the States is no longer natural child birth classes but
    prepared childbirth classes. My instructor was excellent at showing you
    all your options from methods of controlling pain yourself (diffferent
    breathing techniques, focal points, support from your partner, etc) and
    explained all the medical options to help you control the pain. Since
    your birth will not really compare to anyone elses because we each have
    our different levels of pain and thresholds where we can endure pain,
    you can't go in to labor with a set process that you will go through.
    
    My instructor stressed that it is your birth experience and your
    first responsibility is to insure the safe delivery of that baby and 
    still be able to feel in control of it. Luckily, a conference like this 
    is an absolute wealth of knowledge for finding out all the information
    you may need!!!
    
    Also, remember that you may not need a pain reliever but may need other
    relief. I hadn't eaten in over 24 hours during my labor. I was tired
    and very hungry. I kept asking for food but, obviously, I wasn't going
    to get it. What I was offered was medication to slow down the
    contractions so I could rest and they I would have to be "jump started"
    with pitocin which would quicken the contractions. I slept for what I
    thought was hours but it was only a half hour. It was exactly what I
    needed. I woke "refreshed" and ready to start over. Since the
    medication were given through IV, I was also given fluids (I think
    glucose and other nutrients) to build up my energy level. My son was
    born 4 hours later and I honestly don't think I would have had the
    stamina to go on without that rest. 
    
    The whole other side to labor and pain is the psycholgical side. It is
    very difficult to not wonder if you will be able to "survive" it. 
    You will - it may be longer then you liked, but you will survive it.
    Don't let that get the best of you. It is very exciting and think
    "baby" not pain. When they hand that baby to you, you do really forget
    the level of pain you might have just had but you don't forget the
    concept that you did have it. You won't be able to compare it to
    anything you have ever experienced. The last however many hours will
    suddenly seem like it was merely a minute.
    
    I cannot express how important it is for your partner to understand the
    process as well. He really needs to know when he can help and how he
    can help. My husband was "at my beckon call" during labor because he
    knew I needed his support. Funny story - I was confined to the bed at
    this point on my side. I was squeezing the bed rail; I was
    concentrating on the squeeze of my hand rather then the contraction
    itself. I realized that I was putting dents in my hand from my nails. I
    called my husband close and said I needed to squeeze his hand. Well,
    during the next contraction I was squeezing his hand and HE was
    squeezing back. My hand was beet-red and ached. I told him to go find
    me something to squeeze because he was of no use. We do laugh about it
    today - he says he did it because I was killing his hand and it was a
    natural reaction. It wasn't funny at the time! The point is that he
    may not do everything perfectly but if he knows that you do need him
    there no matter what you might say (you're no use) or do (squeeze his
    hand off) then you'll be better off. You may want him to be very
    physical with you one minute and the next you're telling him he's
    having a vasectomy next week. He's got to know to ride YOUR
    rollercoaster. A mild-mannered woman may turn into a raving lunatic
    during labor. You can't predict what you'll do. 
    
    I'm already wondering what my second labor will be like.
    
    Sorry to ramble. Sometimes I think I'm in the wrong occupation!!
    Andrea      

    Alison,
    
    RE: NCT classes - it's a common misunderstanding that NCT stands for
    Natural Childbirth Trust, rather than National Childbirth Trust.  The
    classes we went to did not teach natural childbirth - ie with no pain
    relief or intervention, and as the classes are co-ordinated nationally,
    I hope yours won't either.  So don't worry about being pressurised. 
    The classes we went to told us about all the pain releif options and 
    discussed the pros and cons of each, but stressed that accepting pain 
    relief was NOT a sign of failure.  As it turned out, out of my
    "classmates" we all had some sort of pain relief, and between us all we
    tried everything - TENS, gas and air, pethedine and epidural, and none
    of felt like failures, we all felt like major successes, because each
    of us had the most beautiful baby in the world!
    
    FWIW - I think that the NCT got the "Natural Childbirth" image during
    the seventies when there was a lot of intervention in labour - ie women
    being induced to suit the hospital rather than because it was
    necessary, women being given epidurals they didn't want, lots of
    rupture of membrane, and episiotomies to speed things up, etc etc.  The
    NCT campaigned against this, and were successful in many cases, but it
    sort of got turned around so that people thought what the NCT wanted
    was no intervention at all, which isn't true.
    
    Also FWIW - another hand squeezing story - while I was going through my
    tough transition phase of labour, Steve was standing next to the bed -
    when ever a contraction came on, I reached over for his hand and
    squeezed it hard, however during one contraction, I reached out blindly
    for his hand, missed it, and grabbed the first thing that I came to,
    which happed to be the front of his trousers ... and all that lies
    therein.  I don't know who yelled louder during that contraction.  
    Who says men don't suffer during labour?   Actually I have heard that 
    hand-squeezing makes you more tense, and your partner should encourage 
    you to open your hand up, while he strokes your palm.  Since my transition
     phase was also my unreasonable phase, I think if Steve had tried that I 
    would have ended up sqeezing him even harder where it hurts!
    
    - Janet

>    Epidural, numbs you from waist down.  Completely kills the
>    pain, but stops you from doing what comes naturally and
>    therefore increases the risk of forceps birth and damage
>    to mother.
    
    
    I don't agree with this.  I had an epidural and wouldn't have another 
    baby without it!  I felt everything but the pain and had a perfect 4 
    hour delivery (my first baby).  Before I had the Epidural, my dilitation 
    was 5 cm.  Within an hour my Michele was born!  In other words, I got to 
    10 cm. within an hour.  I felt EVERYTHING but the pain.  It made it much 
    better and easier to push - it was wonderful!
    
    Also - I had no back pain at all.  I've heard that some women do.  I
    think it depends on the person administering the needle.
    
    Hope this helps and GOOD LUCK!
    Pam

    Thoughts on Lamaze/Child Birth classes.  
    
    
    I highly recommend it.  You learn SO MUCH about your body and what is
    happening from the time of your first contraction, to the actual
    delivery, such as 'what's going on during the transition stage!'
    
    By the way, I have a beautiful 6 month old daughter named Michele Renee'!
    
    Again, good luck, they're a lot of fun!
    
    Pam

    One of things we learnt in the NCT classes was abou thaving a birth
    plan. Obviously like any plan it can be changed 8-). It seemed to help
    the Hospital as they knew what we where trying to achieve.
    
    I found the classes very good, informative and sometimes real fun.
    
    We opted [well my wife did 8-)] for the TENS machine and would highly
    recomend them. It worked for us. Jane started using it as soon as she
    thought she was in labour, the "volume" turned right down and then
    built it up as the 27 hours passed.
    
    Jane asked for and received pethadine after about 12 hours [it was a 27 
    hour labour !!!!!] she slept in between contractions for about 1 - 1� hours
    and like an earlier noter this helped her at lot.
    
    Jane didn't like the Gas and Air.. and gave birth just using the tens
    machine. 
    
    Thomas was born, to subdued lighting, and welcomed by a favorite track
    of music of Jane's. Just as we had hoped for and as written in the
    birth plan.
    
    I couldn't recomend the NCT enough [although some of the goodness may
    have been because of the instructor we had], especially if you are a
    first time father-to-be.
    
    Mark 

    I found out yesterday that TENS machines are available in the US,
    but as yet they're being used mostly for the relief of chronic
    pain -- especially useful for after-accident and after-surgery
    pain, according to what I read.  
    
    Apparently they aren't being used for labor yet, however.  If
    someone was interested, I think they could probably call a good
    hospital and ask about it.
    
    --bonnie

    
    Hello all,
    
    I'd just like to remind you parents-to-be 
    that you may not be able to opt for the "perfect" labor and
    delivery. Of course by becoming well informed, you can
    make more rational decisions. But you may not be able to
    decide *anything* beforehand. 
    
    For example, my husband and I discussed and planned 
    how we'd like our baby to be born;
    we hoped to use a bean bag chair on the floor of our
    private hospital room, lights low, calm music playing
    (and me chewing on raspberry tea leaves, I suppose :-))
    and we drew up a birth plan so the hospital would understand
    our preferences. We went to NCT and hospital childbirth
    classes. He nagged me about doing my pelvic floor exercises.
    
    However, as it turned out that my labor lasted from 
    Sunday morning to Wednesday morning (three days, I kid
    you not) we quickly shifted to a slightly different 
    approach (which I would sum up as "Doctor, would you 
    mind swapping this beanbag for all the drugs in this 
    hospital?) After a full day and night of the TENS machine, the
    TENS ceased being useful -- although for the first day it was
    great -- so then I "opted" for pethidin. Then I "opted" for an
    epidural. Then I "opted" for a cesarian. Finally
    I "opted" for an emergency cesarian under a general
    anesthetic. My choices narrowed themselves right down,
    really.
    
    You may think, like I did, that most labors last 10-12 hours
    (that's what they told us in our classes, as I recall) --
    and that those few poor women that do have *really long* labors
    have labors that last all day. [Be honest, how many
    of you moms-to-be, as you are getting closer to your date,
    keep saying to yourselves "Well, it's just one day out
    of the nine months, one day out of my whole life.] This
    really is misleading; many women have labors
    like I did, taking a long time to dilate to 5 or 6 cms.
    
    It wasn't gruesome, wasn't really all that bad. There's
    absolutely no reason to be afraid. (Easy to say, I know.)
    Just learn as much as you can, and then play it as it comes.
    
    All the best wishes,
    Barbara
    
    p.s. I would add that I had no trouble at all coming to terms
    with an unplanned cesarian. In fact, I didn't mind any of
    it, even before the baby was there. And then suddenly she
    was there blinking at me and I was just floating on a cloud
    of happiness. And I still am, a year later.
                                          

    re: .18 Boy you hit it right on the head.  I also remember insisting
    on a birthing room (which I couldn't have because my water broke before 
    I went to the hospital and infection was a concern).  I remember that
    once my labor started it made absolutely no differnce to me what the
    surroundings were and that the safety of the baby, rather than my own
    comfort, took absolute precedence in my mind. You will be amazed what
    thoughts run through your head!  I remember distinctly saying to my
    husband that I couldn't understand how any woman could be stupid enough
    to go through labor twice! 
    
    I was stupid enough!

                 
    Wow,  reading through this note brings it all back!  I'd like to
    add my support to the NCT classes.  We chose them because both my
    husband and I could attend.  I attended both NHS and NCT classes.
                 
    I can see an argument that says that a little knowledge is a dangerous
    thing.  It is important to realise that you can only learn a little
    piece of a big picture.  The reason that some midwives don't like the
    NCT is because it makes a couple feel that they can make decisions
    about the labour when the midwife actually knows better.  Midwives
    help deliver babys every day.  They have a wealth of experience       
    and they should be listened to as well.  We attended the classes      
    and listened to it all.  But we used our judgement as to how much     
    we would acually use.  When the time came and the labour started      
    we made the decisions.  When things started to go wrong we handed     
    the decisions over to the experts.  Our sone was born,  after a       
    36 hour labour and many problems,  without a section or forcepts.     
    This was due to the experience of the Consultants and Midwives.
                                                                  
    Attending the NCT classes helped us to understand what was going
    wrong and when the consultant explained things to us we knew what
    he was talking about.  Without that,  I would have been in a much
    worse state to deliver Tom.                                   
                                                                  
    As far as pain releif goes - It never fail to amase me that we get
    a choice!  Where else would you go for a painful "operation" an
    be asked "What type of pain releif would you like?"  "Do you want
    it to hurt a little or a lot?"  You are given the pain releif that
    you need to take the pain away. - However that aside - my experience
    was:                                                          
                                                                  
    I started with a TENS machine.  It's hard to tell if it works or not,
    as I don't know how it would have felt without it.  I could still feel
    the pain.  I don't like pain!  I then went on to an epidural.  I did
    this because I developed pre-eclampsia, I had not slept for two days
    and I just didn't want to go on! 
    
    Before the labour I decided to leave my options open,  but didn't think
    I would go as far as an epidural.  I decided that I wouldn't have
    pethadine as it passes throught the cord to the baby, and Tom was
    taking long enough.  While the epidural was working it was wonderful. I
    didn't like having to lie down all the time,  but it was a small price
    to pay.  What I didn't realise was that the epidural has to be "topped
    up".  I thought that it was no pain at all.  Beware that if it is not
    topped up in time,  the pain comes back.  There is a gap of about 20
    minutes between them topping it up and it starting to work again.  I
    used gas and air between top ups.  Because my midwife was not qualified
    to top it up herself,  I had to wait for her to fine someone who could.
    At one point this took an hour in all. 
                          
    All in all my advice would be to understand what is available,  and keep
    your options open.  I would have let them cut my head off it if
    I thought it would have got Tom here any quicker!  
                                                        
    On the other hand my friend had a baby last week.  It took her
    45 minutes from start to finish,  she felt nothing.  Everyone is
    different.                                         
                                                       
    No matter what happens in the end you have a lovely baby.  Good
    luck,  Angela                                      
                                                       

Re .19

OK, I'm a father and don't have to experience the "real thing" personally
but, I sure have to share in some of its side effects, so I feel qualified
enough to resopnd to this ....

>    I can see an argument that says that a little knowledge is a dangerous
>    thing.  It is important to realise that you can only learn a little
>    piece of a big picture.  The reason that some midwives don't like the
>    NCT is because it makes a couple feel that they can make decisions
>    about the labour when the midwife actually knows better.  Midwives
>    help deliver babys every day.  They have a wealth of experience       
>    and they should be listened to as well.  We attended the classes      
>    and listened to it all.  But we used our judgement as to how much     
>    we would acually use.  When the time came and the labour started      
>    we made the decisions.  When things started to go wrong we handed     
>    the decisions over to the experts.  Our sone was born,  after a       
>    36 hour labour and many problems,  without a section or forcepts.     
>    This was due to the experience of the Consultants and Midwives.

Sorry to take issue with this, but this is a part of the typical Doctor /
patient mystique that has built up in Britain over many many years ... the
professionals are God and know what's best for you, and therefore you should
be kept in the dark and just take what they dish out to you as gospel.

Doctors are still godly here in N. America, but the patient does tend to be 
better informed and therefore better able to get information from their Dr's
and other health care professionals.  Even so, this do what the Doc thinks
best attitude has resulted in typically 20% of all deliveries being done by
Caesarian and so much medical involvement that the preganant mother might as
well be dying of some fatal disease rather than about to give the miracle of
life to a new child ... which for many centuries had gone previously unaided.
Most people you talk to appreciate the availability of the great medical care
that has resulted in the now wonderful mother and infant mortality rates, but
they do not want it thrust upon them unnecessarily as so often seems to
happen.

Don't get me wrong, I believe in the need for medical involvement ... without
the Caesarian, I wouldn't have 3 wonderful kiddies.  But a Caesarian is MAJOR
surgery and no-one should go through it without knowing the need etc and that
is what childbirth classes and open honest and intelligent conversations with
your Doctor / midwife *before* the event can provide.

Stuart

    Re.  21                                            
                                                                  
    I guess I didn't make my point very well.  I'll try again.  
                                                       
    I thought I said that - it was due to the experience of the consultants
    that I did NOT have a c. section.  If it had been left up to me I would
    have agreed to have one hours before Tom was actually born.  
                                                       
    After 36 hours of heavy labour and many problems with myself and the
    baby I would have agreed to anything to get the baby out safely and
    quickly. His heart beat was slowing dowm,  he had blood taken to see
    how distressed he was,  murconium (spell?) was passed  at least an hour
    before,  he was facing the wrong way,  he was a very big baby (9lb 10oz
    - first child). All these were things,  taught in class as signs of
    danger for the child.  If it wasn't for the experience of the
    Consultant I would have made the wrong decision. Everyone was ready to
    operate if necessary but the Consultant saw it as a last resort,  at
    that time I saw it as the easy/safe way out. In the end I delivered by
    myself.                                                   
                                                              
    This is just my experience,  my opinion.  I was glad I had attended
    the classes as they helped me understand what was happening.  I
    was just trying to point out why the "professionals" don't always
    recommend them.  I certainly don't think that they should control
    the whole process - that's up to the parents.  The more you know
    the better,  was my atitude.  But when things go wrong that's when
    I felt the need for their experience.                     
                                                              
    Angela                               
                                         
                

Ahhhh

I read it the wrong way around .....

But it seems to be the way Doctors seem to want to work ... granted that the
general trend is getting better in that the Doctors are providing us with
considerably more knowledge than they ever used to, but there are still too
many who say "I'm the boss and the less you the patient knows about what I'm
up to the better" ... 

Stuart

    Re .23 last comment about the doctors knowing it all and keeping the
    patient "dumb".
    
    I do agree it happens but any patient that lets it happen is DUMB.
    There is a wealth of information available either through books,
    classes or other people that we all have access to (some countries more
    then others I am quickly finding out). Too many people do believe that
    doctors are "gods" but we all know to many of these "gods" falter. Look
    at the malpractice rate, especially in OB. I think there is a definite
    difference between the way a doctor treats you and the way you are
    treated by childbirth educators. The doctor wants to make sure you are
    healthy and everything is progressing well. Most have a list of do's
    and don'ts that they like you to follow and many are afraid to take a
    stand one way or another and leave things up to your discretion (like
    the usage of nutasweet, alcohol, smoking, amount of exercise, etc). The
    childbirth educator gives you information about childbirth and that
    experience. 
    
    My doctor provides me with a book about pregnancy and childbirth. It is
    general information and not extremely detailed. They do expect the
    mother to educate herself. I'd like to know how many mothers-to-do have
    heard comments like your 50% effaced and walked out of the office not
    knowing what it really meant and being intimidated enough to ask. 
    
    There is a balance between the information you will get from your
    doctor and what you need to learn for yourself. It is finding that
    balance that makes the pregnancy and delivery more understandable and
    less frightening. My doctors office has nurse practitioners who are
    there to answer those questions that you feel are "beneath" the doctor
    and might feel funny asking. They take calls all day long (or will get
    back to you asap). My docotr's office will recommend a list of
    childbirth educators who they feel fit into their practice. Mine was
    EXCELLENT!!!! 
    
    Sorry to ramble. You do need to educate yourself beyond the level of
    information the doctors give you but many people still trust so much in
    the stigma of "being a doctor" that they don't. They assume the doctor
    knows it all (maybe textbook wise) but only very special doctors can
    take the time to answer and educate you on every aspect of a pending
    childbirth experience. Thank god for books, other people and childbirth
    educators who helped me round-out my first experience. The same books,
    people and educator is helping my understand changes with my second
    pregnancy!!!
    
    Andrea                        

    re: .24 
    "any patient that lets it happen is"...uninformed  (we try not
    to use the word DUMB :-)).
    
    I have a minor nit...I don't think that the high malpractice rate is
    necessarily a sign of poor medicine.  I'd guess it is strongly 
    influenced by our lawsuit-happy society.
    
    Carol

    re .25
    
    I tend to agree ... we do expect Doctors to practice an inexact science
    perfectly ...  and hence have a propensity to blame the Doctor for
    things that are often out ouf his/her control.  In a lawsuit happy
    society this translates into lots of malpractice suits.
    
    re several
    
    While saying that patients who let Doctors keep them in the dark is
    dumb, you must remember that in some countries, Britain included,
    until just a very few years ago, this was COMPLETELY normal and
    accepted, so you definitely cannot blame the patient.  You also
    have to realise that in Britain you don't have the same freedom of
    choice in selecting a Doctor as you do in the US, so if you don't
    like your Doctor's ability / manner / whatever, you may or may not
    find a replacement
    
    Stuart

    re .24 & others
    
    This topic certainly took a detour into a subject near and dear to my
    heart today.  First the background - My doctor is British and trained
    over there and is not young.  Second, I'm 20 weeks pregnant and a high
    risk pregnancy.  Third, this is day 27 on bed-rest with no end in
    sight.
    
    I got a 2nd opinion over the phone this week from a previous OB.  Then
    my mother-in-law got a 3rd opinion over the phone from another OB.  I
    then called my doctor's nurse and let her know that I was not
    comfortable with the amount of information that the DR was providing
    me.  I also told her of the other opinions but that I knew he
    was one of the best and was happy with him.  Tomorrow I have an appt.
    to confront my arrogant doctor and get more information.  I came with
    a list of questions to my last appointment but he evaded most of them. 
    Last time after I asked so many questions the doctor was curious as to
    what my career was.  He wasn't pleased that I had read so many
    pregnancy books.  He made a humorous comment that if the doctors that
    wrote the books knew what they were doing they would have busy
    practices like him and wouldn't have time to write books.  I found that
    unusual because my doctor also teaches at GW in DC.  I hope to leave
    his office with answers tomorrow and a referral to a perinatologist
    (high risk pregnancy DR).
    
    FYI - my risk is that I'm leaking amniotic fluid.  This is an unusual
    condition and so far have not found it mentioned in any pregnancy
    books.
    
    Sandy

I wouldn't say your doctor is being arrogant per se, but he is certainly
behaving hte way he was taught ... "the patient does not need to worry
about the details ... that's what I'm here for " It made perfect sense
once upon a time ... but not any more.

Just tell your Doctor that you do like to be well informed and if he won't
provide you with information then you'll only get it from the books he
doesn't like and may as a result get the wrong message!

Good luck ... doctors like this are never easy to deal with.

Stuart

    Sandy, This much be very upsetting for you but you sound like you
    have the right attitude. I think that the doctor is hoping that the
    amniotic sack heals itself and stops leaking. I hope that you
    are seeing a Perinatalogist.
    
    Hang in there, Jan

    re: .28
    
    A schoolmate of mine had this condition during her pregnancy years
    ago; I don't remember what caused it but I do know that after
    something like 17 weeks in bed she delivered a normal baby girl
    who is now a star in her high school swim team.
    
    --bonnie

    re: 29
    Jan - I went to the doctor yesterday hoping that he would refer me to a
    perinatalogist.  I left thankful that I wasn't going to a doctor that
    would turn me over to a perinatalogist.  The first thing the
    perinatalogist in No. VA would do is a test with a high risk of
    miscarriage.  The 2nd opinion I got last week from an ob/gyn said that
    he always recommends terminating the pregnancy.  My doctor believes
    that God should handle this one and we shouldn't do extra tests which
    could cause infection or labor.  I am going to one of the best ob/gyns
    in the area and I will follow his advice and hope that my baby is born
    healthy.  After all, a 50% chance isn't so bad.  Thanks for your
    concern!
    
    re: 30
    Bonnie - thanks for the success story.  This is such an unsual
    condition that it is hard to hear any stories on the subject. 
    Pregnancy books don't even mention it.

    Hello all!  I have searched up and down in this conference, and find it
    hard to believe that this hasn't been discussed.
    
    My first baby was 9lbs. 10 1/2 oz, and needless to say, after 24 hours
    of labor, and endless pushing . . . I like many others had a
    C-sections.  I had very little medication, and had back-labor, and no
    rest stage to my labor . . . WHAT A TRIP!  
    
    I know this is whimpy, but this time, I do not want to go through all
    of this again only to have a C-section.
    
    Now to the all important question.  My doctor is suggesting epidural,
    and with the way that everyone does Lamaze, natural birth, etc., I
    cannot find anyone that has had an epidural.  I trust my doctor, but I
    really want some advise from WOMEN who have gone through it, not the
    man that stood there and said PUSH!
    
    4/5ths of the way toward baby #2!
    
    Jolene

    
    #1 13 hours back labor with pitocin - no painkillers - UGH!
    
    #2 6 hours normal labor with epidural - they gave me the epidural
       at 5 centimeters dialation, the baby was born 45 minutes later.
       I couldn't really push until the epi wore off some.  Recovery
       was several orders of magnitude easier.
    
    Rochelle

    Hi Jolene,
    
    I have to admit that I too was a wimp with my second.  I asked for any
    drugs they would give me.  I really had my mind set that I would not
    take anything but after 6 hrs of increasing pain, back to back
    contractions and no dialation past 6 centimeters I asked for an epidural.
    My doctor didn't see a problem with this but the anesthesiologist did
    not like to give epidurals to women who have had a previous C-section
    because of the remote chance of uterine rupture.  Obviously, if an
    anestised mother's uterus ruptured she would not feel it and the
    doctors would not be able to diagnose it immediately.  My doctor's 
    arguement to the anesthesiologist was that I was on a monitor and they
    would immediately notice the baby's heart rate drop and secondly in the 
    remote chance it did rupture I would already be anestised for surgery.
    
    If I were to have another child I would try (the keyword is TRY) not to 
    have another epidural because even though it gave me a much needed break 
    from the pain it slowed down the baby's heart rate because you have to 
    lie flat and also it inteferred with my pushing ability.  Once it wore 
    off I was able to effectively push the baby out after 20 minutes.
    
    One nice thing my doctor told me was not to be upset if you do take
    drugs when you didn't want to because everyone's tolerance is different
    as well as each delivery is different. It made me feel better instead
    of a wimp because many of my girlfriends went without any intervention.
    
    Angie
    
      
    
      

    I went into labor all gungo-ho on "no drugs" and "no epidural". My
    contractions were bad, I had back labor and my cervix would not dilate.
    So I was induced with pitocin to get the cervix to dilate. So that made
    the contractions worse.I walked as much as I could and sat in the
    jacuzzi to relieve the back pain. This started at about 8:30am. I went
    into the hospital at 11am and stayed there since it was not that busy
    and they could spare the birthing room for me. At about 3am the next
    morning, my OB took one look at me and told me that I looked too tired
    to keep going like this - so he recommended epidural. I finally agreed
    since I *was* tired and could do with 40 winks. After I got the
    epidural I would relax until it was time to push - about 9:30am. They
    did not take the epidural off and the nurse just told me when a
    contraction was coming and I pushed. Avanti was born at 10:05am. 
    
    This time (I am 31 weeks pregnant) I am going with an open mind about
    epidural since it did help me a lot. Of course, there was a window in
    my thigh that the epidural did not take and I could feel (Boy I could
    feel) each contraction in my thigh. I think I am not going to ask for
    any drugs - only epidural.
    
    Shaila

    I thought an epidural would be the answer to all my problems... but
    it only created more. You see, it didn't work. So half my body was
    dead and the other half felt the pain more acutely than if I had not
    had one. Also, it stopped my labor cold so I had to be induced.
    
    I was pretty upset. Next time, I'm not going to even try. I'm just
    going to grit my teeth and get it over with! Having an epidural just
    dragged the delivery out and created more problems than I could have
    ever anticipated.
    
    

    Appologies beforehand.  This is a bit long.
    
    I had an epidural when I was 5-6 cm. My contractions were the worst
    pain I had ever had and I was on the ceiling with each of them. I
    think epidurals in the UK are administered differently than the US.
    Mine took away the pain but I could still feel the pressure so I had to
    continue with the breathing techniques but it was much easier.  Also,
    once the epidural had taken effect, I was allowed to lay on one side or
    the other as it suited me or even sit up if I wanted. I just couldn't
    get out of bed.  I ended up having a C-section because our son was an
    undiagnosed breech.  For the surgery, my epidural was topped up to the 
    point that I felt nothing from the boobs to the toes and Iain was born 
    at 10:47 on a Sunday morning after 9hrs labour. He weighed in at 7'10" 
    and was 21" long.
    
    
    My decision to have an epidural was based on the 2 years I spent as a
    Labour and Delivery nurse in the US. It is very strange to know
    everything there is to know about labour and delivery of babies without
    ever having had the experience myself, and then being on the other side
    of the fence and actually *doing* it.
    
    We used to have about 200 deliveries a month (our C-section rate was
    about 12%) and I had seen many women deliver babies without epidurals
    and many with. It was rare in the extreme for an epidural not to work
    or to be partially effective. The worst problem we had was the mother's
    blood pressure bottoming out after the epidural took effect, which is
    why you always have to have an IV with an epidural.  
    
    All of the OBs that worked at our hospital had standing orders for 
    epidurals if the mothers wanted them.  They all insisted that the cervix 
    be at least 4 cm dilated before they have the epidural.  In my experience 
    those who insisted on an epidural earlier had their labour completely shut 
    dowm or become ineffective and then had to be augmented with Pitocin and
    have a monitor and the whole 9 yards of intervention.  
    
    There were also many times that mothers would be "stuck" at 6 or 7 cm and 
    would have an epidural then move within minutes to 9 or 10 and be ready to 
    push. I had also seen many deliveries where the mother was in agony and the
    father was so upset because he felt helpless.  I suggested an epidural
    and within an hour the situation was completely different. Mom was more
    relaxed, Dad was happier and they both enjoyed the birth of their
    child.
    
    caution: very strong opinion to follow!
    
    
    I would like to say that anyone who chooses to have pain relief during
    labour is most certainly NOT a wimp or a failure.  THIS IS COMPLETE AND
    UTTER RUBBISH! I think these words should not be used even in jest. 
    Those whose delivery is emminent and especially those who have just
    delivered are VERY sensitive and even the slightest negative comment 
    can reduce them to tears and deflate their confidence even further. I
    would never be anything but encouraging and positive to new mothers.
    
    Everyone is different and everyone has a different pain threshold and a 
    different labour.  I blame all these "natural" childbirth proponents for 
    puting this stress and guilt on mothers who choose to have pain relief. 
    (If I ever meet Sheila Kitzinger I shall not be responsible for my 
    actions!) Birth with minimal intervention is of course very desirable. 
    This does not mean that those who must have intervention of some kind are 
    failures or wimps!  After all, the only real goal is a live and healthy 
    baby and the end of it all!
    
    Good Luck to everyone.  Do what is right for YOU!
                
    LaDonna

    I think I agree with LaDonna about the epidural not being a refuge
    for weak women. Its a help. It is my experience that most of the women
    I know that did not have an epidural are those who were to near to 
    delivery to have one; i.e. the idea of an epidural is considered quite
    normal. I myself held the opinion that if and when I would need one,
    I would have one.
    
    As it turned out I ended up having one about 27 hours into the
    irregular labour I was having, about an hour after they broke my water.
    It helped some, but I found that although I was numb from the ribs to
    the pubic hairline, everything below that was still in living colour -
    during the actual delivery I could push well enough but the nurse had
    to tell me when I was having a contraction by keeping her hand on my
    belly.
    
    Monica

Several people mentioned books that had helped them through their
labors.  I just picked something up a the library called "Easing
Labor Pain" by Adrienne Lieberman (the authors name may be slightly
off).  Anyways I found it to be very good so far.  It discusses
most of the options mentioned in previous notes.  It also explains
things like whats going on during a contraction and how your body
is working to get the baby out.

It also talks about relaxation techniques.  I'm a big believer in
relaxation techniques since I've been using them for the last year
to manage back pain.  I think being relaxed and working with your 
body can go a long way towards keeping a positive attitude during
labor.  Of course this won't be put to the test until I actually
go into labor, currently planned for sometime around May 3.

After taking the Lamaze classes and reading a lot I feel like I'll 
be able to handle this (not that I have much choice at this point).  
I used to be really scared at the idea of having an epidural or
C-section, but now I just look at them as options I have depending
on how the labor goes.

I do have my moments when I get nervous about what is going to happen.  
But being educated about all this is the best thing I can do.

Wish me luck (and a short labor !)

Denise

    
    I had the normal fear of pain at the back of my mind
    all through the pregnancy.  I was about 32 weeks pregnant and not 
    terribly uncomfortable when we started the childbirth classes.  
    I remember coming out of the class and telling my husband "I think I
    can handle this belly for the rest of my life -- I don't want to go
    thro' with this delivery business" :-)
    
    By the 40th week, I couldn't wait to get on with the delivery 
    and get it out of the way - pain or more pain !!!
    
    Pam