Comfort Strategies for Labor

We all know that with childbirth comes pain. But there are many strategies for managing pain besides medicine. Pain is natural and it's a sign that labor is progressing. 

Labor Pain

Here are some things to keep in mind about labor pain. 

• Labor pain is productive - it is not a sign that something is wrong. Keep in mind what you will be achieving through the process. 
• Labor pain comes and goes - it is not constant. You will have rest periods in between. 
• Labor pain is predictable - it begins, rises, peaks and subsides.
• Your body works with the pain - endorphins will be released which helps reduce the pain and provide a sense of well-being. 
• There are many effective strategies you can use to lessen labor pain.
• Many women do fine in labor - they draw on their body's natural resources and use pain management techniques. Others need more help to manage their pain.
• Know your options in labor - Different things work for different people. 
• Ask questions - talk with your caregivers. 

Relaxation 

Being able to relax your body gives you control over it. Relaxation is one of the most important factors during labor and birth.

Relaxation reduces pain and muscle tension. There are many studies that show that relaxation reduces tension and anxiety during childbirth. 

Types of Relaxation: 

• Basic (passive) relaxation - body awareness
• Progressive relaxation - relaxing head to toe
• Touch relaxation
• Neuromuscular relaxation - training your body to know the difference between muscle stress and relaxation
• Relaxation with music and visualization 

The key to effective relaxation is frequent and consistent practice. Techniques become more effective and easier to use if your body is used to using them. 

It helps both mom and labor coach to practice together. This way the labor support person will be able to detect tension and then help to ease it by touch or verbal cues.

Visualization & Imagery 

Mental imagery causes physical changes in the body. It can change the course labor. Usually imagery starts as part of a relaxation exercise. 

Examples:

• Imagine you are very comfortable, cozy, and relaxed. Think of words such as floating, drifting, cushioned, or warm. 
• Imagine the contraction as a hug around your baby, not painful or intense. 
• Imagine the cervix opening like a flower, not a tight constriction. 
• Picture the baby moving down the birth canal. 

Music Helps Visualization 

• Music is soothing. Rhythm is a basic human force.
• Listening styles vary. Choose whatever helps you relax. 
• It should be calming and non-intrusive (no more than 60-70 beats per minute). 
• Music without lyrics is often best. 

Make Your Hospital Room as Comfortable as Possible

• Do you prefer sunshine or more subdued lighting?
• Bring your own pillow. Use a pillowcase you will be able to recognize as yours. 
• Adjust your bed for comfort. Change positions. 
• Ask for a rocking chair or birthing ball. 
• Concentrate on the job at hand. Avoid outside distractions. 

Focal Point 

Use a focal point. Keep your eyes open and focused during the contraction. Look at a picture, an object in the room or outside, or at your labor coach and his or her cues. 

Breathing Techniques

Breathing techniques help by taking your mind off your pain and focusing on something else. They are simply a concentration strategy.

Start using these techniques only when your labor contractions are strong enough to distract you from whatever else you are doing. Starting too soon could exhaust you.

Breathing exercises are most helpful when they help you to relax. Vigorous artificial breathing and holding your breath a long time will make your muscles tense, create an imbalance of oxygen and carbon dioxide, and waste energy.

Use each level of breathing during labor if it is helpful to you, regardless of which stage you are in.

The Cleansing Breath

• Begin each contraction with a deep relaxing breath.
• Breathe in through your nose, (deep breath) and out through your mouth (big sigh). This helps you to start off relaxed.
• This deep breath will become a conditioned response to relax your body. It will also provide a good flow of oxygen to the baby.
• When the contraction is over, this deep breath will help you to release any lingering tension from the contraction.
• Cleansing breaths also signal your labor coach that a contraction is beginning or ending.

Slow Deep Breathing

This is a slow, relaxed breathing, usually about half as fast as your normal breathing.

Inhale to the count of five through your nose and then exhale to the count of five through your mouth. If you cannot breathe in through your nose comfortably, you can inhale and exhale through your mouth.

Most important is that you take in and let out equal amounts of air at a slow but comfortable rate. Expand your lungs to a comfortable level (your chest should gently rise), and then exhale slowly (your chest should gently fall).

This type of breathing is often used along with music to aid in relaxation.

It is okay to close your eyes. It may help to use imagery or visualization. Keep your face, mouth and shoulders relaxed.

You will use this technique until it is no longer effective.

Tips
Do not hold your breath!

Practice a few minutes of this breathing before falling asleep at night.

Paced Breathing

Use this type of breathing when contractions become more intense.

This breathing is done in and out through the mouth only. Take a short breath in (“hah”) and then a short breath out (“hee”).

Breathe in and out at a comfortable rate. Pick up the rate of speed as the contraction intensifies or peaks. As the contraction subsides, again lower your rate of breathing. Breathe according to the pain you feel.

Consciously think about the pace of your breathing and the pattern: “Hah– hee hah– hee hah– hee hah– hee”…

Don’t go too fast (hyperventilate). Keep your mouth, face and shoulders relaxed.

Tips
To prevent mouth dryness, bite on ice chips, or rinse your mouth with water or mouthwash. Use lip balm.

Treat contractions one at a time. Work through the pain. It will last 60-90 seconds. Then you will have a break.

Rest between contractions.

Patterned or Pant-Blow Breathing

When contractions become very strong, you may use pant-blow breathing. This breathing follows a repeated pattern and rhythm. Your labor partner can give you verbal cues to help you follow the pattern and rhythm.

Breathe in and out through your mouth. Take 3-4 shallow breaths, followed by a blow, allowing equal amounts of air to flow in and out.

Using the “haa-hee” in and out pant, now add a “hah-who” to make it patterned.

Example:
“Hah-hee, hah-hee, hah-hee, hah-who” (Blow the air all out).

Tips
Your coach needs to be close to you to help keep you on track.
Keep your eyes open and focused.
Your coach can give you instructions, “Breathe- breathe- breathe- blow.”

Breathing to prevent pushing

If you get the urge to push before your labor
nurse or doctor gives the okay to do so, it may be very helpful to use the “blow-blow-blow” method to keep yourself from bearing down.

If you push before it is time, this could cause swelling or tearing of the cervix. This could be painful and may slow the progress of labor.

The urge to push is usually strongest at the peak of the contraction. As this occurs, just “blow-blow-blow” or “pant-pant-pant” until the urge fades away.

Massage

Touch and massage are very healing and are helpful in reducing labor pain.

Touch needs to be firm, but gentle. A light or tickling touch may be irritating.

Firm massage helps to release endorphins, which help to control pain.

Ask your labor coach to help you relax with deep, firm touch such as massage, hugs, and pressure on the lower back, palms or bottom of the feet.

Tip
Bring lotion for massage, so your skin does not get sore.

Counter Pressure

If you have a lot of back pain, your coach can
apply pressure on your lower back using a closed fist or heel of the hand. You will know the best spot.

Often rolling pressure is helpful. Use a rolling pin or cold can of soda from the machine, or ask for an ice glove.

Heat can also be helpful. Use a heating pad or hot water bottle.

Hydrotherapy 

Some women find taking a warm shower or bath can be very relaxing during labor. We have whirlpool type tubs available.

Aromatherapy

Some women find that essential oils help. The oils do not take the place of the medicines or treatments that your doctor prescribes for you. However, essential oils can help with anxiety, pain, nausea, fatigue and trouble sleeping.