You know this evening, I was thinking how wonderful and varied my work is. In fact, I do not call it work, I actually call it a privilege. To be the midwife chosen to share and participate in the care of the woman and her family makes it very special.
I can be on the road going from house to house doing antenatal checks and meeting the family one minute and then rushing off to delivery suite to birth a baby the next. Then, if it is still early in the day, maybe do some more antenatal or postnatal checks on mums and babies.
I consider myself very lucky and I am humbled at the amazing inner strength of women as I share their journey with them as they go through their pregnancy, birth and grow into motherhood.
The lifestyle can be unpredictable, in the sense that I can be anywhere at any given time, that said, I would not change that for the world. Thank you for allowing me to share your journey.
Tuesday, March 22, 2011
Friday, March 18, 2011
Partners in the birthing room
I am going to talk about men. Not men in the general sense but those who are planning to be present at the birth of their baby. Usually sometime after the birth, I chat to the men to see how they got on when their partners were in labour and their thoughts and feelings on the process.
To give a sense of history, men have only been invited into the delivery room for the last 35 years. Before then, when woman went to hospital to birth the baby, traditionally the men would have been sent home and told to come back the following day, or they were sent to waiting room where they would either chain smoke or pace the corridor until they were told the baby had been born.
The results of a study carried out by Bedford & Johnson (1988), found that, father's perceived their presence and role in the birthing room as one of guidance, comforting and protection from an alien enviroment. However, recent research suggest that fathers felt they were excluded from the decision making and were left feeling isolated and frightened (Harvey, 2010).
The main concern that came from the discussions were that men perceived themselves as not being able to do anything for their partner, particularly the pain. To put this into perspective, pain is subjective and it means different things to different people. That said, the pain in labour that your partner will experience is completely normal, in fact, I call it 'Good Pain,' because it lets us know that the woman is in labour and her body is working hard for the baby to be born. The pain of labour also helps her body to release endorphins which are its own powerful morphinelike painkiller.
There are many things that you can do to help your woman in labour. You can be there to hold her hand, tell her you love her, massage her back, tell her you are proud of her, wipe her brow, support her through the pain by telling her how wonderful she is. Help her to remember to drink water between contractions, to breathe through the contractions, to connect with her baby. You can be there to guard the doorway to prevent over excited relatives turning up unannounced and interupting the flow of her labour (unless she has invited them). The Midwife will be there as advocate and support you both, she will explain everything fully so both of you are able to make informed decisions.
While searching for a link for new fathers, I came across an article where a top obstetrician suggests that men should never be at the birth of their child. Michel Odent, who I have quoted before (see Oxytocin the love hormone) in my blog, suggests that, "his presence is a hindrance and a significant factor why labours are longer, more painful and more likely to end in intervention."
Makes interesting reading, here is the link to the article.
http://www.dailymail.co.uk/femail/article-559913/A-obstetrician-men-NEVER-birth-chttp://fatherandchild.org.nz/hild.html
For fathers and their children
http://fatherandchild.org.nz/
Bedford, V.A., Johnson, N., (1988). The role of the father. Midwifery. 4 (4). 190-195.
Harvey, M., (2010). More support needed for new fathers in the delivery room.
http://www.bcu.ac.uk/news-events/news/more-support-needed-for-new-fathers-in-the-delivery-room
To give a sense of history, men have only been invited into the delivery room for the last 35 years. Before then, when woman went to hospital to birth the baby, traditionally the men would have been sent home and told to come back the following day, or they were sent to waiting room where they would either chain smoke or pace the corridor until they were told the baby had been born.
The results of a study carried out by Bedford & Johnson (1988), found that, father's perceived their presence and role in the birthing room as one of guidance, comforting and protection from an alien enviroment. However, recent research suggest that fathers felt they were excluded from the decision making and were left feeling isolated and frightened (Harvey, 2010).
The main concern that came from the discussions were that men perceived themselves as not being able to do anything for their partner, particularly the pain. To put this into perspective, pain is subjective and it means different things to different people. That said, the pain in labour that your partner will experience is completely normal, in fact, I call it 'Good Pain,' because it lets us know that the woman is in labour and her body is working hard for the baby to be born. The pain of labour also helps her body to release endorphins which are its own powerful morphinelike painkiller.
There are many things that you can do to help your woman in labour. You can be there to hold her hand, tell her you love her, massage her back, tell her you are proud of her, wipe her brow, support her through the pain by telling her how wonderful she is. Help her to remember to drink water between contractions, to breathe through the contractions, to connect with her baby. You can be there to guard the doorway to prevent over excited relatives turning up unannounced and interupting the flow of her labour (unless she has invited them). The Midwife will be there as advocate and support you both, she will explain everything fully so both of you are able to make informed decisions.
While searching for a link for new fathers, I came across an article where a top obstetrician suggests that men should never be at the birth of their child. Michel Odent, who I have quoted before (see Oxytocin the love hormone) in my blog, suggests that, "his presence is a hindrance and a significant factor why labours are longer, more painful and more likely to end in intervention."
Makes interesting reading, here is the link to the article.
http://www.dailymail.co.uk/femail/article-559913/A-obstetrician-men-NEVER-birth-chttp://fatherandchild.org.nz/hild.html
For fathers and their children
http://fatherandchild.org.nz/
Bedford, V.A., Johnson, N., (1988). The role of the father. Midwifery. 4 (4). 190-195.
Harvey, M., (2010). More support needed for new fathers in the delivery room.
http://www.bcu.ac.uk/news-events/news/more-support-needed-for-new-fathers-in-the-delivery-room
Sunday, March 6, 2011
Diet in pregnancy
The reason why it is important for you to have a good diet is, not only for you to feel healthy and well during pregnancy, but also for your growing baby.
I thought I would list here the important vitamins and minerals and the food sources where they can be found.
Vitamin A (needed for bone and tissue growth, , healthy skin, eyes and mucous membranes)
Raw carrot, leafy green vegetables such as spinach, pumpkin seeds, parsley, celery, capsecum, cabbage, watercress, tomatoes. Also found in fruit such as mango, papaya, oranges and dried apricots.
Vitamin B (For development of the nervous system and brain)
Also known as the complex vitamin and is found in leafly green vegetables, meat, yeast extract, egg yolk, fish, sweet potatoes, tomatoes, beansprouts, avocados, banana, nuts, mushrooms, currants and wholegrains.
Vitamin C (For the immune system, tissue formation and helps with iron absorbtion and is depleted by smoking)
Found in red pepper, leafy freen vegetables, tomatoes, parsley, kiwi fruit, cherries, broccoli, papaya, strawberries, citrus fruit and melon.
Vitamin D (Needed for bones and teeth)
Also called the sunshine vitamin. Spend 20 minutes a day in full spectrum sunlight. Also found in fish liver oil, salmon, egg yolk and butter.
Vitamin E (Needed for circulation, wound healing and tissue growth)
Found in dark green vegetables, broccoli, eggs, whole grain cereals, tomatoes, olive oil, nuts, pumpkin seeds, avocados and wheatgerm oil.
Vitamin K (Required for normal blood clotting)
Found in leafy green vegetables, kale, turnips, brussel sprouts, broccoli, spring onions, tomatoes, lettuce and asparagus.
Iodine (Thyroid function and energy levels)
Found in seaweed, kelp and iodinised salt.
Zinc (Immune function, nervous and skeletal system)
Found in green vegetables, lentils, almonds, tofu, rice, nuts, pumpkin seeds, whole grain, brewers yeast and oats.
Calcium (Needed for muscle contraction, brain function, involved in blood clotting). Stored in the bones and found in leafy green vegetables, kale, almonds, chick peas, carrots, avocado's, brown rice, sardines and celery.
Iron (Needed to make oxygen carrying proteins and found in red blood cells)
To prevent anaemia, it is found in egg yolk, fish, meat, brewers yeast, kelp, sunflower seeds, pulses,lentils, oats and seaweed.
A friends sister used to make a wonderful nutritious energy drink for our labouring ladies and consisted of delicious lemon and honey, both of which are easily absorbed by the body.
Thank you to Nicole who loaned me, "The Birthkeepers" by Veronika Sophia Robinson. A wonderful book that helps us, as midwives, women, and mothers to remember our roots and to protect and reclaim the ancient tradition of birthing. I have to say that I loved it and it totally resonated with me.
Donley, J., (2003). Compendium for a healthy pregnancy and a normal birth. Auckland.
Robinson, V.S., (2008). The Birthkeepers:reclaiming an ancient tradition. Starflower Press.
I thought I would list here the important vitamins and minerals and the food sources where they can be found.
Vitamin A (needed for bone and tissue growth, , healthy skin, eyes and mucous membranes)
Raw carrot, leafy green vegetables such as spinach, pumpkin seeds, parsley, celery, capsecum, cabbage, watercress, tomatoes. Also found in fruit such as mango, papaya, oranges and dried apricots.
Vitamin B (For development of the nervous system and brain)
Also known as the complex vitamin and is found in leafly green vegetables, meat, yeast extract, egg yolk, fish, sweet potatoes, tomatoes, beansprouts, avocados, banana, nuts, mushrooms, currants and wholegrains.
Vitamin C (For the immune system, tissue formation and helps with iron absorbtion and is depleted by smoking)
Found in red pepper, leafy freen vegetables, tomatoes, parsley, kiwi fruit, cherries, broccoli, papaya, strawberries, citrus fruit and melon.
Vitamin D (Needed for bones and teeth)
Also called the sunshine vitamin. Spend 20 minutes a day in full spectrum sunlight. Also found in fish liver oil, salmon, egg yolk and butter.
Vitamin E (Needed for circulation, wound healing and tissue growth)
Found in dark green vegetables, broccoli, eggs, whole grain cereals, tomatoes, olive oil, nuts, pumpkin seeds, avocados and wheatgerm oil.
Vitamin K (Required for normal blood clotting)
Found in leafy green vegetables, kale, turnips, brussel sprouts, broccoli, spring onions, tomatoes, lettuce and asparagus.
Iodine (Thyroid function and energy levels)
Found in seaweed, kelp and iodinised salt.
Zinc (Immune function, nervous and skeletal system)
Found in green vegetables, lentils, almonds, tofu, rice, nuts, pumpkin seeds, whole grain, brewers yeast and oats.
Calcium (Needed for muscle contraction, brain function, involved in blood clotting). Stored in the bones and found in leafy green vegetables, kale, almonds, chick peas, carrots, avocado's, brown rice, sardines and celery.
Iron (Needed to make oxygen carrying proteins and found in red blood cells)
To prevent anaemia, it is found in egg yolk, fish, meat, brewers yeast, kelp, sunflower seeds, pulses,lentils, oats and seaweed.
A friends sister used to make a wonderful nutritious energy drink for our labouring ladies and consisted of delicious lemon and honey, both of which are easily absorbed by the body.
Thank you to Nicole who loaned me, "The Birthkeepers" by Veronika Sophia Robinson. A wonderful book that helps us, as midwives, women, and mothers to remember our roots and to protect and reclaim the ancient tradition of birthing. I have to say that I loved it and it totally resonated with me.
Donley, J., (2003). Compendium for a healthy pregnancy and a normal birth. Auckland.
Robinson, V.S., (2008). The Birthkeepers:reclaiming an ancient tradition. Starflower Press.
Monday, February 28, 2011
History of Midwifery - Why women died in childbirth
The history of midwifery has always fascinated me and especially those heroes and heroines who have tried to advance the profession of obstetrics and midwifery.
I am going to start with one hero in particular, Ignaz Semmelweis, a Hungarian physician working in Vienna. It was Semmelweis, who in 1847 investigated the cause of puerperal sepsis or childbed fever among women attending the lying-in hospital. He found that there was an increased death rate amongst women during childbirth who were attended by Doctors rather than midwives, who worked in another ward. After conducting his own research, Semmelweis found that the cause of the sepsis was because physicians were not washing their hands between carrying out post-mortems and then attending women in childbirth. Midwives did not attend postmortems so they were not to blame. Semmelweis insisted that physicians attending his ward washed their hands with a chlorinated lime solution and, with this procedure enforced, he found that the death rate dropped considerably.
However, the medical fraternity dismissed Semmelweis' theory and refused to accept the blame for causing so much death. As the germ theory had not yet been developed unfortunately the deaths continued, although Semmelweis continued to persue his theory, he was vilified from every corner of the medical profession and eventually suffered a nervous breakdown. One comment made by an outraged physician to Semmelweis' theory was "A Doctor is a gentleman and a gentleman's hands are clean." That would be funny if it were not so tragic, Semmelweis was committed to an insane asylum where he died in 1865.
By the end of the 19th century, the need for obstetric and midwifery hygiene and cleanliness was accepted by the medical profession. The developement of antiseptic and discovery of antibiotics have greatly reduced the maternal mortality rate.
Further reading:
Pairman, S., Pincombe, J., Thorogood, C., Tracy, S. (2006). Midwifery preparation for
practice. Elsevier:Australia.
http://en.wikipedia.org/wiki/Puerperal_fever
I am going to start with one hero in particular, Ignaz Semmelweis, a Hungarian physician working in Vienna. It was Semmelweis, who in 1847 investigated the cause of puerperal sepsis or childbed fever among women attending the lying-in hospital. He found that there was an increased death rate amongst women during childbirth who were attended by Doctors rather than midwives, who worked in another ward. After conducting his own research, Semmelweis found that the cause of the sepsis was because physicians were not washing their hands between carrying out post-mortems and then attending women in childbirth. Midwives did not attend postmortems so they were not to blame. Semmelweis insisted that physicians attending his ward washed their hands with a chlorinated lime solution and, with this procedure enforced, he found that the death rate dropped considerably.
However, the medical fraternity dismissed Semmelweis' theory and refused to accept the blame for causing so much death. As the germ theory had not yet been developed unfortunately the deaths continued, although Semmelweis continued to persue his theory, he was vilified from every corner of the medical profession and eventually suffered a nervous breakdown. One comment made by an outraged physician to Semmelweis' theory was "A Doctor is a gentleman and a gentleman's hands are clean." That would be funny if it were not so tragic, Semmelweis was committed to an insane asylum where he died in 1865.
By the end of the 19th century, the need for obstetric and midwifery hygiene and cleanliness was accepted by the medical profession. The developement of antiseptic and discovery of antibiotics have greatly reduced the maternal mortality rate.
Further reading:
Pairman, S., Pincombe, J., Thorogood, C., Tracy, S. (2006). Midwifery preparation for
practice. Elsevier:Australia.
http://en.wikipedia.org/wiki/Puerperal_fever
Thursday, February 24, 2011
Monday, February 21, 2011
My first waterbirth
In 1992 when I was a newly qualified midwife and just got my wings and gleaming new gold and blue Queen Charlotte’s medal to prove that I was now well and truly a midwife. Waterbirths had begun to get notice in the press, not yet at the height of popularity but certainly being brought to the attention of women as an alternative option to birthing rather than the hospital delivery bed. A woman and her partner had come to delivery suite with their birth plan and asked for a waterbirth. The ‘old hand’ midwives on delivery suite who’s wisdom in years between them was phenomenal, however viewed waterbirths with somewhat suspicion, thinking it a ‘new age’ idea that would wear off.
This labouring woman wanted her waterbith and was shown to the pool room. However the midwives who were on duty had never dealt with them and were somewhat reluctant to participate or even understand why any woman could possibly want to birth in water. Dolphins, fish and octopus are some of the words that spring to mind when I recall sitting amongst their discussion as to why women should birth on land and not in the water. The midwives suddenly turned and looked at me and said “Marie, you're newly qualified, you know all this stuff, you can birth her.” I smiled sweetly at them and said "of course" through my tightly gritted teeth. As much as I read a lot of information on waterbirths and understood the theory behind it, I had never actually birthed a baby in water. I left the pool filling while the excited but nervous parents waited patiently as I ran to where the text books were kept and pulled out the booklet on waterbirths. I can tell you that I absorbed as much information as I could in the 20 minutes it took for the pool to fill and returned to the smiling parents with, as much of an air of serenity and calmness as I could muster. Inside, my heart was beating like a drum, "you can do this Marie."
Full of confidence and hope and with my head full of wondrous knowledge, I returned to the lady who by now had got into the pool. The list I had memorised from the book, continually churned in my mind :
- · Temperature must be checked every half an hour
- · Check temperature of the woman at the same time
- · Make sure the woman drinks lots of water due to the sauna effect
- Hands off and let the baby come out into the water, Hands off, Hands off, Hands off AND REMEMBER hands off.
With those points in mind and butterflies in my tummy, I made sure that I followed the rules. Every time I thought I should be doing something to the woman (as surely as any good midwife should), I left the room for a few moments to make the partner a drink or pretend to go to the loo, or if I ran out of excuses to leave the room, I sat on my hands, reciting the mantra I had learned, "hands off, hands off." Just a little about task orientation, as nurses we tend to be task orientated to a certain extent, well we were back then where I trained in England and felt that if we are not doing anything to the client we are neglecting in our duties.
Several hours later a little baby girl was born in the water, much to the joy of two very ecstatic parents and I have to say an overjoyed but relieved midwife who, I hasten to add, has never looked back since. I learned so much from that particular couple (thank you guys) who didn’t even realise it was my first (of many) waterbirths. I also learned that midwifery is not theory alone and using four of our five senses, but our wonderful intuition and having faith in a woman and her ability to birth her baby.
Thursday, February 17, 2011
Pain Relief in labour
Clients are often scared when it comes to pain in labour, and it is fear of the unknown for those of you expecting your first baby or, even a subsequent baby if the first time around was not a good experience for you.
I am not not going to lie to you, labour is painful but it is not pain that harms you in any way, in fact, it actually tells us your body and you are going through a completely normal physiological process.
In early labour there are things you can do for yourself to help with the pain. Rest and sleep in the early stages is important, to save your energy for later when the hard work begins. You can also soak in the bath or sit on a plastic chair in the shower and let the warm water flow on your back (especially good for backache).
In established labour
Walking around (being upright) helps gravity bring your baby's head down on your cervix (neck of the womb) to assist in dilatation.
When you are in pain and provided you have had no pharmaceutical analgesia, your body will produce its own 'opiates' which are very similar to morphine but not as strong and act as a natural analgesia or pain killer. The endorphins act on the sensory nerves that carries pain messages to the brain and prevents some of those messages being sent. For those who have been privileged enough to be with a labouring woman, you will notice a change in her as she goes into her 'own space' as she goes between being awake and asleep. Michel Odent, a French obstetrician suggests that these endorphins pass from mother to baby, providing 'pain relief' for the baby.
Gas and air or entonox
A combination of nitrous oxide and oxygen. The labouring woman inhales the gas through a mouth piece at the start of a contraction alll the way through until the contraction finishes. If the apparatus is used correctly it can provide good pain relief although, the effects of gas and air are short lasting as the woman exhales the gas from her lungs when the contraction has finished. Side effects are that, for some women it can make them feel nauseous.
Pethidine
Is a synthetic narcotic drug similar to morphine that is injected in to a vein or buttock during the first stage of labour. It can take 15-20 minutes to take effect and because it can make the woman feel sleepy and crosses the placental barriet, it can make baby sleepy too, so for this reason it is not given within 2-4 hours of birth. Pethidine does not take the pain away, it sedates the woman to enable her sleep between contractions.
Side effects that it can make women feel sleepy, 'out of it' or 'high.' which some woman like and some do not, although until you actually have the drug, it is difficult to say how it will affect you. It can make the woman feel nauseous or even vomit, in which case your midwife can give you something to reduce or stop this. If the pethidine is given near the time your baby is born it can make your baby is sleepy and slow to breathe at birth, the midwife may have to give an antidote called narcan to your baby to reverse the effects of pethidine.
It can take a few days before the pethidine is eliminated from your baby's body so your baby's may be quite sleepy and slow to suck at the breast.
Epidural
The anaesthetist sites the epidural which is an injection of local anaesthetic into the epidural space around the spinal cord. Because there is a complete loss of sensation from the waist down, means that you will be confined to the bed. Advantages are that it is a good form of pain relief although there are rare instances where the epidural block may not work or may partially work, in which case your midwife will contact the anaesthetist to come and check the epidural.
An intravenous drip with be sited in your hand or arm so fluids can be given to you through a vein - this is done as a precaution in case your blood pressure drops following the epidural. You will be continuously monitored on a cardiotocograph, a machine that monitors your contractions and your baby's heart rate. With your consent, a urinary catheter (tube into your bladder) will be inserted because you will not be able to feel the sensation of wanting to pass urine.
The disadvantages with epidurals are that, they can slow down your contractions so a hormone (oxytocin) drip may be needed to speed up your contractions again. On rare occasions the dura or cover of the spinal cord may be punctured and cause leaking of spinal fluid and you develop headaches. If this happens, there is a remedy and the midwife will ask the anaesthetist to see you. An epidural relaxes the muscles of your pelvic floor and may lead to an instrumental (forceps or ventouse) delivery or even a caesarean section. There can be some tenderness over the epidural site for some days following the birth of your baby.
Please chat with your midwife about the benefits and disadvantages of the types of pain relief and options available to you.
Here are some links :
Endorphins
http://primaljourneys.blogspot.com/2009/10/hormones-of-primal-birthing-endorphins.html
Pain relief in labour
http://www.kiwifamilies.co.nz/Topics/Birth/Pain+Relief+in+Labour.html
I am not not going to lie to you, labour is painful but it is not pain that harms you in any way, in fact, it actually tells us your body and you are going through a completely normal physiological process.
In early labour there are things you can do for yourself to help with the pain. Rest and sleep in the early stages is important, to save your energy for later when the hard work begins. You can also soak in the bath or sit on a plastic chair in the shower and let the warm water flow on your back (especially good for backache).
In established labour
Walking around (being upright) helps gravity bring your baby's head down on your cervix (neck of the womb) to assist in dilatation.
- You can get into the warm bath water (see my blog on Waterbirths to see how this helps with pain relief).
- Having your support person massage your back can help to take that pressure off your back and help with pain.
- Warm packs applied to your abdomen or back can help with the pain, a lot of women find a warm pack very helpful for backache in labour.
When you are in pain and provided you have had no pharmaceutical analgesia, your body will produce its own 'opiates' which are very similar to morphine but not as strong and act as a natural analgesia or pain killer. The endorphins act on the sensory nerves that carries pain messages to the brain and prevents some of those messages being sent. For those who have been privileged enough to be with a labouring woman, you will notice a change in her as she goes into her 'own space' as she goes between being awake and asleep. Michel Odent, a French obstetrician suggests that these endorphins pass from mother to baby, providing 'pain relief' for the baby.
Gas and air or entonox
A combination of nitrous oxide and oxygen. The labouring woman inhales the gas through a mouth piece at the start of a contraction alll the way through until the contraction finishes. If the apparatus is used correctly it can provide good pain relief although, the effects of gas and air are short lasting as the woman exhales the gas from her lungs when the contraction has finished. Side effects are that, for some women it can make them feel nauseous.
Pethidine
Is a synthetic narcotic drug similar to morphine that is injected in to a vein or buttock during the first stage of labour. It can take 15-20 minutes to take effect and because it can make the woman feel sleepy and crosses the placental barriet, it can make baby sleepy too, so for this reason it is not given within 2-4 hours of birth. Pethidine does not take the pain away, it sedates the woman to enable her sleep between contractions.
Side effects that it can make women feel sleepy, 'out of it' or 'high.' which some woman like and some do not, although until you actually have the drug, it is difficult to say how it will affect you. It can make the woman feel nauseous or even vomit, in which case your midwife can give you something to reduce or stop this. If the pethidine is given near the time your baby is born it can make your baby is sleepy and slow to breathe at birth, the midwife may have to give an antidote called narcan to your baby to reverse the effects of pethidine.
It can take a few days before the pethidine is eliminated from your baby's body so your baby's may be quite sleepy and slow to suck at the breast.
Epidural
The anaesthetist sites the epidural which is an injection of local anaesthetic into the epidural space around the spinal cord. Because there is a complete loss of sensation from the waist down, means that you will be confined to the bed. Advantages are that it is a good form of pain relief although there are rare instances where the epidural block may not work or may partially work, in which case your midwife will contact the anaesthetist to come and check the epidural.
An intravenous drip with be sited in your hand or arm so fluids can be given to you through a vein - this is done as a precaution in case your blood pressure drops following the epidural. You will be continuously monitored on a cardiotocograph, a machine that monitors your contractions and your baby's heart rate. With your consent, a urinary catheter (tube into your bladder) will be inserted because you will not be able to feel the sensation of wanting to pass urine.
The disadvantages with epidurals are that, they can slow down your contractions so a hormone (oxytocin) drip may be needed to speed up your contractions again. On rare occasions the dura or cover of the spinal cord may be punctured and cause leaking of spinal fluid and you develop headaches. If this happens, there is a remedy and the midwife will ask the anaesthetist to see you. An epidural relaxes the muscles of your pelvic floor and may lead to an instrumental (forceps or ventouse) delivery or even a caesarean section. There can be some tenderness over the epidural site for some days following the birth of your baby.
Please chat with your midwife about the benefits and disadvantages of the types of pain relief and options available to you.
Here are some links :
Endorphins
http://primaljourneys.blogspot.com/2009/10/hormones-of-primal-birthing-endorphins.html
Pain relief in labour
http://www.kiwifamilies.co.nz/Topics/Birth/Pain+Relief+in+Labour.html
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