| Postural alterations and pain prevention in pregnancyDuring pregnancy, various changes occur in the pregnant woman's body, and some of these may cause discomfort. Certain attitudes adopted in daily life may avoid or minimize these discomforts. |
To get out of bed, lie on your side, swing your legs out of bed, and use your arms to help you get up. To get into bed, do this in reverse. When sweeping the house or vacuuming or mopping the floor, try to keep your back straight. Do not bend forward. To make this easier, use a broom with a longer handle or crouch down when sweeping under furniture. When washing the dishes, doing the laundry and ironing, use a support for your feet. This could be a brick or a phone book. Support one foot to relieve your back, changing from one foot to the other from time to time. Do the proposed exercises for avoiding or relieving discomfort. If you do them every day, your back and pelvis will become more relaxed, less tense, and you will feel less pain. These exercises can be performed several times a day, and when you do housework, try to do the exercises both before and afterwards.
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| The role of the pelvic floor muscles in pregnancy and childbirthThe pelvic floor comprises a set of muscles that function to support the internal organs. Weakening of these muscles may lead to dysfunction. |
If your pelvic floor muscles are weak, you may experience stress or urinary incontinence. Pregnancy tends to facilitate urinary incontinence, since, as the fetus grows, these muscles are stretched and become weakened. To avoid or ameliorate this problem, there are some exercises that can strengthen these muscles. However, to perform the exercises, you first need to know how to contract these muscles. To do so, pretend you have to urinate and then hold it, just as you would do if you needed to go to the bathroom and there was no bathroom anywhere near you. Try it. Did you notice that these muscles rise a little and that when you relax they go back down? If you did not feel it, try doing the following test at home: when you are urinating, try to stop the flow. If you succeed, this is the movement you need to do. However, be careful: this test should only be performed once, just for you to recognize the movement. The exercises should be performed at another time; never when you are urinating. The instructor teaches the women the pelvic floor muscle exercises.
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| Labor and breathing during the expulsive phaseLabor can be compared to a trip you are going on to fetch your baby. This trip is divided into three parts: the first is long and difficult; the second is short and nice; and the third you often do not even see. |
In the first part of the trip, there are the contractions that make the cervix dilate for the baby to be able to pass through. The cervix must dilate 10 cm to allow the baby to pass through; for this to occur, the contractions become more and more frequent, stronger and longer lasting. The second part of the trip is when the baby is born. You will probably already have been anesthetized and will not feel any pain. Even so, your participation is very important because you are the one who helps the baby be born by pushing. For you to be able to push hard enough, you first need to have all your strength, which means that you need to have saved enough energy for this moment. To find enough strength to push the baby out, breathe in deeply during the contraction and breathe out strongly and slowly, pushing down with your abdomen as if you were defecating. When required, breathe in again without releasing the abdominal contraction. Continue with this breathing as long as the contraction lasts and then rest until the next contraction. Try this a few times. If when the time comes, you do not manage to do this breathing very easily or you need to increase the force of your pushing, breathe in, hold your breath and push down with your abdomen. When breathing in, try not to release the abdominal contraction. The third part of the trip involves the delivery of the placenta but you may not even notice it because you will be with your baby. Are you able to recognize the signs telling you that you are in labor? When you feel 2–3 contractions in 10 minutes, even if they are painless, or if your water breaks, you are in labor. You may notice that your water has broken in one of two ways: the loss of a great quantity of fluid or a small quantity that keeps your underwear constantly damp. If some of these signs occur, you should go to the hospital. Do not stay at home with contractions as you wait for your water to break or vice-versa.
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| Pain relief techniques for labor During labor, the contractions may range from uncomfortable to quite painful. This depends to a great extent on the woman and on how labor occurs. To facilitate self-control, there are some non-pharmacological techniques that help reduce anxiety, tension and pain. |
Breathing: helps you to relax and reduces the pain. Breathe as if you were smelling a flower and then blowing out a candle during the contractions. During strong contractions, sniff the flower, and knock the candle right over. When the contraction is over, rest and breathe normally. Massage: to help relieve the pain and tension. This should be performed in the sacral region (S2-S4) during contractions by the person accompanying the birth. It should be performed using the palm of the hand and in circular movements. Vertical positions: improve the sensation of comfort, relieve pain and facilitate cervical dilation. The options are as follows: standing, seated, walking, on all fours, sitting on the birth ball or squatting. These positions can be used during the first stage of labor and can be associated with other pain relief techniques such as massage, taking a shower, the birth ball and breathing. Shower: helps relaxation, relieves pain and facilitates cervical dilation. The shower should be hot and prolonged – a minimum of 30 minutes, allowing the water to fall on the back or abdomen. Showers can be taken as often as desired, according to the needs and the degree of pain of each woman.
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