Module 6 : Comfort

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 module 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.

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!

Research has shown that giving birth in an upright position can be beneficial for both mother and baby for several reasons. The key thing to remember is to aim for a position where your torso is 'upright and forward' (i.e. standing, squatting, kneeling upright, or leaning forward on all fours) and to avoid lying on your back during labour for any length of time. 

When the uterus contracts it tilts forward slightly 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. Being upright also makes 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.

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.

You can print out the birth positions hand out below and practise some of these positions in the weeks running up to your due date to see what feels comfortable to you. You can take this handout with you in your hospital bag or remember that you can also ask your midwife for help finding a position that is comfortable for you during labour.

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!

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.