What is Pain and how a Doula helps Decrease Pain

How a doula helps decrease pain.

Pain is felt physically, it may be acute and sharp varying to dull and achy. During labor, it is perceived pain will usually be present during uterine contractions. There may also be positions causing extra pressure in different areas of the body that may cause pain.  It is feasible then to minimize pain to just the internal body functions that cannot be relieved simply by an external force. Pain can also be caused by emotional stresses such as fear and anxiety. How a person mentally copes with pain can also vary changing the effects of a physiologic impulse on the body.  An external focus for pain means the person is looking for pain relief to come from a source outside their own mind and body.  An internal focus for pain means the person is finding ways to cope with pain from within your own mind and body.

From the above we can draw the following conclusions about what may be causing or intensifying pain:

  • A body’s physiological actions
  • Positions
  • Emotions
  • An external focus

It can be worthwhile to note for those aiming to have a natural birth there is a difference between pain and suffering. Pain can be worked through; suffering is more of a mental state that can be controlled more with the state of mind of a person.   The reason this is important to note during natural birthing is it makes working through contractions more tolerable if you are not also suffering.

  • Pain – an unpleasant physical sensation that may or may not be associated with suffering 1
  • Suffering – a distressing psychological state 1

So what can be done to deal with pain during child birth? Looking back up at the 4 conclusion that cause pain, we can note 3 of these can be lessened through states of the mind.  The role of a doula is to assist with helping the mother feel her most comfortable and confident.

  • A body’s physiological action; The body during labor does go through changes, the uterus contracts, the cervix opens. These things will happen.  What a doula does is help the mother perceive these happenings as natural, and as surges, discomfort or pressure versus pain.
  • If a body is in pain because there is additional pressure caused by a position, the position is changed. A doula can help recognize what may be the problem and techniques to lessen additional pressure caused from positioning. If back labor is happening because of the position of the baby, a doula will assist to reposition you to help the baby flip and employ techniques directly to your body to relief some of the pressure.
  • If a mother is fearful or anxious, the natural body reaction to these emotions will hinder the body’s ability to produce endorphins which relieve the body from pain. A doula will recognize fear and anxiety and find ways to work with a mother to lessen these emotions and reach a state of calm and relaxation.
  • An external focus will hinder a person from finding strength and drive from within to work through physical discomfort. This can be likened to a child who falls and requires a kiss on the ‘ouchie’ prior to feeling better. Mentally, this child is requiring something external to feel better. While they may have really injured themselves, they will cope internally as soon as they get their kiss.  While it’s not this simple during labor, the idea is similar in that a person can cope internally but are not choosing to recognize that as an option until after they have an external intervention.  A doula helps in both situations.  Should a person be trying to cope with labor internally, visualizations and breathing techniques can be used to assist.  Should a person require external assistance, massage, oils, acupressure and physical movement can be suggested and applied by a doula.

There are multiple tools in a doula’s practice.  She will read her client and find ways to bring her to a state of comfort and calm.  All of a ladies needs are to be assessed and met by a doula and the birthing team. A doula will look for physiological needs, safety needs, emotional needs, social needs, and esteem opportunities.  A doula has many techniques, some of which she may be familiar with using are listed below:

  • Acupressure
  • Compress application
  • Communication, information given and teaching techniques
  • Making the ideal environment
  • Hydrotherapy
  • Hypnotherapy
  • Massage
  • Movement
  • Music therapy
  • Oil use
  • Positioning
  • Reflexology
  • Rebozo
  • Spirituality
  • Tension release
  • Touch
  • Visualization

1 http://www.childbirthconnection.org/pdfs/comfort-in-labor-simkin.pdf

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