Part 2 - Comfort Measures For Labour


Welcome to part two of my Summer of tips and techniques to ease discomfort and manage the sensations of labour. By the end the series you are going to feel so much more confident and relaxed I hope about your upcoming labour and birth.

I've been running these each day on my For Modern Mothers Facebook page. In this post you'll find a range of comfort measures for labour including - TENS Machines, Doula's, Heat, Aromatherapy and Opioids. It's a balanced look at ALL your options.  



#8 - Kissing

Making out with your partner can be a great way to get labour going (back to that oxytocin again!), and some women report that deep and passionate kissing can be just the thing during the intensity of contractions. Some say 'the same energy that got the baby in, can get the baby out'. Others will tell you that the relaxed open mouth of a kiss will help your cervix to dilate effectively. Nothing to loose and everything to gain from trying!






# 9 - TENS Machine

For many women a tens machine is a great way to have some relief in labour, that you are very much in control of which can be empowering. A TENS Machine (TENS means - transcutaneous electrical nerve stimulation) is a small, battery-operated device that has leads connected to sticky pads called electrodes.You attach these pads directly to your skin on your lower back, and when the machine is switched on small electrical impulses are delivered to the pads which you feel as a tingling sensation. You control this - deciding when to turn it on and how strong to go.

So how does it work?
The electrical impulses from the TENS machine reduce the pain signals going to the spinal cord and brain, which may help relieve pain and relax muscles. They may also stimulate the production of endorphins, which are the body's natural painkillers.

Where do I get one?
You can hire or buy one (they aren't available from your hospital or birth centre, so you need to organise one in advance) from places like Boots. Or ask around women who have already had their babies as they might be selling one.

The feedback I receive from women on my Hypnobirthing courses is that some women love the control and find great relief from TENS, other women find the wires and pads annoying. So I'd suggest trying it out in advance, and remember to have some spare sticky pads too. And don't forget to take it off before you get into a bath, shower or birth pool!


# 10 - Hire A Doula

Having confidence in yourself and your bodys ability to birth your baby is SO important to allow you to relax into your labour and let your body do its amazing thing, uninhibited by fear and stress hormones (that's what we explore on my hypnobirthing courses. And why I explain the 'fear-tension-pain cycle' and importantly give you techniques to break it). Feeling someone is there absolutely 100 percent 'with you' in labour can have huge pain relieving effects. That's where a Doula can come in. 
Here's the research: A Cochrane review ('gold standard' in medical research) that looked at over 15,000 women found that simply having continuous support from the same person in labour leads to less need for pain relief (and fewer interventions, and better outcomes for mums and babies). And amazingly, this continuous support was found to be most effective if that support person was neither a member of hospital staff, not from the womans social network - in other words a Doula.

So what is a Doula?
Doulas are usually experienced women, often who have children of their own, who offer practical and emotional support to women and families in pregnancy, birth and early post natal period. They are for ALL types of birth - home, hospital, birth centre. They do not offer clinical skills and are not medically trained. Find out more from Doula UK, and you can search for a Doula near you there too. I can also give you a list of York Doulas too, just drop me a message or a comment.

There is SO much more to say about Doulas, and I'll being doing a Blog post on my website and a video on my YouTube channel all about the brilliance of Doulas very soon. It's something very close to my heart, as I am a Doula (but sadly due to family commitments I'm not actually 'doulaing' right now) and know what a wonderful and special group of humans these women are! I'd really suggest that every pregnant women look into having a Doula, as the research and evidence is so strong for their brilliant benefits.


# 11 - Aromatherapy

Using essential oils in labour can be a great way to help you to relax, and they are especially useful if you have used them in pregnancy during relaxation too (like when you listen to your hypnobirthing relaxation MP3's, or practicing your breathing). This is because you can use the smell as an 'anchor' to help trigger a sense of relaxation. So you attach a feeling of relaxation to a certain smell (say lavender oil) in pregnancy by using this smell when you relax (roll onto pulse points or a few drops on your pillow when listening to relaxation MP3, use a diffuser, or put essential oils in the bath to relax etc), and then when you smell the same scent in your birth space it triggers the positive emotions and calm feelings deep within you, wherever you are.
Smell is one of the most effectve ways to trigger responses as its a form of 'chemoreception'. This means that our nose changes chemical signals straight into neural impulses, and our reaction to smell is quicker than if we see or hear something.
Remember to choose an essential oil you like, and one safe for pregnancy. Lavender is great, so is mandarin, ylang ylang, jasmine, frankincense or other citrus scents.
It's also great to combine loving touch with comforting smell, so a lovely massage with essential oils from your birth partner is perfect to help you feel comfortable and supported.

I really think aromatherapy is a brilliant way to support and calm in pregnancy and labour, and I did a brilliant course in exactly this. So we talk more about this and you get a guide on my Hypnobirthing & birth preparation course (all about blending oils, other great ideas of how to use them, a full list of oils for pregnancy and labour). Plus you get two aromatherapy roll-ons that are perfect for pregnancy and labour too. Do let me know if you have any questions.


# 12 - Heat

Applying heat to the lower back can be soothing and comforting in labour. You can use a hot water bottle in a cosy cover, or some women use a wheat bag warmed up in the microwave. Or scooping warm water over your lower back whilst in the bath (see Water on day #4) can work too. In contrast some labouring women prefer ice packs or a bag of frozen peas! As with all thing pregnancy, birth and motherhood we are all different and there is no 'right' or 'wrong' - just do what feels best for you in the moment.
Another technique used by some midwives and doulas is to apply very hot flannels to the lower back during surges (contractions if you've not done hypnobirthing!). Perhaps this is where the age-old call for 'hot water and towels' come from? Sometimes a hot flannels are also suggested applied to the perineum in crowning to help to soften and relax this tissue too, and prevent tearing. 
But do use really hot water with caution, you don't want to enter motherhood with first degree burns! 😂


# 13 - Opioids

Some women imagine they will want to take all the drugs in labour, and others want to manage with minimal or no drugs. It is of course absolutely the choice of the women, there is no 'right' or 'wrong' - as will all of pregnancy, birth and motherhood. And you can absolutely change your mind either way.It's your prerogative. Research has shown that hypnobirthing can lead to less need for drugs in labour, and what most women want. But even if you are hypnobirthing I think it's still worth knowing what is available to you, should you want it or if you change your mind - you never know quite how your labour will be. So lets look at opioids today. 
Opioids are a a group of drugs that work by making you 'out of it' so you don't experience pain in the same way (not by numbing your pain receptors as some other drugs do, like an epidural). They come under different names, and can affect you slightly differently. So see whats available at your hospital / birth centre. Pethidine, Diamorphine and Meptidare are administered by injection in the thigh (and also may be able to be prescribed in advance for a homebirth). Remifentanyl comes via infusion that can only be administered by an anaesthesist, so it's not available at home or in a birth centre.
~ If you are not coping well with the discomfort of labour, they will give you relief.
~ You can get some rest of labour is long. 
~ If you don't like the feeling they bring you have to wait for it to wear off (except for Remifententnyl, the drip can be turned off and wears off fairly quickly).
~ All four opioids cross the placenta, so the nearer to baby being born you are given them, the more likely you are to notice an effect in your baby - may be drowsy, slower to breathe, and breastfeeding may be harder to establish.

That's opioids in a nutshell, But ask me if you have any questions. Back tomorrow morning with another comfort measure for you.


# 14 - Vocalising in Labour

Your voice is a natural form for releasing pain. Think about when you stub your toe, or if you've ever had the misfortune to get stung by a wasp - the 'need' to swear and shout loudly comes from deep within youn and really helps to relieve and release. In labour you can harness this idea, using your voice effectively (you don't want to waste precious energy). So humming (if you come to my pregnancy yoga class you may remember the 'Humming Bee' breath), singing, signing out loudly, chanting, repeating a positive affirmation or mantra, roaring or even mooing like a cow can feel really brilliant. Keeping the noises low and sexy (rather than high pitched screaming) is generally more helpful - but as always don't over think it, do what's right for YOU in the moment. And do it without inhibition (another reason privacy and darkness is so important in labour) We are all different and we'll all birth each baby differently too.


So that's the end of part two. I hope you find this series posts helpful and informative. There will be more coming - parts three and four over the next few weeks! Do let me know if you'd like any more details on anything I've mentioned here. And don't forget that I run my For Modern Mothers Hypnobirthing & Birth Preparation classes every month in York. It's a complete birth preparation course covering everything you need to know for a positive and confident birth without fear. Now booking for September, October and November. 

Susan x