So, now you're starting to have a real understanding of what will help you stay relaxed during labour, we're going to have a look in this mdule at some practical ways to help you stay as comfortable as possible. This diagram sums it all up perfectly - the combined factors that are needed to have a better birth and keep the sensations manageable:
Let's take a look at some practical ways that you can help promote comfort, and stay in this cycle of keeping calm and relaxed.
Massage, along with breathing, is one of the key tools to help you stay calm and relaxed during labour. It's beneficial for several reasons - it helps promote feelings of love and being supported which is great for helping the production of oxcytocin (the love hormone). It also acts as a distraction - if you're focussing on the lovely touch of your partner then you're less likely to focus on what's going on around you or sensations happening elsewhere in your body. Massage is also a great way to help you feel relaxed and release any tension or lactic acid from your body.
The key areas to focus on massaging during labour are shoulders, neck, back, sacrum (base of the spine), and bottom. You can use the image above as a guideline for positioning and direction of flow of touch. This is something that you and your partner can practice together during your pregnancy, especially towards the end when you will particularly feel the benefit. Don't get too hung up about technique and if you're 'doing it right'. What's important is that it feels good. Time spent together practising is also strengthening the bond you have together. Try different types of touch - tickly, light touch with finger tips or nails, or a firmer kneading massage and use oil if you prefer. Some types of massage may not provide as much physical relief but all touch will help to keep you calm, relaxed and feeling loved and supported.
You may also find that you have established ‘touches’ as a couple which you find comforting – stroking the hair, a gentle tickle up and down the arm, a foot massage.
An important note to remember though is, while some women love to be massaged and touched during labour, some women don't and prefer not to be touched at all. You won't know until you go into labour so just go with how you feel on the day. Partners, don't take offence if this happens! It's nothing you are doing wrong and you can still support your partner emotionally and practically.
Shaking the apples
This is a technique from leading birth guru Ina May Gaskin which is great for releasing any tension, adrenaline or build up of lactic acid. Stand with your feet hip width apart and make sure that you are braced or leaning against something. The birth partner then needs to give a vigourous rub down your back, hips, bottom and legs, shaking and rubbing to release tension in the muscles and getting the blood flowing. This is great for releasing emotional tension too (use any time things seem to take a 'serious turn' to change focus and lighten the mood) - it often ends in laughter! Birth partners, make sure that you start off gently and then increase speed and pressure.
Many women find that they experience tension/aches in their lower back during pregnancy, particularly during the last few weeks. This is to be expected as the size and weight of your bump puts strain on the back, spine and core muscles of the body. It's also common that some of the sensations of the uterus contracting during labour can be felt in the lower back. This is a great little massage technique to help eliviate pressure on the lower back and can be used as required during your pregnancy or during contractions.
Mum-to-be should position yourself so that your back is easily accessible (on all fours, leaning on a birth ball, seating leaning over a chair or bed etc.), you are comfortable and that you are braced. Birth Partner should then place the balls of your palms onto the base of the spine - the sacral area of the lower back (approximately where the 'dimples' in her back are but let your partner guide you and tell you when you get the right spot). Then gently increase the pressure by leaning your weight onto your arms. Stop and hold once you reach a comfortable point for your partner and maintain as long as required. Using your body weight to apply the pressure means that this is an easy position to hold for a while (arms can get achey during some forms of massage!). This can also be done using a rotational motion if you prefer (using the balls of your palms to create a circle of pressure).
There are many benefits of using water during labour. Most birth centres provide birth pools and you can hire them if you're planning a homebirth.
You can also make use of the relaxing properties of water while you're still at home (if you're intending to go to a hospital/birth centre) - either a bath or shower. Keep in mind though, if you're alone, that you'll need to get out and your contractions may get more intense and regular (a shower may be an easier option than a bath if you're concerned about getting out unaided).
The pelvis is a moveable structure which opens during labour to make room for the baby to move down the birth canal. Movement can really help this process of the pelvis opening up. Swaying, walking or, if you're feeling nice and energetic, dancing are all great ways of keeping moving during labour. They can also used as forms of natural induction to help get things started, if you find yourself impatient to meet your baby and heading past your due date.
Sitting on a birth ball will start a gentle swaying or you can sway or rotate your hips in a circle whilst standing. Walking can be done anywhere but if you are showing signs of being in labour then it's worth staying near to home (walk in circles rather than too far in one direction so that you don't find yourself too far from home if contractions start to grow in intensity). Dancing can be a great mood lifter and form of distraction, as well as getting you moving. Try it in the early stages of labour while you're at home - put on some of your favourite tunes and dance your heart out!
Positions for Birth
The key thing to remember is 'upright and forward' and to avoid lying on your back during labour for any length of time.
When the uterus contracts it tilts forward so any position that is 'upright and forward' is working with your body (rather than fighting it and causing tension), allowing each contraction to be as effective as it can possibly be, and is also making full use of gravity to help baby make their way down.
Lying on your back means that you are not allowing your pelvis the space that it needs to fully open, leaving less space for your baby to move down the birth canal, and therefore making things a little more difficult for yourself. The main blood vessel supplying oxygen to the uterus runs down your back and applying too much pressure on this risks compromising the oxygen supply to your baby. If you imagine the weight of your bump, (baby, fluid and all) is like a bowling ball and if you put a bowling ball down on a hose pipe it would stop the flow of water. this is to be avoided.
You may be asked to lie on your back for any examinations. This is absolutely fine, and nothing to worry about. Just make sure that you move from that position afterwards - it can be easy to forget and stay put.
Listen to your body and move into positions that feel right for you. Don't feel like you have to be 'active' (swaying/dancing/walking) if you are tired, lying on your side is fine if it feels comfortable to you. Just remember that staying in same position for too long can lead to achey muscles and cramps so make sure that you change your position regularly.
During the last few weeks of your pregnancy you may find that you feel generally a bit uncomfortable (your ribs may feel tight, you might find yourself waddling about or unable to touch your feet, you may be incredibly tired a lot of the time , you might have acid indegestion or many other little niggles that you'd rather not have to deal with right now). These are unlikely to go away before the birth so now is a good time to accept that you may experience some discomfort during labour, just as you are experiencing through the pregnancy (unless of course you're super lucky in which case smile and be grateful!). What you are aiming for during the birth is to be 'as comfortable as you can be' and this is a totally achievable state.
Start noticing what positions feel comfortable for you, especially during the last few weeks of your pregnancy. If you can only sleep with some strategically placed cushions then it may be an idea to have lots of cushions around for the birth to help you get as comfortable as possible (this is easy whilst at home, at hospital/birth centre you may have to ask for more pillows when you get there).
Try out the positions from the 'positions for birth' handout and see which ones you like, which ones feel most comfortable for you.
If you find that your temperature is always up and down, and you're hot one minute then cold the next, then have snuggly socks and a hand held fan available to help keep you warm or cool as required.
If you find that you often feel nauseous (or suffer from travel sickness) you can get motion sickness bands which you can wear on your wrists. Some women find that they do feel or actully are sick during labour and the bands can help prevent this.
Remember, any discomfort can nearly always be made more comfortable!
Heat and Cold
A hot water bottle or cold pack can be another way to help ease discomfort. I'm sure you've used one or the other before to ease a period pain or ache or bump and found it really soothing. Place it on your tummy or lower back to help relieve pressure and any aches. A cold, damp flannel or a chilled water spray used on your face can also help to keep you feeling cool and calm.
Birthing balls are usually available now in most birth centres and maternity units. It's definitely worth checking in advance with your local hospital to see if they have them. There are plenty of beneifits to using a birthing ball, from during early pregnancy right through until after your baby is born so you may want to buy (or borrow) one for yourself.
Using the ball during your pregnancy will help to keep with your posture (ideally you want to sit with your hips higher than your knees and your back straight, not slouched). It can help ease any lower back pain that you're experiencing, while at the same time helping to strengthen the muscles supporting the spine and in the thighs. It's particularly good in the last few weeks of pregnancy when it can be uncomfortable to sit on hard chairs or you might struggle to get up and down from your usual spot on the sofa.
Sitting on a birth ball in late pregnancy can also help your baby to get into the correction position, ready for birth, and the gentle swaying motion will help the pelvis to open up. During labour the ball can be used to help support you in many different positions (see birth positions). You can cover it with a blanket or sheet to make it feel more cosy to lean on.
After your baby is born you can continue to use the birthing ball. It can offer a gentle surface to sit on if you're feeling a little tender in the first few days after the birth. The gentle swaying motion can also be soothing for your baby if you use it to sit on while breastfeeding.
Spend some time with your partner trying out some of the massage techniques and find out where you like to be massaged and how. Once you know what you prefer, what makes you feel most relaxed, then start practising your preferred technique regularly (daily if possible). This can be 5 minutes before bed or just while you're sitting watching TV. It's a great chance for you to both have a bit of bonding time together as a couple and is also another chance for you to practise relaxing. Remember that relaxation requires practise and the more regularly you take time to relax, the more easily and naturally you will be able to get into a deeply relaxed state.