comfort measures for active labor
Active labor is the phase of childbirth where contractions become stronger and more frequent, and the cervix continues to dilate. The medical literature describes active labor from around 6-7cm until transition, which occurs during 8-10cm of dilation. Earlier records suggested that active labor begins around 3-4cm and continues until transition.
Active labor can be one of the most intense and challenging phase of childbirth, and women need all the support they can get. Comfort measures are techniques that can help ease the pain and discomfort of labor, and make the process more manageable.
The best comfort measures for managing active labor are: Breathing techniques, hydrotherapy, movement and positioning, acupressure and counter pressure, and finally music and essential oils. Comfort measures can be unique to you and finding the ones that work best for you is easier to do before labor begins versus during labor.
Know that you will find a rhythm and flow that works for coping through contractions, it will get lost and not work, and then you will find another flow. Read on to learn more about these techniques that can work for your unique birth experience.
breathing and relaxation techniques
One of the most effective ways to manage pain and discomfort during labor is to use breathing and relaxation techniques. Slow, deep breathing can help reduce tension in the body, decrease anxiety and stress, and promote relaxation. Other relaxation techniques, such as visualization, meditation, and massage, can also be helpful. A supportive birth partner or a doula can provide guidance and encouragement, and help the mother stay focused and calm.
Slow, controlled, and deep breathing keeps your body in the parasympathetic state, your body’s rest and digest state. In this state, your body is relaxed and feels safe, safe enough to bring a baby into the world without fear. This relaxation and security is what I see as a birth doula that can contribute to a successful vaginal delivery, without birth trauma.
breathing practices
To practice for active labor, it can be helpful to practice cardio exercises where your heart rate increases for about a one minute to 90 seconds with about 2 minutes of rest in between. This is a similar rhythm to active labor. Practicing deep slow breathing, counting to 20 seconds on an inhale and counting to 20 seconds on an exhale can be incredibly effective.
Now this breathing exercise is difficult for many people, especially if you are not used to this type of long extended breathing. At the very least, attempt to take a long inhale and a long exhale. As you continue to practice it will continue to get easier and easier.
homework for practicing breathing techniques in active labor postions
Try practicing these breathing techniques in different positions such as a squat, on a birth ball doing hip circles or sways, in a lunge, or other comfortable positions. This can give you a sense of what it will be like to focus in various movements or positional patterns. When are bodies are in different positions, breathing can feel different because of the way are lungs and rib cages can expand. Notice what positions and movements feel the best for you now, they will likely be important to go to during active labor.
hydrotherapy for active labor
Hydrotherapy, or water therapy, is a popular comfort measure during labor. Soaking in a warm bath or shower can help relax the muscles, ease pain, and reduce stress. The buoyancy of water can also help take the weight off the mother's body and make it easier to move around. Hydrotherapy is particularly helpful during the early stages of labor, before the cervix has fully dilated.
Whenever using the tub or shower, make sure to have support from your partner, the nurse, or from a birth doula. The tub should be safe and comfortable, so use this support. Consider bringing a towel or other item to help with grip on the tub floor.
The sensation of water on a laboring body can sometimes be enough to act as significant comfort measure. Plus, its something you can use whether at home, the hospital, or a birthing center.
spending time in the bathroom during labor
Bathrooms are where we learn from an early age where to relax our pelvic floor muscles, so don’t feel shy spending a major part of your labor in the bathroom. In fact, in addition to the tub, I encourage the moms I work with as a birth doula to spend several contractions every half an hour to an hour on the toilet laboring.
movement and positioning
Moving and changing positions during labor can help the baby descend through the birth canal and ease the pain and discomfort of contractions. Walking, swaying, rocking, and kneeling are all effective ways to keep the mother's body active and engaged.
Sitting on a birthing ball or using a squatting bar can also help open the pelvis and allow gravity to assist in the descent of the baby. A supportive birth partner or a doula can provide physical support and guidance, and help the mother find comfortable positions.
Movement and changing positions frequently, along with having a breathing strategy, are the two CRUCIAL comfort measures to learn and practice for active labor. Having a practical idea of what positions to use and how to breathe through them will get you far.
circuits of movement for active labor
Creating a circuit of several moves is a great way to keep labor progressing, distract you when it comes to time, and keep you from thinking about what to do next when you are holding on by a thread. These circuits are not HIIT related or anything designed to exhaust you, but more like a guide of movements and positions to try so that your body is getting into a new position at a minimum of every 30 minutes, hopefully every 15 minutes or so.
example of active labor circuit:
Contractions are coming every 2 to 3 minutes, with some variation in that pattern.
For 5 contractions, stand with one foot elevated in a “Captain Morgan” style lunge, with your leg raised about a foot or so off the ground (your lifted leg doesn’t need to be hip level). Sway back and forth, lean into the lunge during and after contractions. Switch sides after every contraction or do all 5 on your left side and then 5 more on your right side.
For another 5 contractions, rest on the birth ball. Rock, sway, wiggle, and move your hips in exaggerated shapes to get the benefits of hip relaxation and muscle release. Reset and rest in between contractions by staying seated on the birth ball, but leaning forward and resting your head on a pillow or on a couch/ bed/ hospital bed/ or even partner.
The next 5 contractions, try standing or walking. You can sway side to side or walk slowly through your contractions.
And finally, for this circuit, add some more intensive rest. Try laying on your side for these next 5 contractions. Relaxing and releasing every muscle in your body.
This circuit can be used for as long as it is helping! If you add all the time together for this one circuit, you have moved through a little over an hour of labor. Remember, changing position and incorporating movement is one of the best ways to manage active labor.
additional things to add in each circuit for active labor:
Snacks and hydration are critical in keeping your energy high. Think about taking small sips of electrolyte filled drinks and water. Some women don’t feel hungry when labor gets to this point, that’s totally okay. Think about maybe taking a bite of some protein or even some carbs to keep you fueled for this incredible work you are doing.
Using the toilet was touched upon earlier in this blog, but adding a specific time to use the bathroom is great for your labor. I like to add laboring on the toilet for even 1 or 2 contractions in the middle and end of each circuit. Again this changes pressure from where your uterus is sitting AND releases your pelvic floor muscles to allow for more change and progress in cervical dilation.
Acupressure and counter pressures for active labor management
Acupressure is a traditional Chinese medicine technique that can be helpful during labor. Acupressure uses finger pressure on the specific points in the body to stimulate the flow of energy and blog, and promote relaxation. Acupressure and counter pressures are techniques can help reduce pain, calm the mind, and support the body during labor.
Counter pressure is the application of strong, steady force to an area of the body that alleviates pain, acts as a form of distraction, and relaxes tension in certain muscles and ligaments. A classic example of counter-pressure in labor is the double-hip squeeze. As a birth doula, this is a move I use all the time. In one labor, we used the double-hip squeeze for almost 4 hours during contractions.
Check out this previous blog post here, where I go into more detail on how to perform the double-hip squeeze and other counter pressures to use in labor.
music and aromatherapy for relaxation and distraction in active labor
Music and aromatherapy are two simple but effective comfort measures that can help create a soothing and relaxing atmosphere during labor. Music can help distract the mother from the pain of contractions and provide a calming and reassuring backdrop. Aromatherapy involves the use of essential oils, which can be diffused or applied topically, to promote relaxation, reduce anxiety, and provide a pleasant scent. Lavender, peppermint, and clary sage are popular essential oils for childbirth.
essential oil specifics
Peppermint is used to help with heavy feelings of nausea as well as increasing energy in the room. Lavender is helpful to relax the room and adds a calming presence. For use of many essential oils, I recommend adding the oils onto a washcloth or towel and waving it in the room then keeping it near the birthing woman’s body. This gets the smell in the air, but can be beneficial if all of the sudden, which happens a lot in the transition phase of labor, the scent of the essential oil is no longer wanted or can even make the birthing woman queasy. If this happens, you can just throw the towel out of the room and the smell will dissipate.
conclusion for comfort measures for active labor
In conclusion, active labor can be a challenging and intense experience, but with the right comfort measures, it can also be a manageable and empowering one. Breathing and relaxation techniques, hydrotherapy, movement and positioning, acupuncture and acupressure, and music and aromatherapy are all effective ways to ease the pain and discomfort of labor and provide support for the mother during this critical time. A supportive birth partner or a doula can provide guidance and encouragement, and help the mother feel empowered and in control of her body and her birth experience.