Crying – Labour is emotional, too! It’s not unusual for a woman in labour to cry, scream or curse at different points of her labour. It could be from pain, frustration, lack of sleep, or fear that labour is taking too long.
In a recent study conducted on Nigerian women, it was demonstrated that most African women experience extreme labour pain. This pain during labour, they described as extreme menstrual cramps, strong cramping, severe pressure, extremely strong waves similar to diarrhoea cramps, bad back pain or even an achy feeling, and a broken bone.
Howbeit, the pain varies from woman to woman; and from one pregnancy to the next. Some experience the most painful part of labour in the abdomen, waist, vaginal and the entire body. Some only experience pain at the pelvic girdle, the back and the abdomen.
So is any kind of noise good during childbirth? Not in all circumstances. But, “crying and shouting during labour can help the midwife access the progression of the labour. As childbirth progresses, more pain is experienced. For instance, if she is no longer crying or shouting, there is the possibility that there is no more contraction or its intensity has reduced,” Mrs. Abimbola Adedigba, the Primary Health Care Coordinator, Ibadan North West, said.
Experienced midwives can detect changes in women’s vocalisations during labour, for example, the differences between an “I’m working very hard” noise and an “I’m scared and need reassurance” noise or the panicked sounds that tend to accompany the transition.
However, Professor Adetunji Adeniji, consultant obstetrics and gynaecologist at the Ladoke Akintola University of Technology (LAUTECH) said that screaming or crying acting as a natural form of pain relief in labour for some women is psychological.
Professor Adeniji declared: “when they have a painful thing bottled in, it tends to be more painful than when it is expressed. For those that shout, cry or moan, it is a way of relieving the stress built-in by the pain. It relieves them of some emotions.”
Nonetheless, He added “when they are experiencing pain, one of the things we encourage to relieve pain is to breathe in and out. If they are shouting and screaming, it will negate the practice of breathing in and out.
“For the same psychological support, women who have companionship, say from close relations, including the husband during child delivery also do better than those without such as a support.”
Abdominal or diaphragmatic breathing is beneficial because it helps with relaxation and stress relief and oxygenates deep tissues, strengthening the diaphragm to get ready for pushing a baby out. Holding the breath is associated with more tension in the body and increases the sensation of pain.
However, when dehydration occurs because energy was dissipated to screaming, crying or shouting due to an extricating pain during childbirth, Dr Olusiji Jagun, a consultant obstetrician and gynaecologist at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, said it could slow down the childbirth process.
Dr Jagun added, “It will also affect her energy level when she needs to push the baby out through the birth canal; that is why we discourage a woman in labour screaming, crying or shouting but rather give them some form of anaesthesia to manage their pain.”
He said that pain management in childbirth includes medical and non-medical methods. Medical methods include epidural, analgesics like oral morphine, pethidine (Meperidine) injection and nursing gas while non-medical methods include hypnosis, water bath, walking, perineal massage, emotional support to women from their partners.
During painful contractions, some women paced continually and rested when the pain subsided; because, lying down still aggravated their pain. Some women experienced pain relief from lying on the side, holding the waist, squatting and praying.
According to Dr Jagun, the use of epidural in childbirth is becoming common although the cost has been a challenge to its use by many women.
“These nonmedical methods, including oral morphine, although of different effectiveness in relieving the pain, do not affect contraction progressing in labour. Basically, if you see a woman in labour screaming and crying, you should give some pain relief,” he said.
Dr Monday Famakin, Chief Medical officer of health and Director, Primary Health Care, Ibadan North LGA urges that women in labour avoid screaming and shouting because it can affect oxygen supply to their baby during delivery, and invariably survival.
There’s no reason to be fearful about giving birth. Pain is not necessarily consistent during the labour process, certainly, breaks will be experienced between contractions or while pushing. If feeling nervous about giving birth, a birth preparation class will be useful. The birth preparation classes include instruction on comfort measures during labour.
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