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r a p e r P f o l a v i r r a e h t r o f g n i When it comes to having a baby, you can count on Heywood Hospital for complete support.
We recommend a variety of options to keep you comfortable while in labor. From aromatherapy to epidurals, we will do everything we can to meet your needs, while still providing a safe environment.
To assist you during the birthing process Heywood offers a variety of pain management options including:
Aromatherapy, Music Therapy, Doulas, Lamaze, Hydrotherapy, Narcotic Injections, Intrathecals, Epidurals
Your primary care physician, obstetrician and anesthesiolo - gist are important resources to help answer any questions you may have. We encourage you to ask them to share their knowledge and experience. Knowing about the benefits, safety and risk of all methods used at Heywood Hospital for your care will help provide you with peace of mind.
Dr. Andrea Damour, an obstetrician/gynecologist at Heywood Health Center for Women, with a mother and her newborn. L AROMATHERAPY
What is aromatherapy? Aromatherapy means “treatment using scents”. It is a holistic treatment using pleasant botanical oils such as lavender, rose or chamomile, when inhaled, can have a soothing, relaxing and comforting effect on the body. As a result, they are useful in labor to help alleviate fatigue and anxiety and promote relaxation.
How is it done? At Heywood, we have an assortment of different scents for you to choose from. The oil of your preference is placed in a diffuser which scents the entire room and provides you with the benefits as described above.
What is music therapy? Listening to music can do wonders to relieve stress and help you to relax during your labor. Experts suggest that it is the rhythm or beat of the music that has a calming effect. It is believed that a baby in a mother’s womb is influenced by its mother’s heartbeat, associating it with a safe, relaxing and protective environment. Later in life, this rhythmic beat of the music also becomes associated with a safe and relaxing environment.
How can I use music therapy? At Heywood, there is a CD player in every delivery room and we have a variety of CD’s to promote relaxation. We also encourage you to bring any favorite CD you may have from home that you may find comforting to use throughout your labor. L DOU LAS
What is a doula? A doula is a specially trained labor assistant who provides continuous, uninterrupted care for you and your partner while you are in labor. A doula will help you by offer - ing physical support, emotional support and information about the birth process, technology and alternatives.
What can a doula do? A doula will help provide practical suggestions for working through the pain of contractions and help you to relax by using touch, massage, emotional support, encourage variations in positions and use other labor support techniques to help you through your labor.
What are the benefits to having a doula? Studies have shown that the use of a doula can result in shorter labors, increased comfort, fewer episiotomies, fewer cesarean sections, and greater satisfaction for all.
When can you get a doula? Heywood Hospital has a volunteer doula program that is covered every day and every shift. Most often, a doula can be provided for you when you express or have the need.
L AM AZE
What is Lamaze? Lamaze is a method of childbirth preparation that aims to increase a women’s confidence in her ability to give birth. Women and their significant other are taught various simple coping strategies, of which breathing is one of them. The class also explains the normal birthing process and provides information and tools to help relieve your anxiety and help you make informed decisions.
How can you learn this technique? Heywood Hospital offers a Lamaze course every month. Classes meet one evening a week for 6 weeks and are held in the OBS conference room. You may register for these classes through your physician’s office or by calling the LaChance Maternity Center at (978) 630-6216. L HYD RO THERAPY
What is hydrotherapy? Hydrotherapy is the use of a heated water bath by a laboring woman. Soaking in a pool of water creates a sense of weightlessness and has been found to promote relaxation and comfort. Hydrotherapy has also been found to “speed up” the later stages of labor due to its relaxing effects and stimulation from the warm water. Hydrotherapy may also reduce the need for medications in labor.
When can you use hydrotherapy? If you do not have any contraindications for the use of the tub, and you are greater than 37 weeks gestation as well as greater than 4 cms. dilated, then you may use the tub with your physician’s approval. You will be asked to exit the tub every hour for at least 20 minutes to assess your progress in labor.
Are there any reasons that would prevent you from using hydrotherapy? The tub is not for everybody. If you are having twins, the baby’s presentation is unusual, if the baby’s heart rate is not normal or if there is any complication in the pregnancy, you should not use the tub.
Are there any risks associated with hydrotherapy? Hyperthermia (an increased temperature of the mother or baby) could increase fatigue, and could slow the labor. Signs of hyperthermia are monitored constantly and if there were any signs of this occurring, such as a fever or an increase in the baby’s heart rate, you would be asked to leave the tub immediately. Studies to date have not shown an increased rate of infection in women who use hydrotherapy, but infections do occur in water and on dry land. Caution is exercised to decrease the risk of infection and any patient at an increased risk of infection, would not be allowed to use the tub. There may be unknown risks. Water immersion for pain relief in water has been utilized for several years and to date there are no concrete hazards to its use. We feel confident that this is a safe way to labor and as long as the research remains favorable, we will offer this option. L NAR COTIC INJECTIONS
How does this work? Half to two thirds of women are not able to use natural childbirth methods to stay comfortable and will need something more to help them through their labor. Many women find that injections of narcotics help them remain comfortable.
How does this work? The medications that will be used may be given in a shot form or through an intravenous and will help with relaxation and may cause you to sleep between contractions. If narcotic injections are given too early, they may slow or stop the labor and if given too late, can cause respiratory depression to your newborn.
L INTRATHECALS
What is an intrathecal? Intrathecal analgesia or anesthesia is a single injection of a combination of narcotic medicines that is given through a thin spinal needle directly into the spinal fluid. An intrathecal is quick to administer, effective in providing comfort in most cases and allows you to recognize when to start pushing. Intrathecals also do not reduce your ability to push when it is time to deliver your baby. The amount of medicine that is used has no measurable effect on the baby.
Are there side effects? Side effects with intrathecal analgesia are quite limited. While we use very small doses of narcotics, they still can cause itching, nausea and difficulty urinating. An intrathecal can also lower your blood pressure and depress breathing, so we moni - tor closely while the intrathecal is becoming established. Headache following an intrathecal is much less common than it use to be. When can you receive an intrathecal? If given too early, an intrathecal can slow down your labor, therefore, your family doctor or obstetrician and anesthesiologist, will determine when your labor has progressed far enough to give the intrathecal. Usually, it is preferred that you are at least 4 cms. dilated before an intrathecal is given.
How long will it last? Generally, an intrathecal will last at least 6 –12 hours.
Is there any reason that an intrathecal cannot be given? There are very few reasons that a patient may not be allowed to have an intrathecal. You should not have an intrathecal if you have a skin infection on your back or your blood won’t clot – low platelets or use of blood thinners.
L EPIDURALS
What is an epidural? Epidural analgesia is an injection of a narcotic medication into the epidural space in the lower back through tiny plastic tubing. Anesthesiologists will first place a needle into this epidural space and the tiny tubing is inserted through the needle. The needle is then removed and the tubing remains in the space. The tubing is then taped against the skin so it will not fall out. There may be one narcotic medication or a combination of medications that are then slowly and continually, infused through the tubing. This results in effective relief of pain, by stopping pain nerves in your back from sending pain signals to your brain. It takes ten to twenty minutes for the epidural to reduce your pain. The effect on sensation and the amount of numbness that you might experience differs from person to person. Some patients may have normal sensation and movement while others may experience numbness and weakness in your legs. In addition to the continual administration of the narcotic medication, you will be given a special machine called a PCEA (Patient Controlled Epidural Analgesia) pump. If your pain should increase, this machine will allow you to press a button and a safe amount of additional medication will be delivered to control your pain. If labor is expected to be especially long, difficult, or if a C-section is more likely to be needed, your doctors may recommend epidural analgesia. Are there side effects? Epidurals require larger doses of narcotics than do the intrathecals so the baby is more likely to be affected. Also, epidurals may cause hypotension (low blood pres - sure), and decreased respirations. Epidurals often cause numbness of the legs, which can make it difficult to tell when it is time to push. Additionally, an epidural tends to decrease your ability to push during the second stage of labor. As a result, the use of forceps or a vacuum extractor is more common with epidurals. As with intrathecals, itching can also occur, though usually mild. This can be treated with medicine. Most likely, an epidural will cause a temporary inability to urinate and will require the need to insert a foley catheter. This is removed, not long after the epidural is discontinued. Sometimes, an epidural will result in a “patchy” or one-sided numbness. Changing your position, giving more medication or reinserting the tubing in your back may help to correct this. Lastly, as with the intrathecals, it is possible to get a headache.
When can you receive an epidural? If breathing, relaxation or other means of support do not control your pain, thenL your physician will discuss with you the option of epidural or intrathecal analgesia. If it is determined that an epidural is appropriate for you, then the epidural catheter can be inserted most any time once labor is established. The time that the medica - tion starts most likely will occur once you are at least 4 cms. dilated. If started too soon, an epidural can slow down labor.
How long will it last? An epidural will last for as long as your labor lasts.
Is there any reason why an epidural cannot be given? As with an intrathecal, there are few reasons why a patient cannot be given an epidural. Any allergies to the local anesthetic, any skin breakdown or localized infection on the back in the area of insertion or any patient with methemaglobenemia would not be allowed to receive an epidural.
For more information about your delivery options or any other services, please call Heywood Hospital’s LaChance Maternity Center at (978) 630-6216 or (978) 630-6228.
“My hospital stay was the greatest gift .” LKristen Bessette with her daughter, Grace, who was delivered at Heywood’s LaChance Maternity Center. L