Cupids Health

Natural Labor Pain Management




A wide
variety of natural labor pain management techniques may be used
to ensure a smoother birth experience.  It’s quite common to use
different methods throughout the different stages of birth. 
There is no one-size-fits-all approach.  The most effective strategy is to listen
to one’s body – preferences will change throughout labor –
be open to new ideas.

Expectant
women often ask veteran mothers, “How
painful is childbirth?”
 The true answer to this
question is that most pain in labor is extrinsically created and
preventable.  It is crucial to
first address unnecessary sources of discomfort in labor which include anxiety, inadequate nutrition, and ineffective body positioning.
 Eliminating these
factors will lead to a smoother, more comfortable birth experience.

The
most critical labor pain management technique is
relaxation – mental, physical and emotional.  Relaxation is the foundation of a comfortable
natural birth.  For more information on specific relaxation techniques
for labor, see the Relaxation Techniques section.

Throughout
birthing, it’s normal for women to rotate between favorite labor pain
management techniques.  A woman may initially find comfort in the
water, only
to find that once transition begins, her body desires to be on dry
land.  After a few minutes, she may again desire to be back in
the water to birth her baby.  As labour progresses, the body
and the baby’s position constantly evolve to create the optimal
conditions for birth.  As a result, the need for different
forms of labor pain management evolves simultaneously.

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Dealing
with Discomfort

Since the sources of
discomfort can be interrelated, effectively
maintaining a high level of comfort in birth requires addressing all
three factors.  Once they have been properly addressed, any
residual discomfort in labor will be greatly minimized and can be
addressed with any of the following labor pain management techniques:

Counter
Pressure

Counter pressure is an effective labor pain
management strategy
for back labor or other area-specific discomfort.  It is
performed by applying pressure, usually significant pressure, to an
area of discomfort, such as the small of the back.  Back labor
can also be a sign of an occiput-posterior baby, or one that is facing
the mother’s abdomen rather than her spine.  With this type of
presentation, the baby’s face may be pressed against the mother’s
pelvic bones, causing discomfort for both mother and baby. The head
isn’t able to flex properly to allow the smallest diameter
to pass through the birth path. In this case, techniques such as

lunges
or the
lift technique
,
may help the baby rotate into an optimal birthing
position.

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Environmental
Conditions

Birth
affects, and is affected by, every
sense in the body.  By giving special attention to all the
senses, we can bring harmony to the mother as a whole.  Labor
pain
management techniques should address all the senses.  For
the visual sense, try dimming the lights or using candles to bring a
soft glow to the birth environment.  For the sense of smell,
use aromatherapy, scented candles, or essential oils to bring calming,
soothing scents.  For the auditory channel, speak in low,
soothing tones.  Refrain from unnecessary chatter or
extraneous background noise.  Relaxation music, such as that
used for
relaxation practice during the pregnancy, can be softly played.  For the tactile sense, use
counter-pressure, massage, or light touch massage, as the mother
wishes.  Bring soft towels, blankets or pillows to avoid rough
textures.

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Breathing
Techniques

Breathing
techniques, such as sleep/rhythmic breathing, can center birthing women
and
focus their mental state.  Sleep breathing is performed by
filling the abdomen first, rather than the lungs.  The mother
is to inhale for a count of 4, then exhale to a count of 8. 
She should focus on making her abdomen rise and fall, rather than
collapsing her lungs or using shallow clavicular breathing. 
This type of breathing is similar to the pattern used during sleep,
hence, the name.

Breathing can also be
used as a force to expel the baby.  Women can
actually
“breathe” their babies down the birth path by sending breath
down
through their body.  An excellent visualization to pair with
this type of breathing is to envision the body as a “J” with the
breath following that shape down and out the birth
path.  Instead of blowing the air out of the mouth, think
instead of directing it downward.  An excellent way to monitor
whether this type of breathing is being done correctly is to place one
hand on top of the belly, right beneath the bust. 
This area at the top of the belly should tighten as the breath is
expelled.  Another advantage of this breathing technique is
that it allows the perineum to stay relaxed while the baby is
descending, thus reducing the risk of tearing and allowing a smoother,
shorter
pushing stage, or eliminating it entirely.

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Water

The
use of water is well-documented as a labor pain management
technique.  Laboring women can
get in the shower and direct the water stream to specific areas of
discomfort.  Using a labor tub decreases the pressure on the
mother’s body, alleviating pressure and making her more
buoyant.  This can enhance her relaxation and facilitate
comfortable birthing positions.  Complete submersion is not
always encouraged in early labor as the water may lessen the
concentration of oxytocin in the mother’s body, thus slowing
labor.  See the
Waterbirth section for detailed information.

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Birthing
Aids

A
wide variety of common household items and some commercially-available
tools can be used for labor pain management.  For a hospital
birth, women can request the use of a birthing
ball,
childbirth squat bar or kneeler to help with appropriate positioning. For detailed
instructions on the importance of using effective positioning in labor,
please refer to the full Birth Positions section.

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Vocalization

Voice
is a powerful tool.  A birthing woman may choose to
moan with her contractions.  She may choose to softly
sing,
chant, or grunt.  She needs to follow her body and know that
whatever sounds she makes are good sounds, are natural
sounds.  There are no apologies here; she must follow her
body’s lead throughout the process of birthing.

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Visualization

Mental
imagery is a highly-effective labor pain management technique, used
frequently by professional
athletes to naturally enhance their performance.  A mother can
use the same technique to visual herself in each of the stages of birth
– how she will respond to the different changes and challenges she may
face.  When we visualize a sequence of events as we would like
them to happen, we mentally prepare ourselves to act in that
situation.  This reduces anxiety of the unknown in that the
scene has become a familiar one, not a scary new experience. 
Laboring women may visualize their cervix opening, their
baby descending the
birth path, or their breath as it enters and exits the body. 
These techniques are particularly effective when paired with a imagery
relaxation script, either read by a birth companion or in audio form.

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Emotional
Support

Next to relaxation, emotional
support
may be the most
critical, and most overlooked, natural labor pain management technique
for all
labouring
women. 
Studies have shown that women supported by
other women, including a
doula, or knowledgeable birthing companions, experience more positive,
less complicated births and report more satisfaction with their birth
experiences.  They also show less use of interventions during
birthing
and faster recovery.

When a
woman is laboring, she may need someone to be her voice.  When
she becomes immersed in her work, the work of birthing her child, she
may depend on others to monitor her needs – is her jaw clenched or her
eyes shut tight, does she need to alter her position, is she breathing
effectively – and suggest comfort measures along the journey. 

She needs someone to lean on, both
physically and mentally.  Just the simple fact of knowing that
she is surrounded by those people with genuine concern for her
well-being and that of her baby, can put her mind at ease and allow her
to focus on the task at hand. 

Most
critical of all, women need to be reminded that
not only can
they give birth naturally, but that they are giving birth
naturally.  That each surge of a contraction is bringing them
closer to their child, that each breath brings them closer to
motherhood,
when the real
worries begin!

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References

Royal
College of Midwives. 2006. “Immersion in water during labour
and birth.” Joint Position Paper no. 1. London, Royal College of
Obstetricians and Gynecologists and Royal College of Midwives.

Ros,
Andrea, Ricardo
Felberbaum, Iris Jahnke, Klaus Diedrich, Peter
Schmucker, and Michael Huppe. 2007 “Epidural anaesthesia for labour:
does it influence the mode of delivery?” In Archives of Gynecology and
Obstetrics. V. 275(4):269-274(6).

Cluett
E R, Nikodem VC, McCandlish RE, Burns EE. Immersion in water in
pregnancy, labour and birth. Cochrane Database of Systematic
Reviews
2002, Issue 2. Art. No.: CD000111. DOI:
10.1002/14651858.CD000111.pub2.

Geissbühler
V, Eberhard J:  Waterbirths: A Comparative Study.
 Fetal
Diagn Ther 2000;15:291-300 (DOI: 10.1159/000021024)

Smith
CA, Collins CT, Cyna AM, Crowther CA. Complementary and alternative
therapies for pain management in labour. Cochrane Database of
Systematic Reviews
2006, Issue 4. Art. No.: CD003521. DOI:
10.1002/14651858.CD003521.pub2.

Lowe NK. The nature of labor pain. Am J
Obstet
Gynecol 2002;186(Suppl 5):S16-24.

Lowe NK. Differences in first and
second stage labor pain between nulliparous and multiparous women. J
Psychosom Obstet Gynecol 1992;13:243-53.

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by Catherine Beier, MS, CBE




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