Third childbirth class.

[rivka]

Class was amazing last night.

The entire session focused on labor pain and how to cope with it. Michele organized the discussion around a handy acronym: labor pain is Purposeful, Anticipated, Intermittent, and Normal. Compared to other kinds of pain (such as a broken bone), she said, these factors make labor pain more manageable. But she also reviewed other things which will influence how much pain we'll experience: the mother's pelvis, the baby's size, the baby's positioning (here there was a long discursion into "back labor," how it happens, why it hurts, how to cope, and how to turn the baby), how we care for ourselves and are cared for during labor, and then various emotional factors.

She wants us to start thinking about how we deal with pain and hospitals, and to discuss those things with our partners, because personal history is a major factor in coping with labor pain. One of the guys in the class volunteered that his main experience of hospitals was going, as a child, with his mortician father to pick up "removals." He's now struggling to develop a more positive context for the hospital where his baby will be born. I mentioned my surgical history, and said that although I feel very secure in my ability to handle pain, people keep telling me that labor pain will be "different" - so I'm not sure whether I'm being overconfident.

She did a nice presentation about the pain gate theory, which I'm familiar with from my behavioral medicine courses. The basic idea is that the experience of pain can be reduced or blocked by flooding the nerve pathways with competing sensations. (This is why, when you hit your funnybone, it helps to rub it - you're providing a strong competing stimulus. It's also why you can slam your head against the headboard during sex and barely even notice - because your sensory neurons are busy. Not that she used that second example.) A lot of labor coping techniques involve rhythmic movements, hot or cold sensations, and massage, which are all efforts to exploit the pain gate mechanism by providing competing stimulation.

Then we watched a video. A very different video. She told us that she'd started us off with "mild" videos, because none of us had any experience observing labor and delivery. This one was a simple presentation of, essentially, home movie clips of women in labor, with none of the sounds or sights edited out, and no music or voiceover added on to help us keep our distance. She warned us that laboring women tend to make a lot of noises - what she described as "work" noises, not screaming - and that we might be uncomfortable hearing them. And then she rolled the tape, and, yeah.

I had a hard time with it. Part of me was doing what I was supposed to - taking mental notes about how they got through contractions using the "3 R's" of relaxation, rhythm, and ritual - and part of me was being overwhelmed by the similarity to, um, people with severe autism or mental retardation. The repetitive, rhythmic moans, the inward attention, the stereotyped movements (tapping, rocking)... yeah. Disturbing. Now I know what I need to get over before labor. Although maybe it feels different when it's you?

We talked about our reactions to the video for a few minutes. (I wasn't the only one who found it hard to watch.) We were briefly sidetracked by a conversation about what you wear during labor (nothing you want to keep, apparently) and why they put the baby directly on the mother's naked abdomen. And then it was time for what we'd all been waiting for: explanation and practice of various labor coping tools. Some of them were presented verbally (for example, positive affirmations). Some of them we've already been practicing (for example, relaxation exercises). For the rest, she set up five stations around the downstairs of her house, and we rotated through practicing each one: lunges, using a birth ball, heat and cold and counterpressure, specific pelvic and spinal pressure techniques individually taught by Michelle, and back pain relief measures.

I don't remember everything we got to try, but I did make notes immediately afterward about what worked well for me:

Counterpressure: having Michael put firm pressure on my lower back and just lean.

Heat: she gave us instructions on how to make a "rice sock," which is exactly what it sounds like: a rice-filled sock that can be heated in the microwave and then used to provide heat and/or pressure. We barely tried out cold, because it was already a cold day, but I made a mental note to get an additional bag of frozen soybeans (our default household ice pack) so that we can use one while the other is chilling.

Lunges with a footstool: lunges apparently help with hip pain by opening up the pelvis to the side. You put one foot on a low stool, point that toe at a 90-degree angle from your body, and lean out to the side. It felt good, and I could see how it would help my pelvis open up, but it was also immediately obvious that I need to start practicing it now if I'm going to want to do it in labor. I got tired very quickly when I tried to lunge on my right (weaker) leg. It was especially pleasant to do the lunges with Michael holding my hand and swaying back and forth in the same rhythm.

Rocking on the birth ball: sitting on a birth ball is more or less the functional equivalent of squatting, and far more comfortable. She also encouraged us to practice rocking our pelvis back and forth on the ball. It felt like a useful thing to do.

Kneeling on the birth ball: well, kneeling on the floor with my upper body draped over the birth ball, and sort of rolling back and forth. This felt great, especially when Michael put firm pressure on my lower back.

Leaning over the birth ball while it was on the couch: like the previous one, but it was easier to breathe because I was less bent over.

Slow dancing: standing face to face with our arms around each other, rocking from side to side. This was lovely. I felt very warm and supported.

Sitting with Michael kneeling: I sat in a chair with my legs apart, leaned forward and rested my arms around Michael's shoulders as he knelt in front of me. Then we rocked from side to side. Also very nice.

Kneeling with Michael sitting: he sat in the chair, and I got down on my knees and rested my head in his lap. He could stroke my hair as I rocked back and forth, which felt great.

Double hip squeeze: this is one that we almost didn't try, and boy am I glad that we did. We had a careful conversation with Michele about my pelvic architecture, and then she showed Michael how to do this thing. He'll have to describe it, because of course I couldn't see anything - I leaned against the kitchen counter, and she showed him how to apply pressure to specific points on my sacrum. Whatever it was, it felt great.

Some miscellaneous notes for labor prep:
- we'll want to make sure that there are plenty of pillows or whatever to kneel on, because both of us spent a lot of time on our knees.
- a lot of the positions that felt good to me involved leaning, which might lead to back strain because of my uneven arm lengths. We need to figure out something to prop up my right arm when I lean, so that my back stays straight. Michael will also try to keep track of my posture and notice if my back is twisting.
- I need to start practicing lunges and pelvic rocking now. That stuff is tiring.
- Michael is absolutely phenomenal at encouraging me, calming me, responding to my feedback, and cooperatively working out coping stuff with me. I knew that, but this was a good time to be reminded. I have no fears that he won't be a good birth partner - just fears that I'm going to annoy the hell out of him.

Comments

[windsea.livejournal.com]

I remember the rocking, and that sense of going entirely into oneself. It's part and parcel of the pain gate/distraction efforts, I think. I remember I felt at time that if anyone distracted me from *me* I would lose it altogether.

[minnehaha.livejournal.com]

How are you doing with that other pain you were having a while back? Surgery site on your side was really bothering you, as I recall it.

Sorry if you've mentioned it; I've gotten behind everywhere in the LJverse.

K.

[rivka.livejournal.com]

Yeah, Michele was very clear about the fact that effective rituals shouldn't be disrupted or changed in any way by the other people present. One of the women in the video shrieked "don't talk!!" after what sounded to me like only the slightest of sounds from one of her birth assistants, and boy did they shut up quickly.

[rivka.livejournal.com]

I stopped physical therapy before I should have, because the Christmas holidays intervened. I keep meaning to get back over there. But the pain is nowhere near what it was - it's an occasional bothersome ache, instead of an impossible-to-ignore fierce burning agony.

[therealjae.livejournal.com]

So, why *do* they put the baby on the mother's abdomen? I assumed it was just that it was kind of nice.

-J

[geekymary.livejournal.com]

My only recommendation is to practice and to make sure your partner's ready with things to try. I felt really prepared, I knew a lot of techniques and then ... forgot everything because of the pain. Later I thought about it and wondered why I didn't try walking or a birth ball or a shower.

[casperflea.livejournal.com]

I was SO NOISY in labor - rhythmic moaning. It really helped me, and didn't feel strange to me at all, though I imagine it might have been strange to watch. I think, in general, it is easier to do labor than to watch it, especially in one that you love. You might want to talk about this with your partner.

My favorite labor moment was when I said to a solicitous mr. flea, who was talking me through a contraction, "Dude, your breath sucks." He went to the vending machine and got mints and gum!

[rivka.livejournal.com]

The point of being immediately skin-to-skin with the baby is to warm her up and help her regulate her body temperature. (The alternative is to put her in an electric warmer.)

It also appears that babies have a strong instinct to nurse immediately following delivery, which is helped by having the scents of birth still present (because of the hormonal component). So if you put the baby right on the mother's abdomen, there's an excellent chance she'll actually inch her way up to the breast and latch on without help. Whereas if you take her away, wash and dress her, and put her under a warmer for a while, that interferes with the immediate instinctual response - which might mean more trouble latching on properly and initiating breastfeeding. Immediate nursing also makes the uterus contract, which helps stop the mother's bleeding.

Additionally? Having the baby put immediately on your abdomen supposedly is kind of nice. :-)

[rivka.livejournal.com]

Oh, and thanks for asking.

[therealjae.livejournal.com]

How efficient the human animal is, in that so many things that are kind of nice are also really *useful*. :-)

-J

[wiredferret.livejournal.com]

(heh) The told us about the breath thing.

The rhythmic stuff is kinda disturbing, viewed abstractly. To me, it felt like that time when you know you will get to orgasm THIS WAY and no other, and if there is any stopping, you may not make it, and then the hating. Yeah.

I was cranky, this time around, because I wanted to bounce (between say, 2 and 4 cm), and they wanted to monitor, so they wouldn't get me a birth ball. I was pretty euphoric at that point, so maybe I was scaring them.

And my pet peeve during labor with Baz was that there were several people telling me what to do at the end stage. I finally (after much swearing, including words sil said he didn't know I knew) got them to funnel everything through the midwife and sil.

The baby on the tummy thing is very nice, although they will want to take her to check the apgars. I found that was okay with me, because both my children were really alert, and came right back and nursed again.

I normally try to keep my trap shut, but:

[ailbhe]

A few points about pain during labour: I normally cope quite well with pain, and I didn't cope with labour pain at all; I just endured it, which felt quite different to me. I found pacing helped most; yes, autistic-type behaviours; I got really, really good at Scrabble in labour, as a displacement activity I suppose, and did lots of repetitive physical activity, and repeated myself a lot in monologue.

Sitting and rocking on the birth ball to open my pelvis more during labour hurt like hell but was good to do because it felt so purposeful, sort of like peeling off a scab or something; the more it hurt, the more I knew it was working. Same with pacing.

You probably will annoy the hell out of him, mainly by being in pain that he can't take away, but you'll both forgive each other very very quickly.

I did a lot of leaning over a sofa covered in very very soft pillows, and kneeling on pillows. Bed pillows, not sofa cushions, in case clarification is necessary.

Lavender baths helped me a lot during early labour, and I should know, I was in early labour a long time.

I found the pain really very copable with until things went wrong, when it was no longer necessary to cope with the pain - no-one expected me to or tried to make me, no-one wanted me to "be reasonable" or anything. Everyone just wanted me to get through the pain, because the thing about labour pain that is easiest to forget is that *it eventually stops*. That's guaranteed, unlike just about all the other pain I've had, though they all stopped too.

The main thing, I suppose, is that I'm a little worried that you're so accustomed to pain that you'll try to COPE or DEAL or something, when there's no need, and coping just makes it harder. There's so much pressure on, well, everyone to have a Byootiful Natchral Childbirth, and that's great, but there seems to be more on people who are used to pain, and that's frankly not fair.

But up until things were really going noticably wrong, I found the pain easy to deal with. What broke me was knowing that things had gone wrong, not the pain levels. The pain didn't increase after it became clear things were wrong; I just found it less purposeful.

I'm glad you're getting such good antenatal classes; ours weren't half as to-the-point as yours. I bet it helps a lot.

Eee! So soon! Babybabybabybabybabybabybaby!

A.

[papersky.livejournal.com]

I flat out couldn't do the lunges, and everything went OK anyway. (No tear, no cut, no stitches.) So don't worry about it too much. Labour is work, it's very tiring. Something that makes you more tired might be more trouble than the worth of it. It'll be OK.

The thing with the pain is that you're supposed to relax into it, and everything you already know about pain is about getting around it, past it, through it. I couldn't help tensing against labour pain. It's not that it's worse pain than anything else, it's the weird intermittentness of it, and the way when it comes back again it seems so rough. (When I was writing Prize in the Game, rysmiel couldn't believe I was going to write Conal-POV male labour pains. But I did, and out of my real experience.)

On the rice sock -- it's possible to buy made ones. The one I have also contains lavender, which smells nice, and which someone else made in pretty material. If you get a biggish one, you can use it ever after as a neck rest on long distance plane flights. I know you can sew so this isn't a problem for you, but if any of the other people can't sew it might be worth mentioning looking for them. Actually I bought mine in a Welsh Craft shop aimed at tourists, so maybe they're actually less available than I think. What a good thing they last forever!

[tammylc.livejournal.com]

This is why I encourage people to have a doula, or as you say - a well prepared labor partner (maybe with a written list of techniques so they can't forget either?) - because it seems like it would be easy to forget, and part of a doula's role is to make suggestions for relieving pain and helping labor move forward.

[rivka.livejournal.com]

saoba is going to be our labor coach, and I think she'll be incredibly helpful. And Michael is paying very close attention to all of this advance preparation. But yeah, a written list sounds like a good idea.

[rivka.livejournal.com]

Not unwelcome at all, thanks. I like to be hyper-prepared for things and make a lot of plans, so it's good to be reminded that "battle plans seldom outlast first contact with the enemy."

[kightp.livejournal.com]

Wow.

Thank you for a detailed glimpse at a part of life I have no direct experience with. It sounds like you're in really good hands (both your teacher's and Michael's).

As for what to wear: Do you have a beloved but threadbare old nightie that's nearing its last gasp? This might be a fine time to get the very last bit of wear out of it and give you something familiar and comfy to wear.

And then have a brand-new, pretty, celebration nightie waiting to change into after you've got yourself a baby. (-:

Sorry if I am intruding..

[old-hedwig.livejournal.com]

I saw this on dglenn friends page.

I had my 3 at home, 9lb8oz, 10lb8oz, 10lb4oz. Walking around the house (naked!) helped at first, then walking around and stopping to lean into hubby during the contractions. Later when the back labor kicked in, hot showers, and then having hubby put a heating pad hard against my back. It was actually quite hot, and was hurting his hand and he kept asking me if I wanted it turned down, to which I said NO! KEEP IT ON ME!. As soon as the baby came out, I yelled at him to get that hot thing off me. I know I was pretty bossy while in labor, as well as completely unwilling to wear clothing, these urges went away so quickly after birth it was amazing.

[ailsaek.livejournal.com]

They definitely don't. And sometimes things you think might feel good, once you get to actually giving birth, don't feel good at all. And don't be surprised if at some point during labor you find yourself feeling irrationally angry. It's happened to me both times, and I know I'm not the only person who reacts that way.

[rivka.livejournal.com]

As for what to wear: Do you have a beloved but threadbare old nightie that's nearing its last gasp?

Alas, the question you should be asking is, "do you have any nighties at all?" In fact, I don't. For the rare occasions in which I need sleepwear, I sleep in a T-shirt and a pair of silk long johns. Not very appropriate for labor, even if the long johns did fit over my belly.

go naked if you can

[old-hedwig.livejournal.com]

Women in labor lose all sense of modesty, and its much easier to just wear nothing if you can get away with it.

After, you will be bleeding pretty heavily for some days, and most likely sweating a huge amount at night. The ideal nightie is absorbent and washable, and has buttons or nursing slits down the front.

Re: Sorry if I am intruding..

[old-hedwig.livejournal.com]

Oh, and I mood like a cow. Hubby thinks this is just the funniest thing ever. So funny he forgave me for digging my nails into him for pushing.

[kightp.livejournal.com]

*grin* An old shirt of Mischa's, maybe? Or, really, *anything* comfy and almost worn out. It's not like the fashion police are going to be peeking into the delivery room and giving you demerits. (-:

[windsea.livejournal.com]

LOL. I remember that sensation.

If you'd like to read an account of a somewhat chaotic day, my daughter's birth story is at

http://groups.google.ca/groups?q=%22joanne+cook%22+%22birth+story%22&hl=en&lr=&ie=UTF-8&selm=2u9f6f%24c2i%40owl.nstn.ns.ca&rnum=1

Note that she was #2, rather than #1, so there were more distractions :-)

[wiredferret.livejournal.com]

Indeed. Angrier than you've ever been, without verbal wit to express it. At least I was.

[wiredferret.livejournal.com]

Possibly because I did waterbirth, and possibly because I don't have hospital issues, I let them give me a hospital gown, and it worked fine for all the time I was clothed, which involved some messy bits, yes.

[klwalton.livejournal.com]

When deep in transition labor with my older son, Tim and my doctor started to talk. Pat, my nurse, told me I said, softly but firmly, "Get the fuck out of this room if you're going to talk." I don't actually remember saying that, but I do remember them leaving the room. :)

[sashajwolf.livejournal.com]

I did scream in my first labour, but being at that time quite active in a choir, apparently I screamed a recognisable, consistent musical note. aegidian found this rather eerie, but it did mean my throat didn't hurt afterwards.

I do recognise the description of going into myself. I didn't find it unpleasant - I think it really is different when it's you. It's a mechanism to deal with the pain, so almost by definition, it comes as a relief, you know?

The gate theory of pain is what makes TENS machines work, at least partly. I found those really helpful in my first two labours, but less to in my third. I think what made the difference was that the first two times, I put it on very early, because those two labours started during waking hours. The third time, it started at night, so I followed the advice of taking two paracetamol and going back to bed for as long as possible (there's no way I can sleep with a TENS machine on.) Then, by the time I was awake, the contractions were too well-established for the TENS sensation to be able to override them.

[saoba.livejournal.com]

Written list: good. You and Michael will both be likely to be distracted and focussed at the same time.

Language availability may be limited. Some women in labor find actually putting together sentences is too much work for them, the same way people involved in major heavy lifting do. I know of a woman who, unable to say "Please don't stroke my hair right now, it's distracting me", snapped out the couple's safeword. He got it at once, snatching his hand away as if burned. The doctor missed the exchange entirely, and she didn't remember doing it after the birth. If I hadn't been there to verify it, I think she would have believed her partner was joshing her.

My second labor was my easiest. I had been riding my bike up until my eighth month and was in the best shape of my life. There may have been some connection there.

Things with scents can be okay, or problematic. I had to send a father off to the shower when his formerly charming aftershave became a tool of the devil, literally in htge space of a few minutes.

More comments possible after I get back from the gym.

Have I mentioned how excited I am for you guys? I mean, wow. Baby!

[writingortyping.livejournal.com]

Beware - they don't actually last forever. My mother went to drag her (old, much used) rice-heater-thingy out of the closet, and the stitches gave.

Cleanup was not fun.

[writingortyping.livejournal.com]

Instead of baby stuff, I once gave a friend a very cosy, colorful flannel robe. She LIVED in it for the first few weeks after she gave birth.

[ailbhe]

The pyjamas I laboured in are fine now. It all washed out ok. Just so you know. Mind you, I mainly laboured in the tops of them, but the pants were all covered in ick of many kinds before we reached "mainly", and they're fine now.

I bought a new dressing gown for hospital, and I was so pleased - it felt really good to have something nice and new and clean to wear after the birth. Also, my mother ironed my nighties and pyjamas while I was in hospital, and that was incredibly lovely too. Just raised my spirits about 27 notches.

I wore the robe again in hospital in December and it made me feel much better; brought back all the warm fuzzy new-baby feelings again.

A.

Re: go naked if you can

[ailbhe]

My personal sense of modesty and violation increased as I laboured. Just as a contrary datapoint. I had been told it wouldn't, and kept waiting to feel better about it all. Oopsie.

[rivka.livejournal.com]

I encountered my mother once, just a few minutes after she discovered that a feather pillow she'd laundered had burst in the dryer.

It was the kind of scene one doesn't forget quickly.

[tammylc.livejournal.com]

My room in the mother-baby ward was so unbearably warm that I spent most of my time in the hospital wearing as few clothes as possible.

[lissamc.livejournal.com]

I journaled both my delivery experiences within a day of giving birth. (If you ever want to see the entries, just ask. I was mainly writing to the kids' future selves, in case they wondered about it when they got older.) With Michelle at the end there I just zoned out, riding the waves of the contractions up and back down. There came a time when I knew it wasn't going to get any worse, and that then made it easier because the *not knowing* what I was going to feel was the hardest part. Once I knew exactly what to expect I could cope. That labor took a day and a half all told, with only a shot of Demerol part way through to let me grab a few hours sleep. (Sleep helped immensely.)

Kevin's birth was different. It took 3 1/2 hours total, and it *hurt* it came on so strong and fast. After the first hour and a half I decided natural childbirth could take a flying leap, I wanted the epidural. And you know? That worked too. Different labors, different pains, different ways to cope. Listen to your body. It knows what to do and what it wants.

[beckyzoole.livejournal.com]

With both children I found that all the techniques I'd learned really worked for the first eight or nine hours. But I got tired -- tired of leaning into the pain, tired of pacing, tired of kneeling and rocking and everything else. I was pretty tired to begin with, too, because I find it difficult to sleep during the last few weeks of pregnancy. As I became more and more tired, it became more and more difficult to work with the pain. I was angry as hell and just wanted to SLEEP.

The point is, I am very glad I got an epidural so I could sleep a few hours. When it wore off and an intense labor pain jolted me awake, I had progressed several centimeters. I made it through another few hours of labor and transition with no further meds. God bless epidurals.

Every birth is different, every woman's body is different. Do the best you can with your labor, don't feel bad if you need meds, and be incredibly proud of yourself if you don't need them after all. But most of all, enjoy the baby!

[rivka.livejournal.com]

The point is, I am very glad I got an epidural so I could sleep a few hours. When it wore off and an intense labor pain jolted me awake, I had progressed several centimeters. I made it through another few hours of labor and transition with no further meds. God bless epidurals.

I am probably not a candidate for an epidural, because I've had a spinal fusion. It's above where they would place an epidural, but my understanding is that a lot of anesthesiologists still get pretty twitchy about it. I'm not relying on having it as an option, which means that my choices pretty much boil down to (a) narcotics, or (b) nothing.

[rivka.livejournal.com]

It seems as though TENS units are commonly used in labor in the UK - I don't know why they're not readily available in the US. I know people who have used them for chronic pain, but they're not generally presented as a childbirth option.

Nitrous oxide is the other option that British women have and American women don't.

[almeda.livejournal.com]

I'm so, so glad that the Medical Establishment is much more interested in all kinds of semi-innate ways of making birth easier to deal with for all concerned than they were when I, or even my 11-year-old baby sis, was/were born. I have friends with horror stories (the hospital giving the baby formula immediately, even though she wanted to nurse it, which led to the baby rejecting the boob entirely; doctors rushing to a C-section because of schedule tightness or the faintest worry that something might be 'off,' meaning all later kids had to be C'ed out too; others gorier than I want to even mention).

Not that I'm pregnant now, or plan to be even in the next year. But hearing other folks talk about their experiences (good AND bad!) helps me fortify myself against the idea, and feel more strongly about finding myself a good doula/midwife/etc who will actually LISTEN to us, and an obstetrician likewise.

[sashajwolf.livejournal.com]

Wow. I can't imagine not having nitrous oxide available - I used it in all my labours and found it really useful towards the end of the first stage (less so in the second stage, because I found it harder to focus enough to push properly while using it.)

The obstetric TENS units are different from the regular pain relief ones - they have a booster button to use during the contractions. Most hospitals participate in rental schemes, and so does our largest pharmacy chain, so they're very easy to come by.

Given that these are both fairly cheap, non-invasive options with no significant side effects, it seems strange that they'd be hard to get in the US. You'd think insurers would prefer them.

[rivka.livejournal.com]

I think that the "Medical Establishment" is probably still divided on these issues - there are certainly still OBs who have 80% episiotomy rates, for example, and hospitals where it's still routine to separate mothers and babies after birth for observation. I chose my providers (midwife and hospital) very carefully to ensure that I had the best possible chance of a low-intervention birth.

(And note that, if you have a midwife, you typically don't have a separate obstetrician unless serious complications arise at some point.)

[rivka.livejournal.com]

There has been much speculation in my pregnancy newsgroup (misc.kids.pregnancy) about why nitrous isn't available for childbirth in the US. Some people have said that it's because having tanks of nitrous just hanging around the hospital invites theft or recreational use by hospital staff (compared to, say, narcotics, which are easier to lock up). But I can't imagine that the drug abuse rates are different enough between the two countries to make a huge difference.

I don't have any theories at all about the TENS units, but I'll ask my midwife. Although it's probably a moot point for me, given that I'm planning to spend a hell of a lot of time in the birthing tub... which is probably incompatible with electrical equipment.

[sashajwolf.livejournal.com]

In most modern UK maternity units, the nitrous oxide is piped into each delivery room, so there is no freestanding tank in the room. There must be a central supply somewhere, but I don't see why it couldn't be in a lockable room. The older ones do sometimes have tanks in each room, but I've never heard drug abuse even mentioned as a concern in that connection. Midwives routinely carry small tanks of it in their cars for use in home births.

Hot water does feel nice in labour. It does also lessen the strength (and hence the efficacy) of the contractions, though, and I think using it too soon in my first labour was part of the reason why my contractions stopped and I eventually needed syntocin to get them going again. By the time of my second labour, they'd changed the advice so that you were only recommended to use a bath or a birthing pool once your labour was very well established, so I chose not to use it second and third time round and just stuck to the TENS instead. Different choices for different people :-)