Coping techniques without drugs
Certain strategies lay the foundation to help you cope with the pain of labor. These include working with a provider you trust; knowing ahead of time what pain relief strategies are available in your chosen birth setting and maximizing your range of safe options; and giving birth in a safe, comfortable space, surrounded by people who will provide you with good support.
Most women labor best in a calm, nurturing environment. For instance, having privacy, dim lights, quiet voices, and/or music of your choosing can contribute to your sense of ease and safety.
Some of the strategies listed below can help reduce pain, while others can help you cope better with it. Women’s responses to these techniques vary; you may find that some techniques are helpful while others are not. Your support team can help you try different strategies and see what works. An experienced nurse, midwife, or doula will have suggestions for specific techniques to assist you. In some cases, there is little scientific evidence that a particular strategy is helpful, but it is included as some women find it comforting and it poses no risks.
Movement, Positions, and Rhythm
Having the freedom to move and change positions makes labor more manageable for many women. Upright movements, such as walking, swaying, lunging, moving on a birthing ball, and dancing, can help reduce discomfort and help move the baby down into a good position for birth. As labor progresses, you may find yourself staying in one place or gravitating to a bed, but you are unlikely to want to lie on your back. Upright positions may be more comfortable and may open your pelvis to help the baby descend. Being on your hands and knees can help relieve back pain. Lying on your side helps you rest your legs and may help the baby to rotate into a good position for birth.
In active labor, you turn inward, and you develop a rhythm that takes you through each contraction and rest period. You may rock back and forth, moan, curl around a partner’s hand during each contraction, and then want massage or total silence in between. The pattern that works for you will be uniquely yours. While the woman is in this zone, she can benefit when her support team reinforces her rhythm/ritual and keeps interruptions to a minimum.
The two things that helped me through the labor were mooing and yelling at the top of my lungs. Mooing was the only sort of deep moaning noise that made my whole body feel good, but it did not fit into my mental picture of myself as a chic, polite woman, so I kept making myself laugh. I would do these big low bellows and then burst out laughing because I was so embarrassed, but then that felt really good, so I would just keep laughing.
Many hospitals may restrict your movement, especially if you are alone, so try to have a support person with you and try to maintain your freedom to move during your labor. If you are encumbered with multiple attachments such as blood pressure cuffs, IVs, a bladder catheter, and electronic fetal monitoring equipment, it may be impossible to move freely. You have a right to refuse all these monitors. If you do accept them, you can adapt by standing by your bed, sitting in a chair, swaying in your partner’s arms, and so forth. If you have an epidural or have taken medicines that can make you feel dizzy, you will likely be restricted to bed.
The Comfort of Water
Being in water during labor can be wonderfully soothing and can help you relax. Many studies have shown water immersion during labor to be safe for both mother and baby while also reducing the mother’s pain and her need for pain medication. Women who bathe or shower during labor have high satisfaction with this method.
When using a tub, work with your midwife or physician to determine when and for how long you can be in the bath, so that you can avoid any negative effects. If a woman enters the bath before she is in active labor or stays in for more than one or two hours, labor progress can be slowed. Drink plenty of fluids, and keep the tub water at body temperature to avoid getting dehydrated or overheated.
If a tub is not available, showers are also a good option during labor. Standing and swaying under the water or holding an extended showerhead and letting the water run over your belly can be very helpful.
Focusing on your breath, a calming and centering technique used in meditation and yoga, may help in labor as well. Classic strategies include a deep, sighing breath at the beginning and end of each contraction to release tension. During contractions, you can pay attention to your breath, letting it anchor you to the moment as your contraction begins. Or breathe along with the contraction, matching your breathing to the rise and fall of the contraction as it becomes stronger, peaks, and subsides. Repeating affirmations may also be helpful. Focusing on exhaling slowly between contractions as you relax muscles and get rid of tension can help as well.
The use of hypnosis in labor has undergone a recent renaissance. Self-hypnosis involves practicing techniques before labor begins that you can use to help trigger deep relaxation when the contractions start. You can practice these on your own or with a partner. Several kinds of pre-natal classes are available to learn hypnosis for birthing.
The human touch is a powerful way to relieve pain and reduce anxiety in labor. Touch may range from a supportive hand placed for reassurance in one spot, such as on your arm, to light stroking on your back and arms as you have a contraction to a firm massage on your neck and shoulders between contractions. Counter-pressure is using a special kind of touch to help relieve back pain in labor. Someone places the palms of her or his hands over your lower back where the sacrum (the triangular area at the base of the spine) is and then firmly presses in and supports your back during a contraction, holding it until the contraction is over. Another technique is squeezing in on both hips, which places pressure on the outside of your pelvic bones.
In the midst of the wildness of transition, as I was on hands and knees throwing up into a bowl, my midwife placed her hand right at the small of my back. After giving birth, I couldn’t conjure up in my mind what a contraction felt like, but I will always remember just how that touch felt.
Heat and Cold
At times during labor, an ice pack on your lower back or a warm compress on your abdomen or back may be just the right thing. (Wrap an ice pack so that the ice is never directly in contact with your skin, and a warm compress should never be too hot to hold comfortably in the hand.) At other times, a cold washcloth on your forehead or on the back of your neck may feel perfect. The changing sensations can sometimes distract you from labor pain.
When I was home-birthing my baby daughter, my four-year-old son, Alex, held an ice-cold wet washcloth to my forehead during the most intense part of my labor. It was extremely soothing and also allowed me to direct my focus to a single place without distraction. It was definitely one of the best tools for birthing comfortably and calmly. Not to mention, it was a wonderful way for my son to participate in the birth of his sister!
For information on medications that can ease labor pain, see Medications for Pain Relief.