You may have heard on the news of the possible epidural shortage that’s happening across the globe. What’s really happening is a shortage of epidural tubes (specifically it’s the ink that prints onto the tube that is the shortage). This can feel very scary to people who were planning to use an epidural as part of their pain management plan. We want to reassure all expectant families that there are MANY ways to cope in labour and we’re here to help you find solutions that will work for YOU.
Here in Toronto, where our Discover Birth team serves the community, the discussion about the epidural shortage is increasing and some hospitals are preparing for how to handle the situation. Some hospitals have told local media that they have many months or weeks of supply but this comment can be a little misleading to the reality of this dynamically changing situation as Health Ontario will be managing the supply across Ontario to ensure fair and equitable distribution of epidural kits.
It’s an important time to make sure you are acquiring additional knowledge and connecting with your birth team and preparing for multiple birth scenarios, which can help you feel confident to deal with the unexpected during labour.
Dr Filteau, the vice-president of the Canadian Anesthesiologists’ Society suggested in a recent interview with CTV that pregnant people should be considering birthing coaches and learning about alternatives to prepare themselves in case an epidural cannot be provided. As birth workers we can help our clients better understand the options around pain and coping. The many ways to mitigate pain, about our body’s ability to navigate labour, and a million other things.
If hiring a birth doula is not something you’re wanting to do but you KNOW you need to prepare for the possibility of not being able to access an epidural, we have some wonderful courses available to help you and your other labour support people prepare for how to help you cope through labour.
So What’s the Deal with Pain Anyhow?
It’s certainly not lost on any of us in Canada that there are more countries around the world who don’t have epidural access than countries like ours who do. And of COURSE we know that the birthing people in those countries get through labour just fine..many of whom go on to have more babies. So why do about 60% of Canadians use epidurals in their labours? Well this stems from our general societal views around pain, and the availability of this medication. Pain perceptions are cultural. There are many places around the world where pain is not seen as a ‘bad’ thing but rather a signal that something is going on and we need to turn our attention to it. In North America a good portion of our medical system and their training is built around the notion that pain is bad and that the goal is to make it go away. Of course there are many situations where we might not see any benefit to feeling pain, but the truth is there are many good reasons to FEEL what is going on in labour. When we feel things in our labour it may help to:
- Make our labours shorter
- Increase our endorphins (which is a morphine-like chemical that makes us feel better)
- Endorphins can also help our baby cope with labour better
- Guide us into positions that will facilitate the descent of the baby
- Keep us upright so gravity and position changes will help our baby get into the optimal position for labour and birth
- Keep our adrenaline levels up, which help our babies to be born with energy and vitality, which helps with their breathing, feeding and APGAR scores
- Go within. When the surges of labour increase we tend to become more internally focused and go into a “labour lala land” where our coping capacity increases
- Birth with an incredible cocktail of “love hormones” that help us to fall in love with our baby
- …and SO much more!
Learning about the Neuromatrix Theory of Pain, and specifically the Gate Control Theory can help you better understand how pain messages travel in the body and what we can do to BLOCK many of those pain messages.
I remember learning about the Gate Control Theory early in my career and thinking “this must be why labours are shorter and easier when a doula is present”, because doulas are masters of the Gate Control Theory!
Doulas and your support people can help you PERCEIVE less pain in your labour with a number of non-medical comfort measures. A good prenatal class should teach you at least 15-20 different ways you can cope with pain. We are happy to include this in all our classes but are also happy to create a customized private class just for you either virtually or in-person to help your labour support people learn how to utilize these critical skills. Go here to book.
One of the tools we often use in class is the Comfort Measures Pie Chart. This should be completely filled out with comfort measures you’ll use in labour to help you cope. There are MANY options out there. Please feel free to download this and use it to help prepare for your upcoming birth. You may also enjoy purchasing our Birth Deck which is full of comfort measure ideas your labour support people can use, as well as various affirmations and inspirational quotes to help you prepare for your upcoming birth.
There is no question many nurses and midwives possess amazing skills to help people through labour, but we also know the nursing/midwifery shortage is REAL. Nurses and midwives are burnt out from two and a half years of dealing with COVID and shortages. It’s important to not count on staff to be able to be by your side teaching all of these techniques in labour. Now is the time to create a plan with your labour support team to support YOU and the staff who are working so diligently to support you and your family.
You are STRONG and you have done hard things before. You can do THIS. We’re here to support you in any way we can. Please feel free to reach out at any time.