Gotta move, gotta rock, gotta sing! Comfort Measures and Coping Techniques for Labor
By Milon Nagi
At a recent Healthy Birth Choices Workshop, we gathered to hear three new moms share the comfort measures and techniques they used to cope with labor. We were also joined by Zoe Kogan, licensed acupuncturist, who took us through some acupressure points and massage techniques which can encourage labor. It was striking to hear, coming through the unique and individual nature of each story, the common themes that emerged as each woman found her way through to the birth of her baby.
When Vicki began to feel the sensations that led to her baby’s birth, she didn’t at first recognize them as labor – she thought it was heartburn. Having known for over a week that her cervix was already 3cm dilated, she had learned through experience that “that effacement, that dilation doesn’t mean anything until labor really happens.” She went about her day, downloading songs from iTunes for her birth playlist and, as her contractions grew closer, checking in with her midwife, who told her it didn’t sound like labor yet. “She told me, ‘Call me when you can’t stand it anymore’,” Vicki recalls.
To ease the discomfort, Vicki got into her tub. And, when the sensations became more intense, she asked her doula to come over. She remembers feeling “huge relief” when her doula arrived, thinking “I can finally relax, I’m just going to do whatever she tells me to.” Her doula, realizing that Vicki was experiencing a back labor, recommended that she stand in the shower with the hot water raining down on her back. It felt good and there was a possibility it could encourage her baby to change positions. She stayed there for 45 minutes and, in the meantime, her doula encouraged her husband to take a nap. Emerging from the shower, Vicki followed her urge to lean forward onto the bed through contractions. She moved to laboring on the birth ball to help her baby come down. Eventually, her doula suggested now may be a good time to go to the hospital. “I don’t know how she knew,” Vicki says, “she recognized from my face or something that I was ready – I didn’t even know that.”
Her doula helped her dress and they moved to the hospital. During the car ride, especially, Vicki’s music helped her to stay present and cope with her labor. She remembers laboring without a room for a while, until a nurse noticed her squatting and “corkscrew walking” through contractions in the hallway and she was finally checked and put into a labor room. Vicki recalls noticing that it was dark when they arrived (around 6am) and seeing more light as time went on. Having arrived pushing, she expected to have her baby before breakfast. Her baby’s unusual position, however (his head was tilted to one side and he was “sunny side up”) meant that it took a while for him to make his way out. With her midwife’s and doula’s support, Vicki pushed for several hours in different positions, fending off threats of a cesarean section from the attending OB (who later returned with students to observe her, impressed with her progress!) and at one point accepting some Pitocin to keep her contractions strong. Her birth team encouraged her and reminded her how strong she was, her doula massaging and shaking her tired legs between contractions. With their “incredible” support, she gave triumphant birth to her baby son, River, just as she had hoped to.
Late in Sarah’s pregnancy with her first baby, her OB suggested inducing labor. She still had a few days before hitting 42 weeks, but the weekend was approaching – and her hospital did not provide inductions over the weekend. Though induction and Pitocin were not what Sarah wanted, she felt she had no choice. But once on the monitors at the hospital, she noticed some blips. “Are those contractions?,” she asked the nurse. It turned out they were and, after some negotiating and signing some forms, she and her husband called off the induction and returned home to await labor. She spent the day having meals with her visiting family and walking around the neighborhood. Her labor intensified overnight as she lay in bed spooned together with her husband, who woke to squeeze her hips during contractions through the night.
Sarah called her doula to join them in the morning and together they made their way back to the hospital. Her favorite doctor was still on call and supported her wishes, while her doula helped her to settle in and regain her rhythm in the hospital room. Her OB broke her water and they realized there was meconium (baby’s first bowel movement) present, which very much upset Sarah. “I knew it was bad but I couldn’t remember why,” she remembers. Her doula was able to give them information about meconium which she found very reassuring and helpful in those moments. Due to the meconium, Sarah’s OB decided to start a pitocin IV which made her contractions very intense. As a runner, she now drew on those coping methods, reminding herself that “you can do anything for three minutes.” She remembers feeling constrained by the IV as she couldn’t walk around freely, but laboring and moving around on the birth ball helped a great deal. Standing and slow dancing leaning on her husband felt good, particularly when she was feeling an urge to push. She found the scent of Clary Sage oil, brought by her doula, very comforting in labor, as well as Peppermint oil which helped her to fight off a wave of nausea and feel ready to push when the time came. She wanted to avoid pain medication, reminding herself “there’s a reason for the pain – it will end and I’ll have a beautiful baby.” With her husband’s and doula’s support, after 27 hours of labor, she successfully gave birth to her 9.5lb baby.
Pregnant again, Sarah decided to have her second baby at home with a midwife. Again, her labor began as she approached 42 weeks. But, this time, things went quite differently. On Christmas Day, she went to bed early as she wasn’t feeling great. She dreamed that she was in Maine and her midwife was telling her to come home. She woke out of her dream at 3am in active labor, her contractions already three minutes apart! Knowing that she was staying home took away the stress of deciding when to go to hospital, and helped Sarah considerably to cope with and relax into her labor. She called her doula and rocked and slow danced through contractions with her husband. Laboring in water in her birth pool was especially helpful and, just four hours after waking, Sarah pushed her new baby boy into the world.
At 8 days past her due date, Biba was discouraged to learn that her cervix was not yet dilating and to hear her OB suggest inducing her labor. “It was actually the opposite of what I wanted,” she says. Leaving this appointment, she walked all the way through Central Park and straight to her acupuncturist’s office. The acupuncture treatment encouraged some early contractions. Her labor began in earnest the very next day when, walking near her house, she felt a contraction that felt different. More like that one followed, and soon she was laboring at home with contractions 5 minutes apart and intense. By the time her husband came home, she recalls, she was walking around and around the Christmas tree. Being upright and moving around felt soothing. “I didn’t sit down again until around 10.30 that night when I was putting on my shoes for the hospital!,” she told us. Her husband, Cori, applied some counterpressure on her lower back through contractions, which felt very good. She found it helpful to moan and vocalize through contractions, remembering what she had read in Ina May Gaskin’s books about an open, soft throat being reflected in an open, soft cervix – indeed, she remembers singing a lot at home in the week leading up to her labor, with this in mind. Supported by her doula, they continued to labor at home until almost an hour after the time her doctor had asked her to go to hospital. “I didn’t want to go in yet,” says Biba.
While Biba didn’t enjoy the car ride to hospital, she found her contractions slowed during this time, which helped her to cope. Once in hospital and settled into a room, she felt most comfortable on a chair which was intended for the nurse. “I didn’t touch the hospital bed,” she says. Being upright and in motion was what felt good. Then, she decided to try the bathtub, which was a profound relief. “Even though you’re still having a baby,” she says, “it feels really nice to labor in water.” She counseled people to pack a tub stopper, noting that even hospital rooms that have a tub don’t always have a stopper!
With her doula’s and her husband’s encouragement Biba continued to labored until she was fully dilated. “She kept focused on each minute,” says Cori. “Kept her head in the game.” Then, moving to the bed, she began to push, at first using the squat bar to support her in a squatting position. With her doctor’s guidance on when to push and when to wait, she gave birth to her baby girl.
As these stories suggest, and as Shara Frederick, moderating the workshop, pointed out, the comfort tools we use in labor are the tools we use to cope with pain and stress in our everyday lives. “People who need to move, need to move; people who need to rock, need to rock; people who need to sing, need to sing.” We do not go into labor without any information on how to cope. A good Childbirth Education class, our reading and the guidance and support of a doula can help us to clarify what may feel good and ease our path once labor starts. These tools may look different for each person. But, as Biba notes: “If you can be relaxed I think everything is better. That’s it.”
Milon is a doula, writer, and long-time volunteer member of CiC’s Program Committee.