Comfort measures in labour

So labour has started – this is it! But what do you do?

  • If your husband or doula isn’t there – then tell him what is happening.
  • Take a walk
    • If its getting hot and you have access to stairs then walking up them will help.  You can go sideways to get a rolling motion to help baby move further down into the pelvis.
  • If you have a birthing ball (a large exercise ball will do) then sit on this as it is great for helping your posture but also opening your pelvis. Think figure of 8 movements rather than bouncing.
  • Take a shower
  • Time your contractions – not every one but just to keep track
  • Go to the toilet – a full bladder can slow labour down (this is something to carry on doing through labour)
  • Finish packing your bags
  • Take some last pregnancy photos
  • Play cards
  • Go to the movies
  • Watch a film at home
  • Go out for dinner
  • Avoid a bath as full immersion in water can lower your oxytocin levels and slow birthing down. 
  • Stay in the moment – don’t worry about things to come
  • Sit on the toilet – the dilation station! Honestly with a pillow it can be pretty comfortable – I just want you to picture the power that gravity has so seat up and sit down.
  • Dance
  • Eat and drink – this may be monitored more when you are in hospital so take the time to build some energy stores.
  • Relax – this is the last time it will be just the two of you so enjoy it!

Using rhythm

Walking, squatting, rocking, swaying side to side on the ball or just leaning against something
whilst moaning or using controlled breathing is a great way to deal with the sensations that you will be feeling. If your birth partner or doula can mirror you then that can help you use the patterns of sound and motion you are making to overcome any discomfort you may be feeling.

Note to partner 

  • Do not be hurt if she asks you to stop mirroring her or encouraging her to breathe – she may want to be left alone.
  • If she looses her rhythm then bring her back gently by reminding her to keep her rhythm – this can happen in the most intense parts of labour.

Positions for labour

Position and moving around in labour is a really helpful coping mechanism.  You may find that These are positions that are great throughout labour.it helps you feel in control over your body or you may be surprised at how much it controls you, that you will resort to one position as it feels comfortable over and over again.

Look at the different positions in this diagram – they either require some movement or notice that there is very little pressure on the pelvis.  Movement keeps that open and allows the baby to drop, by avoiding pressing on the coccyx or back of the pelvis we are helping your baby to make space for baby to come down.  They can’t be born until the head is touching the top of the cervix so that is one of the primary functions of your contractions – to get that baby down!

Note to partner 

  • Encourage movement if you can – just changing position once an hour can make a big difference. Even getting her up regularly to go to the bathroom and then back to the same position is better than nothing.
  • But again if she prefers one above all else and tells you she doesn’t want to change don’t be offended and don’t force it!

Counter pressure

So like the side lying release and the hip presses which are detailed below – a counter pressure is designed to basically confuse the brain a little.  Placing an ice pack on the head or heat pack between the shoulder blades means that the brain gets a bit overloaded and doesn’t quite know where to send its sensation receptors so it sends them everywhere and diffuses the feelings through the body.  Most hospitals will carry ice packs for you, heat pads may be trickier but in my experience most women prefer cold over heat in labour.

Note to partner 

  • An ice pack when contractions are really starting to get closer together is a great idea.

Other things

Using a shawl, sling wrap or rebozo if you have one is another great method of relieving some of the sensations that you are going through.

Here you can see it being used as a belly support.  This is a super easy technique to be used from early labour.  You may find that you will instinctively pull during a contraction so take care to ensure that your bump is properly fitted in and that the top and bottom edges of the wrap are touching you all the way round with no gaps. The video below gives instructions on how to do this as well as some insight into the history of the rebozo.

https://www.youtube.com/watch?v=vFGOC0GOZ7Y

Using your hips

So baby has to descend through your pelvis and that is where you will feel the bulk of your birthing sensations.  There are some very simple moves your support person can do to help you through contractions.

Note to partner

  • Practice these movements.
  • These are really powerful movements and should really be used once we know that labour is established.  Trust this voice of experience when I tell you that these are effective but can also be tiring so wait as long as you can until starting these.

Hip squeezes.

Now this is done during a contraction and only for its duration.  The pregnant person can be on the bed, leaning on a birthing ball or standing that doesn’t matter.  This press is great for opening the pelvis, allowing the baby to drop and providing that all important counter pressure. It can help relieve back pain too!

The women on the clip below are actually my Lamaze teachers by the way!

https://www.youtube.com/watch?v=A3H1e_1bBMc

Side lying release

If you are not going to practice anything else then just work on this one! It is super powerful and I’ve found it to be amazingly effective as non medical pain relief. So I use this when I’m supporting births with the birthing person lying on their side and I just provide a counter pressure whilst they are having a contraction.  My hands are one on top of the other with the fingers interlinked and I apply gentle but firm pressure to the top of the pelvic bone (I can feel the top of the leg with the lower side of my hand).  Now I like my ladies to move (even when they are bed bound you can get movement in!) So do this for an absolute maximum of five contractions and then roll over – remember movement will help baby move down, keep your pelvis engaged and with this exercise ensure that we are engaging all of the pelvic floor muscles, not just those on one side.

This video features a slightly different version which can help baby engage more and speed up labour.  Both versions require the back and pelvis to be straight (stacked) so there is no tilt as that can potentially cause issues.

https://www.youtube.com/watch?v=I_kMy5MWy8Q

https://www.spinningbabies.com/pregnancy-birth/techniques/side-lying-release/

Further resources

https://www.nationalpartnership.org/our-work/resources/health-care/maternity/comfort-in-labor-simkin.pdf