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Comfort and pain during labour

Labour is intense, to say the least. But does it have to be painful? It can be helpful to reframe the sensations you are feeling. In the words of Ina May Gaskin “labour is an interesting sensation that requires all of your attention”. Many people prefer to refer to surges or rushes as opposed to contraction, HypnoBirthing follows this tenant as well.

The Pain-Tension-Fear Cycle

It’s very common to hThe Pain-Tension-Fear Cycleave fears surrounding birth. When we experience fear it releases adrenaline which in turn can cause ineffective muscle contractions around the uterus. As a result the production of oxytocin and endorphins decrease and the muscles in the uterus start working against each other. All of this restricts blood flow to your uterus and is a trigger for pain. It also lowers your pain threshold. In dangerous situations, this fear-pain-tension cycle allows for response and survival, in birth it can become a complication. Often, as the pain increases the fear increases and then the tension increases resulting in a repeating, and counter-productive, cycle. So, reducing pain really comes down to reducing tension in your body.

Breaking the Cycle

In her book “The Birth Partner” Patty Simkin discusses The 3 R’s of labour. These are Relaxation, Rhythm and Ritual. Engaging in all 3 of these brings you into the present moment and allows you to move through each contraction without being overwhelmed by them. Often rituals will arise spontaneously during the course or your labour and they can change as your labour progresses. The best rituals involve rhythm and repetition, which lead to relaxation. Things to incorporate in your rituals include: focusing on the breath, staring into someones eyes, “slow dancing” with your birth partner, dancing to music, or anything else that feels good to you in the moment.

Helpful hints for your birth partner

Penny Simkin’s book The Birth Partner also outlines a great tool for partners. It is called the Take-Charge routine and is outlined in detail in her book. It is great to use when the birthing person is having difficulty maintaining their ritual or is appearing to be overwhelmed or distressed.

1) Remain calm, others pick up on your energy
2) Stay close, bring your face close to theirs
3) Anchor them by calmly holding their shoulders or hands
4) Get them to look at you, eye contact itself can help to bring them back to the moment
5) Talk to them in between contractions, make suggestions of rituals to try, such as concentrating on the breath
6) Help them regain their rhythm, move your body with theirs

It may also help to remind birthing persons that they are about to meet their baby.

Tips to use in the moment

Any of the following can be helpful during labour, but remember that the right thing for you to do is whatever makes you fell calm, safe and relaxed.

  • Discuss any fears that you are experiencing with your doula, partner or care provider
  • Progressive relaxation, guided meditation or visualizations
  • Make noise and breath with sound
  • Change positions: hands and knees, on a birth ball, walking around, slow dancing
  • Acupressure
  • Use water such as a shower or birthing pool
  • Ask for assistance and allow your partner and doula to support you with hip squeezes, low back pressure, massage, etc
  • Hot or cold applications to your face, back or neck

Sample Visualization script:

Close your eyes and take a few deep breaths, allow your body to relax. Imagine that on each breath you inhale a beautiful white light. Follow this light as it fills your entire body and surrounds your baby. It feels safe, comforting and full of love. As you breath allow this light to move down, through your cervix and birth canal. This light allows your cervix to relax and open with ease and creates a clear path for you baby’s journey into the world. Take a few more deep breaths sending love to your baby while you both enjoy this beautiful light, when you feel ready, open your eyes.

Massage:

Massage is a great way for your birth partner to support you both before and during labour. Light touch massage serves as a tactile reminder for you to relax whereas deeper massage can help to ground and ease muscle tension.

Light touch massage: Use the whole hands or finger tips, run them gently up and down the length of your partners arms, back or thighs.

Deep massage: Can be performed on feet, shoulders or the lower back, ask your partner how much pressure feels good and where they prefer to be touched.

Acupressure:

Acupressure can be used by your birth partner or doula during your labour, many people find it extremely helpful in reducing pain sensations. It works best if you apply medium to firm pressure. It should be mildly uncomfortable but not painful.

1) In between the thumb and the first finger, in the fleshy portion, called large intestine 4, this point is well studied for relieving pain
2) 4 fingers width above the bone of the inner ankle, called spleen 6, this point helps to dilate the cervix
3) On the top of the foot in between the big toe and the second toe, approximately one inch from the web, this point is very grounding and also helps with pain relief

Positions that may be helpful:

  • Hands and Knees
  • Assisted squat
  • Cross legged
  • Leaning forward
  • Leaning backward
  • Slow dancing

Really, what it all comes down to is finding what works for you. You may have to try all of these things and more before you find it. What’s working may also change as labour progresses, walking through High Park when the cherry blossoms are out may be great for early labour, but it’s not the best as things become more intense. Surrounding yourself with people who can help remind you to try something new is probably the best thing you can do for yourself.

 

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This article is meant to provide information only, it does not substitute for personalized medical care.

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