Eight top tips from doula & mum of five, Cathy, Chilled Mama.
Generally the things that women do naturally during tightenings not only help cope with the
discomfort, they also help birth move along.
Most forms of pharmacological pain relief work on relaxing the muscles and altering the woman’s perception of pain. Relaxation, hypnosis, and focused breathing, as well as meditation and imagery, can create similar states. Some women using these techniques report experiencing no pain during contractions. Focused breathing also ensures adequate oxygen to the uterus muscle which stops it ‘hitting the wall’. All of these help reduce adrenaline and increase the flow of oxytocin and endorphins.
Women naturally tend to rock, sway, march, walk through contractions. All these movements help the pain but also help the baby to move down. Early labour put some funky music on and sway those hips, feet wide, making room for the baby to move down. Follow your instincts. I've known women make movements such as high marching or lunges, that on hindsight were just what the baby needed.
In labour women usually use positions that ease the pain – upright, leaning forward. This helps not just because of gravity, but because of the shape of the uterus (which tilts forward in labour) but also the shape of the pelvis.
There are more surfaces to lean on at home, in early labour or home birth. In hospital you can raise the hospital bed or lean on your partner or sit/lean on a birth ball. You can even put a birth ball on the bed and kneel over it there. Sitting on a toilet or birth stool can be really comfortable towards the end of labour. You can hire inflatable birth stools.
Lying on your back on the bed is generally found to be more painful. If you have continual monitoring you can sit on a chair or birth ball, or lie on your side. If you do end up on your side, a peanut shaped 'ball' is great for keeping your hips apart, giving baby room to move down. If you are on the bed temporarily for any reason, such as a check, you might need help – or even reminding/encouraging – to get off the bed.
Use different positions at different times for what suits and helps you. Let your instincts take over, with confidence.
Using water in a bath or birth pool is often referred to as ‘the midwives’ epidural’ as the warmth of the water interrupts the nerve pathway. According to the gate control theory of pain, warmth, counter pressure, relaxation, and distraction all close the gateway to stop the messages getting to the brain. Relaxation from being in water causes a surge in oxytocin, which helps labour move on.
Massage and counter pressure can be useful in reducing the pain messages that reach the brain. Massage of back or legs, and hip squeezes are most common. Partners can do counter pressure on the thighs or on the lower back (with their hands or a tennis ball). The latter is particularly useful with back ache labour. There is a massage technique your partner can do which I call 'wash on, wash off'. Alternate hand starting in lower back, move up and round following the hip bone. Cup the side of the hip and return. Other hand. So women do not wish to be touched in labour. Touch, including stroking, hugs and kisses also release oxytocin, which increases the waves of power. I have seen this work.
6. Continuity of care
The continuous presence of another woman who has had a positive experience of birth herself, be it midwife, doula, or relative/friend, giving emotional support has been shown to be effective in reducing the amount of pharmacological pain relief needed, and reduces the need for interventions. It is the single biggest impact on having a straightforward birth. It is in the NICE caesarean guidelines: Every woman should be told that having another woman with her in labour reduces the chance of having a caesarean.
Humming, singing, making 'ooooo' 'aaahhhhh' sounds can help you be relaxed and release tension. Don't feel inhibited. These sounds keep the throat open and relaxed, which means the vagina will be open and relaxed. (Yes, there really is a link.) Some people are really quiet in labour. Don't make a noise just because you should. Try with & without. Just check the sounds you are making are helping you to be relaxed, not tensed. Relaxed sounds tend to be lower, and tense sounds higher. Turning a tense sound into a relaxed sound can make all the difference. One client, having a vbac, got stuck, labour had stalled. She was fighting the waves of labour, and saying 'No'. I whispered to her that she was where she wanted to be, at home, in the pool, having her baby, she changed and started to say 'Yes! Yes!' Baby was born five minutes later.
8. Confident attitude
Research has found that women who think they will be able to cope with the pain use less
pharmacological pain relief. ‘Self talk’, affirmations or mantras can help with this. It helps you to have confidence if you have a range of tools to use, like the ones in this list, that you know will help you in labour.
Each one of these things will bring the discomfort level down. In my last labour I can honestly say that while I was doing these things I felt no discomfort. I knew it was there. If I stopped doing any of them it would increase, but while I was in the pool, relaxing, focusing on my out breath, singing, with my partner, doula, midwives supporting me, totally in the zone, then I could do it. And each wave of labour that passed, saw my confidence grow.
You have all these tools in your tool box, plus you know yourself. Try different things out to see what works for you, and what doesn't. Change and try new things as labour progresses. Just like any other mammal would. You carry within you thousands of years of knowledge in your bones.
You can do this!
I am a doula, antenatal teacher and more. Check out my website for more ways to start calm, confident and in control in pregnancy and birth, including my Chilled Mama Pregnancy Retreat Days, plus info for partners.