Non Pharmacologic Management During Labor
Labor is such an amazing journey and the destination is meeting your beautiful baby. For any journey it is wise to prepare and labor is no different. Some women will embark upon the journey of labor with little to no idea of what to expect. This article is a good place to start because I will describe different comfort measures and how they can be used to alleviate discomfort during labor. Ultimately, coping with the discomfort of labor is up to you. Preparation is for you labor is key and implementing these strategies can help you to cope with the discomfort and/or pain of labor. This article presents both non pharmacologic, non medications, and pharmacologic, medications, pain management strategies to be used during labor. All of this information is meant to provide you with the best evidence to help you guide your decisions for your labor plan.
Non pharmacologic strategies: Available in all settings
Labor support: Anyone can provide labor support. But there are individuals who are trained specifically to offer support during labor and they are called doulas. Doulas have a solid understanding of labor and can offer advice about movement, position changes, pretty much all aspects of labor. Doulas can also explain different interventions or act as an advocate for you during your labor. If possible establish a good relationship prior to your labor. A support person can also be a spouse, partner, friend, parent, pretty much anyone you feel very comfortable with and communicate well with. They should understand that you will need their support during labor whether that is physical, emotional, or otherwise. A support person is key in labor. Because labor can be a long physical and emotional journey it is important for your support person to rest and recharge during your labor as well.
Hydrotherapy: Hydrotherapy is the use of water during labor or birth. Commonly people tend to think of women birthing in a tub. While that is an excellent example of hydrotherapy, there are so many other uses for water during labor. A shower or soaking in a bath tub is useful during early labor when the contractions are not too strong and a woman needs rest.
Hydrotherapy can be used all throughout your labor and is often a helpful tool for relaxation, management of discomfort, and can help to reduce the chemicals called catecholamines circulating in your blood during painful contractions. Submersion in a tub is also said to increase a woman's hydrostatic pressure and shift extracellular fluid into the woman's circulation. Basically it increases blood flow to the uterus increasing its efficiency.
Acupressure/ Acupuncture: Acupuncture is needling of specific points to promote blood flow and stimulate the flow of Qi. The thinking is that this will stimulate the body to produce its own endorphins to decrease pain. Acupuncture has to be performed by a trained professional but some hospitals have them on staff and/or you can seek them out in your community. Acupressure is performed by applying steady pressure to acupoints with a thumb or finger instead of a needle. Research about pressure points yield results of which points to stimulate and how and can provide benefit with minimal if any risk.
Breathing and Relaxation exercises: Do not underestimate the power of breathing and relaxation exercises! I would advise you to start doing some sort of breathing and relaxation exercises prior to labor. Practicing can help to get your mind and body prepared for the journey ahead. There are so many different resources available for meditation and relaxation exercises. Visualization and affirmations are very useful to prepare your mind for the labor journey ahead! Start before labor so you are ready when you are in the throes of labor.
Sterile water injections: The goal of this is to reduce back pain in labor. Small injections of sterile water are placed in the lumbar area of the back. These injections are placed with a needle and sterile water and cause a stinging or burning sensation for 30 seconds to 90 seconds. The pain is thought to be relieved due to the irritation of another part of the body through the gate theory of pain. Women report a decrease in back pain felt during labor.
Movement during labor: This is such an amazing tool to decrease pain in labor. I also think your body is communicating to you how to move by signaling pain or discomfort in a certain area. If you move during contractions and throughout your labor it is essentially helping your baby to navigate its way into your pelvis. The movement is also good to open the diameters of your pelvis. Gravity, with an upright position, helps and can shorten the duration of labor. Upright positions include standing, sitting, kneeling, and squatting and variations of each. Dancing is also a great option during labor. It releases feel good chemicals, oxytocin, which increase the feeling of bliss and euphoria. Dancing also helps to move baby into the correct position in the pelvis.
Birthing balls: As seen to the right, birthing balls are great for labor and prior to labor. The birthing ball puts a mother into a position where she is supported and can relax while allowing her to move her hips and relieve back pain during labor. A peanut ball, shaped like a peanut, can be placed between a woman's legs during labor when she is in a lying position and widen the diameters of the pelvis.
Touch and Massage: If a woman is comfortable with touch and massage it can be a great way to help relieve discomfort. Often we think of touch and massage as a way to relieve pain from sore muscles. Touch during labor may help stimulate the release of our own natural pain relieving chemicals. Touch and massage encourage the release of oxytocin which is our love chemical and helps us to feel a state of bliss. Do not underestimate the power of a caring or loving touch during labor. Kissing, hugging, cuddling, and playfulness are all very helpful tools during labor.
