Birth

Natural Pain Relief During Childbirth

The key players in pain relief and even pleasure during birth are oxytocin and opioids. They diminish pain, trigger pleasurable sensations and increase feelings of empathy. As the level of pain increases, as do these hormones, allowing the body to experience both intense pain and intense pleasure at the same time. However, these hormones are primarily released when a woman feels relaxed and safe. They are secreted in spurts and not continuously, and levels decrease over time unless you retrigger their release with stimulation. Anything that causes tenseness, anxiety, stress or fear can easily inhibit their release – turning a potentially pleasurable experience, into a horrifically painful one. 

The below flow chart helps explain how our perceptions can influence pain:


Pain relief is centered around getting these hormones flowing - creating a safe, relaxed, comfortable and stress free birth experience. Below is a list of factors that can greatly contribute to creating a pain free birth experience:

Confident, Supportive Midwife and Companions
Remember this is YOUR birth. It's an instinctive inclination to be in a private, secluded, safe location. A calm relaxed atmosphere is integral to birth pain management. Whether it be your partner, mother, sister, or best friend, choose companions who will create a relaxed and supportive atmosphere. For instance a woman who has naturally given birth herself may provide much needed empathy and wisdom, while your partner may bring a sense of familiarity, security and safety.


For professional support, a doula is a trained birth support person, providing practical support and ensuring your birth choices are respected. The benefits of having a professional doula attend your birth are well documented:

  • 50% reduction in the cesarean rate
  • 25% shorter childbirth
  • 60% reduction in epidural requests
  • 40% reduction in oxytocin use
  • 30% reduction in analgesia use
  • 40% reduction in forceps delivery
- Excerpted from Mothering the Mother: How a Doula Can Help You Have a Shorter Easier and Healthier Birth,  Klaus, Kennell, and Klaus (1993).

For more information about the role and benefits of a doula click here.

Abdominal Breathing
Abdominal breathing focuses your mind and increases oxygen and energy flow to muscles. It involves slow, repetitive, deep breathing using the full extent of your lung capacity. Completely forget the "hee hee hee" breathing you see in movies, it's not relaxing. Anytime you feel your breath shortening, return your focus to deep, slow, long breaths.


Vocalisation
Completely allow yourself to vocalise when you feel the urge. Let out deep, low moans, with your mouth gently open, like the deep growl of a tigress. Ina May Gaskin calls it the "sphincter law" - if your jaw and mouth are relaxed so is your bottom. Grit your teeth and tighten your mouth and your bottom gets tense. Try it.

Movement
Repetitive movement helps you relax, helps prevent you from tensing your muscles too intensely, improves blood flow, and helps baby descend deeper into your pelvis.

Rhythmic Movement
Helps you focus and relax. You could try slow dancing, belly dancing, or simply swaying back and forth. Even if you prefer to sit you could still rock back and forth if you crave movement.

Walking
If you feel the urge to walk, then walk, around the room, through the house, or even outside. When a contraction comes brace yourself on something like a tree, a low table, or hold onto somebody - put your arms around their neck and let them support your weight.

Birth Balls
Provide excellent support to your pregnant body while allowing you to move relatively freely while sitting on them. You can also drape across them while you're on your knees or squatting.

Positions

Do not lie on your back
Lying on your back causes more painful contractions, less effective contractions, longer labour, reduced blood flow to your baby, and narrower passage through the pelvis for baby to pass through.

Below is a very informative and eye-opening clip about the risks of lying on your back in relation to newborn birth injuries. A must watch...


Squatting
Squatting opens the passage through the pelvis for baby to pass through, uses gravity to help baby descend deeper into the pelvis, helps prevent perineal tears, allows you to be more in control of pushing, and helps you focus on pushing with the right muscles. A squat bar on a hospital bed, a birth stool, or a handle or counter can be used to hold onto for support while squatting. Try doing 100 squats per day during pregnancy to help build strength and flexibility.


Hands and Knees
For mothers who are experiencing back pain during childbirth, a hands and knees position can help to relieve some of the back pressure. It also uses gravity to help encourage the baby to turn to an easier position.


There are many other great positions to try during childbirth, for a more comprehensive list of positions have a look at any of these three charts available to download:
http://www.mediafire.com/view/kv17ai69ag34yy8/Birthing_Positions_Chart.png
http://www.mediafire.com/view/x633da4kcgl7l06/Birthing_Positions.pdf
http://www.mediafire.com/view/exm355gyrey5u1e/birth_positions_-_good.jpg

Water birth
A warm bath improves blood flow, reduces pulse rate, helps you relax, and improves the effectiveness of contractions. It also reduces the effect of gravity on the back and buttocks, minimizing pain. Do not worry if baby is delivered in the water - baby can quickly be lifted out, and will still be drawing oxygen from the umbilical cord (it's spent the last nine months immersed in fluid anyway).

Photo Credit: www.mygoodbirth.com
Visualization
Visualization is an excellent tool to help focus and gain control over your body. I found myself doing this automatically when giving birth and it worked very well. It involves imagining a particular scene in vivid detail. A few examples would be...
Imagine the walls of the cervix opening with ease and comfort, with no limit to their ability to open to whatever size needed. 
Imagine the space inside your cervix getting larger and larger, opening to unimaginable proportions!
With every contraction imagine baby edging further and further down the wide open birth canal. 
Imagine baby sliding down and out of the birth canal like a slippery, fun waterslide. 
Positive Birth Affirmation
Positive birth affirmations are the basis of the popular HypnoBirthing technique. By repeating positive birth affirmations we're able to turn negative perceptions about birth into positive ones - which has a profound affect when it comes to your ability to relax and manage pain. Here are some great examples from The Baby Dust Diaries...
"Birth is an easy and natural occurrence for which my body has been perfectly designed."
"My pelvis releases and opens as have those of countless women before me."
"My body knows how to have this baby just as my body knew how to grow this baby"
"I surrender my birthing over to my body."
"The strength of my uterine contractions is a sign of my feminine strength." 
"Good strong contractions help my baby come into the world."
"I greet each contraction with openness and expansion."
"I allow my body's natural anesthesia to flow through my body."
"The power of birth strengthens me." 
"I am now willing to experience all my feelings."
"This day, hour, and minute is sacred and blessed."
A wonderful downloadable PDF packed choc with affirmations can be found here.

Affirmations are most effective when practiced in a meditative state, regularly throughout pregnancy, so they're well entrenched by the time the big day comes.

Massage
Massage during childbirth reduces pain, alleviates tension and anxiety, stimulates contractions, improves the flexibility of muscles, facilitates blood flow, circulation and fluid drainage, helps revitalize the mind and body, and offers a sense of emotional support. The areas of the body likely to need massage during childbirth include the back, buttocks, inner thighs, legs, feet, stomach and hands.

A laboring woman's back in particular can get extremely sore, and a good rub can make a world of difference. The back pain can be more intense than the contractions - this has been named 'back labor', and occurs in 25% of births. Usually the back pain is caused by baby being in the 'occput posterior position', in which baby's back is pushing against mum's spine. If your back is sore during childbirth, make sure you speak up, don't grin and bear it! It may mean you're experiencing 'back labor' and you need to change position onto your hands and knees to ease pressure on your spine, and receive a good back rub.

Aside from using hands for massage, a rolling pin, or other massage tool can be useful, and of course a little massage oil or lotion. Below is a list of essential oils recommended for birth that when blended with a carrier oil make an excellent massage oil:
Geranium - Great for the circulation and helps breathing.
Jasmine - Warm and fragrant and has anti-spasmodic and analgesic properties. It is also very beneficial in a compress on the lower abdomen to help expel the placenta.
Lavender - Antiseptic and excellent for aching backs and limbs. It is recommended in a bath during the early stages and is wonderful for the healing of vaginal tears or episiotomy scars.
Neroli - Helps combat any fear or apprehension.
Rose - A very feminine oil and is a uterine tonic which helps to regulate labour.
Ylang Ylang - Very calming and helps lower the blood pressure.
Clary sage - Can be used as it is a sedative, with analgesic properties.

Reflexology and Acupressure
Reflexology and accupressure both involve the application of pressure, to points on the feet or hands (reflexology) and the rest of the body (accupressure), which effectively correspond to various organs and systems in the body. Massaging and applying pressure to the following pressure points during childbirth effectively lessens pain:
Between the puffy pads under the big toe and next toe
Just below the centre of the ball of the foot
All along the inner ball of the foot
Upper buttocks between dimples
Side buttocks 
Center shoulder
Between thumb and forefinger
Along the middle crease of the palm
Either side of the archilles





Graphics by Debra Betts

An excellent site referenceing these points in more detail, along with pictures and video is available here.You should also be careful not to apply too much pressure, or you'll cause more pain than good.

Arnica
Arnica reduces fatigue, bruising, and trauma; it controls bleeding, prevents hemorrhaging, and minimizes the strain on soft tissues. After childbirth, it eases afterpains, assists in the contraction of the uterus and relieves retention of urine after long childbirth.
During childbirth it's recommended to take 200c potency Arnica every 3 hours, and continue this dosage throughout the day after delivery. From the second day onwards you can use the 30c potency every 3 hours.
A Wet Dose can be made by mixing the arnica with spring water.

Vitamin E
Vitamin E prepares the cervix and perenium for stretching, encourages skin healing and reduces scarring after injury. It is recommended to take 800 units of Vitamin E every 3 hours during childbirth.

Hot or Cold Application
Face cloths or cloth nappies, and a bucket of steaming hot or icey cold water
Wheat or rice packs frozen or heated
Hotwater bottles
Hot showers
It can be useful to focus the hot or cold on your back (especially when experiencing 'back labor') or lower abdomen. It can also be useful to have a washable pouch to place a hot or cold pack in, which has an elastic belt with velcro fastenings to wrap it around your abdomen and hold it in place.

Perineal Castor Oil Pack
Caster oil helps relieve prenatal pain, makes perineal tissues supple, helps prevent perineal tearing, and has healing and restorative properties. A heat pack increases blood flow to the area, relieves pain, and improves circulation. To make a caster oil pack...
Use only cold pressed castor oil.
Soak a soft cloth in the oil, wring it out, and put it on your perineum.
Place a heat pack on the cloth – make sure the heat pack has a waterproof cover or the caster oil will soak in and stain it.
Leave it as long as needed.
A mini hot water bottle makes a
great water proof hot pack
Perineal Massage
Perineal massage lubricates the tissue making it softer, more supple, and more flexibile. It also familiarizes you with the stretching sensations of birth, helping you learn to keep your perineal area relaxed, thus preventing tears.

Here are some excellent step-by-step instructions by Birthing Naturally
Perineal massage is usually done by the mother herself, or her partner. It can be done for up to 10 minutes a day during the last four weeks of pregnancy.
Wash hands thoroughly. Ensure there are no sharp or long nails that may scratch the mother.
Locate the perineum, directly below the vagina. It is the skin between the vagina and the anus. Apply some cold pressed and pure oil (such as olive oil) to this skin.
Place the thumbs at the base of the vagina, allowing them the slide inside the vagina (to about the first joint) moving some oil with them.
Using gentle but firm pressure, move the thumbs from the base of the vagina up the side walls as if you were making a "U".
Return the thumbs to the base of the vagina, and repeat procedure.
As the mother becomes more comfortable with the stretch, you may increase the amount you stretch the skin.

Pelvic & Abdominal Muscle Exercise
The ability to relax the pelvic muscles during birth is immensely helpful. Think of the pelvic muscles like a door that needs to relax and open in order to let baby through. Tensing these muscles prolongs birth, increases pain, and increases the risk of perineal tearing.
The abdominal muscles, in particular the deep transverse abdominal muscles, aid in pushing baby out during the descent stage of birth. The combination of relaxed pelvic muscles and toned transverse abdominal muscles ensures you are using your body most effectively, instead of fighting against the surges (contractions). See this article for an excellent list of pregnancy exercises to help prepare the pelvic and abdominal muscles for birth.




Sources:
Avoiding Tears and Episiotomies by Rachel Silber
Labor Massage by NativeRemedies.com
Point location Videos by Debra Betts
Positive Birth Affirmations by Baby Dust Diaries
Arnica after birth by ABCHomeopathy.com
Unassisted Birth Tips by Pregnancy-and-giving-birth.com

You Might Also Like

12 comments

  1. LOVE this post, Cherie! Heading into my last trimester, with a birth partner (hubs) that will be deployed in the last weeks of my pregnancy, but should be here for birth - this is an excellent reference for him. Everything is in one place, well described, and very thorough! Thank you!

    And I love the new blog look :)

    ReplyDelete
  2. How exciting, good luck! I'm sure it'll be a wonderful experience for you and your partner. I got excited researching for this post, thinking if I ever get pregnant again I'll be making it as relaxing and sensual as humanly possible.

    Glad you found it helpful ;)

    ReplyDelete
  3. Thank you for this, for taking the time to compile it all in one place, I have already ‘bookmarked’ it and will be re-reading again and again. And again!

    I am hoping to have a VBAC, after an emergency, but necessary (?) caesarean for my first born. I am very much hoping for a successful natural birth this time – am currently 17 weeks WITH twins, so anything to help will be a wonderful help! We would have loved to go the Independent/Private Midwife path, even a homebirth, but there is no way we can afford the IM - I keep coming across websites for some that are no longer practicing as it is just not financially feasible for them, with the insurance and laws/regulations for private midwifery (I am in Australia). I’ve heard that the laws may change again soon, but not soon enough for us, so public system it is! Am looking into a Doula and arming myself with all the info I can get, so we can have as natural a birth with as little intervention as possible, regardless of the fact that twins are considered ‘high risk’, pfft! Thank you, this has helped a lot!

    ReplyDelete
  4. Here in NZ I have a fantastic midwife called Lyn Allport, independent midwives are free here. I wish you could come here!

    I'm glad you found the info helpful. There is so much more to know. My advice would be to keep studying until you feel confident you could manage your birth on your own. Then atleast you'll know the lingo, and can speak confidently with your birth assistant about what's going on. And you'll know the full consequences of an intervention before ever agreeing to it.

    Remember the most important element is to be relaxed - bring every comfort measure possible, and remove every source of stress possible.

    I hope you find a great doula, midwife and hospital to birth your wee bubs naturally :) x

    ReplyDelete
  5. I wish I could come to NZ too! I love NZ! How awesome is that, that independent midwives are free, so they should be, or at least more accessible, and not anywhere from $4,000-8,000, ridiculous! Free up the hospitals for the people who are really sick, not just doing what is natural – having a baby!

    I was hoping for an *easy* VBAC, until we discovered we are having twins, we then had to cancel our spot at the birth centre as they don’t do twin births, vbac or not. So far the hospital midwives are happy and supportive of my wanting to vbac and have a doula, funny that the birth centre midwives aren’t, but as long as I am allowed the choice and make my way through this pregnancy relaxed, then that is a fantastic start. I do not want to be induced as I read that twins get induced for so many silly reasons, but I also read that twins can go to full term and very happily and healthily come into this world naturally…fingers crossed they are facing the right way when the time comes…at least I know that they don’t induce with a vbac, one in my favour!

    Thank you for your supportive words, I have enjoyed reading through you blog since stumbling upon it. I don’t have a blog to link to, so couldn’t figure out how to put my name, I often don’t comment because of this, but really wanted to today!

    Cheers,
    Sarah

    ReplyDelete
  6. Thanks Sarah! I'm really happy you commented.

    One note about getting induced - labours can go on for hours and literally stay at a standstill not progressing, simply because the mother is not relaxed. I've heard of mothers getting stuck for 24 hours because they were in an environment that was making them stressed.

    It happened to me too. I felt quite uncomfortable up on the bed, with my midwife and partner constantly wanting to inspect my genitals and wiping my bottom. I wanted to run away down the hall of the hospital, but I ended up settling for the toilet to get some privacy, and voila the baby crowned.

    I found that having other people around actually made me feel a little embarrassed and apprehensive. So whatever works for you, if you want privacy, go ahead and demand it, you're running the show.

    All the best for you and your family ;)x

    ReplyDelete
  7. alas- i have also retreated to the toilet for both of my labors... i think subconsciously we want a safe little cave for ourselves :) support is truly key- if you feel safe and supported then you feel invincible

    ReplyDelete
  8. Jo, a safe little cave would be perfect ;)

    ReplyDelete
  9. This is an amazing post, thanks so much!!

    Instinctively, I know that I want just myself and my partner at the birth (with my IM hovering of course!). But my mother will be offended for the rest of her life if I don't want her there and I could seriously damage our relationship. So hard to know what to do!!

    ReplyDelete
  10. Haha Em, Mmmm that's a hard one! I had my mother there for all my births mainly because I was scared, & she was wonderful. I'm not christian, but she is, & she prayed for me when she could see I was struggling, & I'll always appreciate & remember that.
    But after 3 births I'm not scared to give birth anymore, & my mother's not scared for me either. She understands I know what I need & want during birth.
    But a first birth in the family is a big deal! All my siblings came for that one! I can see why your mum would want to be part of it - she's the matriarch of the family.
    I'd definitely have a long, gentle, chat to your mother about your instinctive need for privacy so she has time to get used to be idea she may have to be outside the room.
    Good luck! So glad you found it helpful.

    ReplyDelete
  11. This is interesting and full of good info. I've given birth naturally before (out of a hospital and with a midwife) but I have to admit my fear of going through the pain again is what is currently preventing me from having another baby. I had a rapid labor. I woke up with 3 minute apart contraction and then a couple hours later had the baby. It was bearable until the last 15 minutes when my water broke during the pushing stage. I know it was just 15 minutes, but it was still really bad and I felt desperate and like I wanted to run away. I was able to relax up to that point, but then it was just too hard and it was happening so fast. I really want to find a way to handle the end better.

    I had a baby once before in a hospital, also rapid, and that was a billion times worse. The epidural failed and they did a bunch of crap to me against my wishes that made it much, much more painful. I would only ever go to a hospital to give birth if it was genuinely unavoidable, because it was a nightmare.

    Maybe slower labors are easier because you have more time to adapt. I always felt like things were going too fast, but I had a 2 hour and a 3.5 hour labor, so that isn't typical.

    -AK

    ReplyDelete
  12. Thank you so much for sharing all this brilliant information! Your efforts of spreading knowledge about peaceful birth are so admirable. We also have the mission of spreading awareness and education about safe, peaceful birth at Midwife International through training midwives around the world. Please check out our website at http://midwifeinternational.org/.

    Thank you for all that you do.

    ReplyDelete