Comfort Measures for Labor

By Penny Simkin, Janet Whalley, and Ann Keppler
Issue 95, July/August 1999

Women respond differently to labor, depending on the nature of their labors, their sense of readiness, their coping styles, and their goals and expectations. As you prepare and rehearse for labor, learn various comfort measures and then adapt them to suit you. Use this knowledge to develop your own style for labor. Think about what helps you to relax: music, massage, soothing voices, a bath or shower, meditation, prayer, chanting or humming, or thinking about or visualizing pleasant places and pleasing activities. Plan to use these familiar comfort measures to help you relax in labor as well.

Unlike most pain, which is associated with injury, illness, or stress, the pain of labor is associated with a normal healthy body function. By recognizing your labor pain as productive and positive – a part of the process that brings the baby – you can help reduce the pain to a more manageable level. To cope with your pain, you may find it most helpful to "tune into it" – focus on it, accept it, and tailor your response to it. Or you may prefer to use distraction techniques, concentrating on outside stimuli, to keep yourself from focusing on your pain.

Many women successfully employ both tuning in and distraction. For instance, in early labor they relax, breathe slowly and easily through out their contractions, close their eyes, and visualize either something very soothing and pleasant or the uterine contractions opening the cervix and pressing the baby downward.

As labor becomes more intense, some continue in this way; others lighten and speed up their breathing. Then, during late labor (transition), when contractions are very intense and close, many women find they cannot continue as before. They find they must open their eyes, focus outside (perhaps on their partner’s face), and follow outside directions (their partner guiding their breathing with verbal directions, with hand signals, or by breathing with them). Sometimes more complex breathing patterns are helpful.

The following comfort measures are based on relaxation, the key to pain control in labor. Learn and adapt them to suit yourself.

Attention-Focusing
During labor contractions, it helps to focus your attention on something. Many women prefer an internal focus. They might visualize exactly what is happening – contractions of the uterine muscle pulling the cervix open, the baby pressing down and opening the cervix.

Others prefer to visualize something calming and pleasant– the beach, a mountaintop, a happy memory, or they visualize themselves as above their contractions, like a gull above a stormy sea, soaring over, but very much in touch with, the contractions.

Still others visualize each contraction as a hurdle to be overcome, for example, a steep hill to be climbed, a footrace, a wave to ride.

You might also find it helpful to look at something. This visual focus is often called an external focal point. You may wish to look at your partner’s face, a picture on the wall, a reminder of the baby (perhaps a toy), an object in the room, a flower, or even a crack in the plaster. Some women focus on the same thing for many contractions; others change focal points often. Others focus on a line, such as the edge of a window, and follow that line visually during the contraction.

Many women find it helpful to focus on touch in the form of a particular rhythmic massage stroke or pressure on one area or a tight embrace. This is called a tactile focus.

Still other women focus on sounds, an auditory focus – taped music, the soothing voice of the birth partner, a tape recording of various environmental sounds (surf, rain, a babbling brook), repeating rhythms, or other sounds.

Some women focus on a particular mental activity (a song, a poem, a chant, a mantra, Bible verses, a repeated saying, counting backward), breathing in a complex pattern, or relaxing the body step by step. Others focus on a physical activity, performing a series of particular movements (pelvic rocking, swaying, walking, dancing, effleurage, or others).

As you and your partner practice breathing and relaxing together through mock (pretend) contractions, try the attention-focusing techniques described above. You will probably discover a preference for some over others. Be ready to try more than one if a particular focus loses its appeal in labor.

Massage and Touch
Effleurage is a light, rhythmic stroking of the abdomen, back, or thighs. It can help with relaxation and pain relief when done on bare skin by you or your partner.

Some women prefer an extremely light, even "tickly" stroking, while others find a firmer touch more soothing. As you and your partner prepare for labor, try varying the pressure and rhythm of effleurage until you discover the most appealing stroke. Then practice it as part of your labor preparation. Effleurage over the lower abdomen, following the lower curve of the uterus, is most popular. Some people think of it as stroking the baby’s head. Others like to the stroke the abdomen in circles with both hands.