Managing Labour Naturally
Pain relief during labour is on most pregnant women's minds. Everyone's tolerance to pain is different, and as such our need for pain relief will vary. Thankfully there is a whole range of pain relief options available to women in New Zealand; some are widely available; some you may need to arrange in advance. Remember you may have a substantial number of hours in labour so it makes sense to have a 'toolkit' of pain relief options ready before you go into labour.
If you are planning to have your baby in hospital or a birthing centre, then it is a good idea to remain at home for as long as possible. You will feel more comfortable and safe at home, but keep in close contact with your LMC, so you can work through the first stages of labour at home. By doing this, you often lessen the likelihood of medical intervention when you get to hospital. There are lots of pain relief options that can be used at home, such as a TENS unit, heat, massage and taking a shower or bath.
In the early stages of labour, distraction helps pass the time and may help avoid the need for medical pain relief, so start putting your ‘toolkit’ together by considering the following:
- TENS (Transcutaneous Electrical Nerve Stimulation)
- Water: shower and birthing pool
- Breathing Techniques
- Preparing your senses
- Labour Aides
- Birthing Positions
TENS (Transcutaneous Electrical Nerve Stimulation)
TENS is one of the safest, most effective forms of modern pain control available to women during childbirth. The treatment is widely approved and recommended by medical professionals. It allows you to experience a mobile, drug-free labour, where you are in control of your pain relief.
How does TENS work?
TENS machines work in two ways:
1. On a high pulse rate of 90-130 Hz (the normal method of use), the electrical impulses generated by the TENS machine interfere with and block pain messages sent to the brain. This is due to the gate control theory of pain. This proposes that there is a gate mechanism in the brain and spinal cord nerves (the central nervous system). When the gate is open, pain messages get through to the brain and we feel pain. When the gate is closed, these pain messages are blocked and we do not feel pain. TENS machines are thought to stimulate certain non-pain-carrying nerves and close the gate. In effect, the brain is busy dealing with the messages it receives quickly from the TENS machine, rather than the slower (more painful) pain signals that the body is receiving from elsewhere. It explains why, if you injure yourself, rubbing that area can temporarily reduce the pain.
2. When the machine is set on a low pulse rate (2-5 Hz) it stimulates the body to make its own pain-easing chemicals called endorphins. These act a bit like morphine to block pain signals.
Benefits of Labour TENS
- No harm to baby.
- Drug-free pain control.
- No side effects or drowsiness.
- Used at home when contractions start.
- Can be used with other methods/drugs.
- Proven up to 80% effective for reducing labour pain.
- Non-invasive, giving freedom to move and walk about.
TENS - Frequently Asked Questions
What does TENS feel like?
TENS feels like a pleasant tingling sensation on the skin where the electrode pads are placed.
How is Labour TENS used?
Self-adhesive electrodes are placed on the lower and mid-back. You switch on the TENS and dial it up until you can feel the tingling. It’s up to the user to increase the intensity with each contraction. The unit can be worn as needed for as long as desired, but labour pains will require a minimum of 30 minutes in order to feel the benefit. Labour TENS is best used at home when the contractions begin, then continued through the stages of labour and can help for several hours after birth. Labour TENS help with uterine contractions after birth and whilst breast feeding.
When do I start using Labour TENS?
Labour TENS is used in the first stage of labour when the contractions begin and are becoming painful. The earlier the TENS is used, the better. This gives your body time to build up natural endorphins.
How long should Labour TENS be used for?
The unit can be worn for as long as desired. Many women find the TENS particularly useful to use for the long hours of labour at home before going to the hospital or birthing unit and also for the car trip to the hospital.
Is TENS safe?
Yes, very safe. Labour TENS units are specifically designed for labour. However, there are a few precautions:
- Do not use over broken or desensitised skin.
- Do not use before 36 weeks, unless approved by your doctor.
- Seek advice from a doctor, if you have unstable epilepsy or a pacemaker.
I would like a waterbirth, can I still use a Labour TENS?
Yes, although NOT whilst in the water. You need to REMOVE the TENS BEFORE you enter the water. While you are in the water, your birthing partner can be responsible for preparing the TENS unit, so it can go straight back on when you come out of the water.
Can I take the TENS into hospital with me?
Yes. Midwives and doctors are usually very happy for women to use TENS. Check with your midwife or doctor, if you are unsure. You may need to turn the TENS off temporarily, if electronic monitoring equipment is being used.
What type of TENS unit should I use?
Make sure you use a TENS unit specifically designed for labour. An 'obstetric' or 'labour' TENS will have a boost button which is used specifically for contractions. Make sure the unit is modern and comes with brand new electrodes that can be put on and taken off again. Every unit should come with batteries and instructions. TENS units hired from NatalCare Naturally offer modern, reliable TENS units with all these important features.
Where can I hire a TENS unit?
Here! You can make your booking on-line through NatalCare Naturally. The hire fee includes 6 weeks hire, FREE door-to-door courier service anywhere in New Zealand and FREE return postage. The unit arrives to you 3 weeks prior to your due date and it is due back 3 weeks after your due date.
When should I book a TENS?
The second trimester is a good time to book your TENS, but you can book earlier if you wish. If you have left it to the third trimester or even a couple of days before your due date, don’t worry, book online here and a unit should still be available for immediate dispatch.
Water - shower or birthing pool
The use of water is well-documented as a labour pain management technique. Heat has been one of the most effective ways to help control pain for thousands of years. Labouring women can get in the shower and direct the water stream to specific areas of discomfort.
The main role of water is to help you get through labour by adopting a natural, instinctive position throughout the whole process of childbirth. Relaxing the muscles will make contractions significantly easier to bear.
The weightlessness and buoyancy of your body in water makes it easier to change positions while you float. In a relaxed state, your body will be producing more useful hormones facilitating a smoother, quicker progression of labour.
Rhythmic breathing during labour maximises the amount of oxygen available to you and your baby. Breathing techniques can also help you cope with the pain of contractions.
Simple Breathing Techniques
Think of the word “relax”.
It has two syllables, “re” and “lax”. Now try this exercise. As you breathe in, think “re” to yourself, and as you breathe out, think “lax”. Don’t let your mind wander away from repeating the word “relax”’ in tune with your breathing. When you breathe out, try to let go of any tensions in your body. Focus on the muscles which you know become tense when you’re stressed. Remember, every time you breathe out: “laaaax”. The out-breath is the one to focus on: the in-breath takes care of itself!
Try counted breathing.
As you breathe in, count slowly up to three or four (or whatever number seems comfortable for you) and as you breathe out, count back from three or four. You might find that it’s more comfortable to breathe in to a count of three and out to a count of four.
Try breathing in through your nose and out through your mouth.
Keep your mouth very soft as you sigh the breath out. Many women also find it helpful to make a sound on the out-breath, such as “oooooooh” or “aaaaaah”. In between contractions, have sips of water to prevent your mouth from becoming dry.
For more information and advice on breathing, download our free e-book here.
Labouring in alternative positions can help with the descent of the baby, as well as provide comfort and ease pain during childbirth. There are many options: walking, pelvic rocking, positioning pillows for comfort, slow dancing with your partner, sitting and swaying on a birth ball (a large physiotherapy ball), lifting up the abdomen and rocking in a rocking chair.
Lying down during childbirth can work against the labouring body. It is great for brief moments of rest and gives the mother a chance to catch her breath, but try not to stay flat for too long.
Massage can be very beneficial for women in labour, but there are some tips and suggestions a birth partner should keep in mind in order to help during childbirth. In labour you go through many physical and emotional changes in a short period of time, so continued support from a caring birth partner can make a huge difference to your childbirth experience.
Remind your birthing partner to always ask before beginning massage during labour. This is very important, because when a woman is in the middle of a contraction this can be a negative distraction. Suggest they wait quietly until the contraction is over and then ask, ‘Would you like me to rub your belly or massage your hands?’. That way you can let them know where and when you most need a massage.
Aromatherapy involves the use of plant oils, usually in the form of essential oils, to enhance physical and mental well-being. Essential oils can be added to a carrier oil, for massaging a particular area. Alternatively, oils can be used with an oil burner or vaporiser, so that the scent is carried in the air.
Each oil has different effects on the senses. If you have previously used aromatherapy oils or used the scents of lemon and ginger to counteract morning sickness earlier in pregnancy, then you will already be aware of the benefits.
Numerous oils may be beneficial during labour to help relieve stress, help you relax, act as a uterine tonic, stimulate circulation and much more. If you have any doubt as to the potency of essential oils then remember that doctors caution against the use of certain oils during pregnancy, usually this is because of possible effects they may have on the uterus. At the very least, aromatherapy will mask the hospital scent that so many people find unpleasant and unsettling.
For more information about using aromatherapy during labour, download our free e-book here.
Preparing your Senses
Birth affects, and is affected by, every sense in the body. By giving attention to all your senses, you can bring holistic harmony. Labour pain management techniques should address all the senses.
For the visual sense, try dimming lights or using lamps to bring a soft glow to the birth environment. The majority of women go into labour in the middle of the night. This is no accident. Our melatonin levels are increased at night, which allows our bodies to relax, which in turn brings on labour. When we are exposed to light in labour, it has been shown to slow contractions, or even stop them altogether.
For the sense of smell, using aromatherapy, scented candles, or essential oils can bring much needed calm to the room.
For the auditory channel, speak in low, soothing tones. Refrain from unnecessary chatter or background noise. Music, such as that used for relaxation practice during the pregnancy, can be softly played to facilitate relaxation in labour.
For the tactile sense, use counter-pressure, massage or light touch massage, as and when it feels good for you. Bring soft towels, blankets or pillows to avoid rough textures. Consider who you want with you during labour, at home or in the birthing suite. This is not a time for unwelcome visitors! Ask your birthing partner to carefully monitor who is in the room. If you prefer mobile phones to be switched off and windows to be open or closed, then share this with your birthing partner prior to labour.
Voice is a powerful tool. You may choose to moan with your contractions. You may choose to softly sing, chant or grunt. You should follow your body and know that whatever sounds you make are natural and therefore, good. There are no apologies here; you must follow your body's lead throughout the process of birthing.
Mental imagery is a highly-effective labour pain management technique. It is used frequently by professional athletes to naturally enhance their performance, so why not in this highly physical performance! You can use the same technique to visualise yourself in each of stage of birth. Try to imagine how you will respond to the different changes and challenges you may face. When we visualise a sequence of events as we would like them to happen, we mentally prepare ourselves to act in the same way when the time finally comes. This reduces anxiety of the unknown because the scene has become a familiar one, and will no longer be a scary, new experience.
For more information about using visualisation during labour, download our free e-book here.
Try repeating these positive affirmations over and over again. You can make up your own and repeat the affirmations aloud or in your mind while moving through each contraction:
“I can do this. I am strong.”
“I am one step closer to meeting my baby.”
“I trust in my ability to birth my baby.”
“I trust my body and know I can do this.”
There are a number of people who offer courses for pregnant women in ‘hypnobirthing’. This is a program of deep relaxation, visualisation and self-hypnosis that teaches women to replace concepts of long, painful labour with expectations of calm, relaxed and comfortable birthing.
Hypnobirthing teachers believe a lot of the pain of childbirth is caused by fear, which releases hormones that constrict the birthing muscles. By teaching deep relaxation techniques, women produce more endorphins (‘feel-good’ natural painrelieving hormones) and therefore have a shorter, far less painful birth.
Reflexology is an ancient practice, in which pressure is applied to specific body parts - generally the soles of the feet - to relax other body parts.
During labour, a reflexologist can help women cope with pain, and speed the process of childbirth by applying pressure and stroking specific ankle points, which are said to stimulate the pituitary glands to release pain killing hormones.
If you plan to use reflexology during labour, plan ahead and find an experienced reflexologist in your area.
Hot and Cold Compresses
Sometimes a simple heating pad may work wonders to relieve the pain you feel while giving birth. Either make or purchase a wheat bag and show your birthing partner how to heat it prior to labour. A hot water bottle or warm, wet or dry towels placed on the abdomen can provide comfort.
Some women prefer applying cold packs, such as an ice pack, on the lower back, or a cool cloth on the face or neck. If you experience nausea, then a cold facecloth across the forehead or neck can help. Remind your birthing partner of these things and include these items in your ‘pain relief tool-kit’.
Birthing balls were originally developed by physiotherapists to be used for exercise and treating orthopedic and neural disorders, however pregnant woman have found them equally beneficial. Using the ball throughout pregnancy can help strengthen the spinal muscles, making them less vulnerable to the back pain that increases as each month passes.
During labour, a ball is a much easier place to sit, relax and move on than a bed. The natural squatting position on the ball will also help to align the foetus and provides pelvic support. Squatting has also been shown to speed up labour. Gentle movement on the ball is a good way to relieve contraction pains. Some hospital and birthing suites have their own supply of birthing balls or you could borrow one.
There is no one perfect position for labour. Most women end up changing positions frequently during labour. If lying on your back on the bed is not comfortable or does not feel right for you, then move around and change positions. Let your body be your guide. During early labour, the more that you walk and move around and are upright, the more you are encouraging your baby to descend into the birth canal.
Left to your own devices, without consciously thinking about it, you are likely to find positions that work for you and your body. If you're looking for ideas, below are some positions that may work for you. Go over these positions with your birthing partner ahead of labour, so they are aware of the options.
For more information about birthing positions during labour, download our free e-book here.