Low platelet count, epidural not even an option!

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Permalink Reply by Rachel on August 24, 2009 at 8:50pm

Just to set your mind at ease, I have big kids also, and the size makes no difference on how painful it is. In fact I just had a friend give birth to a 11lb 8 oz baby and she did it natural and loved it:) The biggest difference for you will be how you view the actual labor and birth. With an epidural, it's more of a waiting game. It's very none involved. Whereas going natural, it's work (though very satisfying work). You have to change your mindset. Keep in mind the positives also. Almost everyone has an easier recovery with a natural labor. Plus, you are less likely to have an instruments delivery, cutting down on the tears and such. A good many receive emotional and spiritual benefits also. I can tell you that with my first one, I felt the most amazing joy I have ever felt.

I wrote a blog on emergency pain control that you might want to take a look at: http://thebeginningofmotherhood.blogspot.com/2009/02/emergency-pain...

Look for positive natural birth experiences. While I can't guarantee that yours will be absolutely positive and wonderful, I can tell you the the possibility of having the most amazing experience you've ever had is there. Take care, and don't let yourself give into your fears.

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Permalink Reply by Amy on August 25, 2009 at 11:12am

I would suggest downloading/reviewing this info on comfort measures:

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

As stated before, size really doesn't make a difference in the level of pain. However, fear definitely does! The more fearful you are, the more tense you will be and the more pain you will experience. The more pain you feel, the more scared you will be and more tension you will feel, etc. It is a vicious cycle that is best avoided by being as relaxed as possible.

I would also caution you to ask some questions of your provider if the topic of induction is brought up again. You didn't mention why your others were induced, but for the record, many inductions are not medically necessary. I'm certainly not saying that was the case for you, but docs suggest inductions often and it doesn't automatically mean there is a valid medical reason. If you can avoid it, by all means it would be in your best interest to do so. As you have experienced, it often makes labor more intense and painful.

Nature has supplied us with the hormonal orchestration required for birth. Oxytocin (which powers normal labor) is released in waves with each contraction, unlike with Pitocin which is continuous. As the labor progresses, your body will also increase it's release of endorphins (which are your body's own natural opiates) that not only make it so you notice the pain less, but also help get you "in the zone" which will also assist in handling the sensations of labor and birth. When you have an epidural, your body stops releasing these endorphins. The hormonal cocktail you have at the end of the birth is unlike anything you've ever experienced. That is certainly not to say medicated birth is unfulfilling--just that it is very different emotionally from non-medicated birth.

I would also highly recommend having a doula to help you with breathing, comfort and relaxation. Studies show that women who use a doula are less likely to require pain meds and usually have shorter labors.

Best wishes,
~Amy
(certified childbirth educator)

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Permalink Reply by Tracy Donegan on August 25, 2009 at 1:42pm

Hi Michelle,

I agree about having a doula - your doula can help you with all kinds of comfort measures and really be a rock for you. Avoiding induction without a medical indication will definitely contribute to a much more manageable birth.

The amount of pain you experience is determined by a few factors

How much pain you expect to experience...

Your emotional state (anxiety amplifies adrenaline making it harder for those lovely endorphins do to their job....!!)

Your focus on the sensations - with 4 little ones already at home you'll have more than enough distractions at home for you in early labor.

Are you giving birth in a hospital that has a labor pool...or at least a bath? Warm water is an amazing pain reliever and it tends to shorten the birth process too. I would plan on spending a LOT of time in the bath/shower at home. Hypnosis for birth is a fantastic tool - but you need to be realistic about how much time you have to commit to a program with a busy household - I've worked with GentleBirth Moms as late as 38 weeks and they've had very positive births and as Rachel said your mindset is so important.

You can do this! You just might surprise yourself at how well you do!

Tracy

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Permalink Reply by Rebekah Hanson on August 25, 2009 at 2:33pm

I would have recommended taking The Bradley Method classes. But they your pretty close to your due date. They like to have 12-14 weeks for the classes. But you could still get the book and read up on how to have a natural birth.
If you have a home birth you could labor in water. That's suppose to cut the labor pain down. Big Babies shouldn't effect the contractions. Since it's not your first Child you should be able to give birth no problem without the epidural. My Cousin gave birth to a 10lb baby. It was her second and she did a water birth and she
said it wasn't any different from her first which was a 8lb baby.
If your going to be at a Hospital then read up on the Bradley Method. That's what I would recommend. If you can Labor and give birth in water I would recommend that also.
Good Luck!

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Permalink Reply by KM on August 25, 2009 at 3:44pm

I would recommend hypnosis. You don't have a ton of time but their are home study courses and if you're dedicated and do the work, it is successful. A lot of what you practice is dispelling fears, like the big baby fear, and the pain fear, and re-wiring your subconscious to not be afraid. There are both physical and emotional reasons why fear can cause more discomfort during birthing, and hypnosis will help with these. As with anything you have to be willing and open, but if you are, it will work. Go to the Hypnobabies site and they have a ton of testimonies, and I believe some vid too? Your body was designed to do this and you CAN DO IT! Getting rid of your fear is your first step towards an amazing experience I believe you will be thankful you had!

Good luck!

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Permalink Reply by Michelle Manke on August 25, 2009 at 6:42pm

Thanks ladies for all your advice!
I am amazed as I look back at all my birthing experiences to realize that I have listened to my doctors and have taken what they have said as the gospel truth! Did I really need to be induced with my other children, NO! They always made me feel that a pain free birth was the way to go! Just in the short time I have been researching this I have come to see things in a completely different way! I know I can do this! Tomorrow I plan on researching a doula in my area, I really think that will help! I also will research the bradley method and the hypnobabies!

I will let everyone know how it goes! Thanks again!

Michelle

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Permalink Reply by Nicole Olivani on August 26, 2009 at 6:47pm

Hi Michele,
I was diagnosed with low platelets during my last pregnancy (VBAC'd 12/24/08) - I was diagnosed with pregnancy related ITP. I believe at one point before delivering I was as low as 70,000, maybe lower. It seems even though I alerted my OB during my 1st pregnancy that this seemed to run in my family nothing was really followed and I delivered (via c-section due to breech position) well below 100,000 and obviously had an epidural. This time it was monitored by maternal fetal medicine (high risk obs) in addition to my normal prenatal care from my midwife. As it dropped lower and lower they discussed 2 options.....one being steroids and one being IV treatment (sorry I can't remember the exact meds they would use to raise the levels). I was put on steroids and my platelet number increased.....I ended up opting for no epi but I could have gotten one at that point. The high risk dr's said that the individual anestisiologists (sorry, can't spell tonight) on call determines the minimum platelet level they are comfortable with. I would inquire about these options and see call the anestesia dept. at the hospital and see what their "cut off" may be.

Also, my 2 sisters had this issue and both were induced for each of their 4 kids - with an epidural for all but one of the 8. One had 3 vbacs.

Hope this helps! Also, while labor and delivery does hurt (esp. when the baby is in posterior position!) my doula made a WORLD of difference and I HIGHLY recommend you look into that option! Good luck!

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Permalink Reply by Natalie Eaton on August 26, 2009 at 4:36pm

I am a newly qualified midwife from the UK, and Last month, I worked as a doula for my twin sisters first birth.

Many of the advise given before we was great but part of me wanted to give you some advice too.

As much as many people will be cross at me to say this, i have to. I said this to my sister when preparing her for labour. Labour does hurt. a lot. Forgive me for the bluntness but no matter how many classes you go to or how skilled you be come at hypnosis, this fact remains. But theres hope! You have the power and the ability to mentally prepare yourself to experience this pain. But first, i recommend that you learn about how labour works. Study yourself (personally) the mechanism of labour, learn about the hormones which interact to control your labour. Understanding labour helps you through labour. In addition, you need to acknowledge that it will hurt and find something to focus on which reminds you every step of the way that "that every contraction, is one less contraction"

Preparing and accepting that it will hurt is challenging, it isn't easy. But the pride and empowerment you will feel will be so worth your effort. My sister's strength was tested and she now understands how strong she truly is. I've never felt so proud of her.

Having someone who will acknowledge ur pain will help also. One of the greatest problems i experience in my job is that the birthing partners are often unequipped to support their labouring loved one. Seeing their loved one in pain causes them obvious stress -which is understandable - but their stress will affect the womans coping mechanisms therefore i advise you to choose your partner carefully. I know your maternity services in the USA are very different to my own therefore i do strongly suggest either a midwife or experienced doula, and who can keep you focused and get you through.

I wish i could be there for you. I would love to support you through your labour. Every woman feels the same anxieties during this part of their pregnancy. With the right support, and the right personal focus and mentality from the start, you can achieve your best birth.

All the very best
Love
Natalie xx

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Permalink Reply by Rachel on August 26, 2009 at 8:31pm

I agree that it is necessary to acknowledge the pain of labor. I understand that many women have felt like their labor's where relatively painless, but I think this sets us up to think that all labors will be painless. Then when the pain hits, you aren't ready for it. You have to make peace with pain, in my opinion.

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Permalink Reply by Cherylyn on August 29, 2009 at 8:29pm

Everyone has given wonderful advice, but there is something I would like to add.

I think pain is relative. Yes, labor is painful, but my experiences in the births of my 5 children have taught me that it really is all about perspective, fear and how relaxed you can be. My 5th baby was born at home just over 6 weeks ago, and it was the best birth by far! I've had 2 births with pitocin and epidurals in the hospital, 2 non-medicated births in the hospital, and one at home that turned out to be a surprise breech. When I look back at my birth experiences, it has been a journey. The first was the most painful because I was unprepared and didn't know how to deal with the contractions, and I was naive to think I was prepared when I really wasn't. I was also very scared, and I think that had a lot to do with it. The reason I feel the last birth was the best is because it didn't hurt nearly as much as the others, and I feel that was because of my state of mind and emotional well-being. I embraced my body and the process of labor and my baby, and I was very much as peace through the whole thing. There was much less pain, even though he was breech. You can definitely do this, and you can do it amazingly well!

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Permalink Reply by Jackie Wood on August 27, 2009 at 6:37am

mine was 9lbs 8oz with no epidral. she is my only. but the fact she was big wasnt that bad the contractions were what i woukd have wanted the meds for. after its over u will feel very good that u did it by yourself

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Permalink Reply by Fiona Beitdashtoo on August 27, 2009 at 5:07pm

Hi Michelle,

I know you only have 7 weeks to go until your baby is due, but Hypnobabies does offer some great resources to not just manage the birth experience, but also make it much more comfortable. You should check out the various MP3s and even the home study course.

If you have questions, and want to talk to someone at Hypnobabies to help you find out the best way to prepare for your baby's birth with no drugs please call 1-877-55-HYPNO.

You can do this! Your body was built to have your babies :)

Fiona

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