We can all agree that labor and delivery involve pain. However, there are different ways to think about and cope with pain and discomfort. During my first pregnancy, I made the mistake of sharing my plans for a natural birth with a hair salon full of other mothers. They scoffed at my intention with phrases like "wait and see" and "you'll change your mind in the moment." Maybe I would, maybe I wouldn't, but I was determined not to feel scared. Whatever your plans, here are some helpful things you can do now to make labor less painful. Experts agree that preparing for the big day can have a positive impact on your childbirth experience.
"First of all," says Kate Howell, a certified yoga instructor who teaches prenatal and postpartum classes, "we have to forget every image we've seen in movies or TV shows portraying women going into active labor with no warning signs. I mean the ones with a woman's water breaking in the middle of the grocery store or a restaurant totally out of the blue. The scenes usually resolve in a hospital room with the woman in labor in a hospital gown screaming for drugs and cursing her husband. Well, this is just not the way labor happens. Nevertheless, this is the way laboring women have been portrayed, and we have grown up consuming these scenes." From re-thinking pain and developing coping strategies to hiring a doula or taking a childbirth class, here's a definitive list of tips from experts in childbirth.
1. Consider What Pain Means To You
"Pain itself has no emotional component," says Amy Gilliland, a DONA International birth doula trainer and PhD in Human Development and Family Studies. However, Gilliland adds, people tell themselves stories about what pain means, which triggers negative feelings. She recommends asking questions such as "When have you had pain before? Does pain make you feel anxious or fearful? Do some things hurt more than others?"
Christine Strain, a DONA certified labor doula, adds that "It can be helpful to think of labor pain as pain with a purpose, instead of pain that signifies something is wrong, like injury or infection. Also, the amount of pain in childbirth varies greatly not only from person to person, but even with each individual birth in the same person."
Once you understand your own perception of pain, you can choose the coping strategies that will work best for you.
2. Develop Strategies For Coping With Pain
We're lucky to have so many options for pain management, from medical solutions like an epidural to massage and mental techniques. To prepare for coping with pain during labor, it helps to plan and practice strategies in advance. Even if you plan to have an epidural, you may still have to deal with discomfort in early labor. And sometimes labor progresses so quickly that it's too late for an epidural once you get to the hospital. So draw up a plan for your "ideal" birth experience, but prepare for every scenario.
To help her clients prepare, Gilliland asks questions like, "How have you coped with pain before? What works for you? What kinds of things do people do in general when they have pain? What skills do you already have to get through pain? What kind of pain is actually positive, meaning you put up with it to get the reward?"
For example, says Megan Davidson, a certified labor and postpartum doula and childbirth educator, "We all have coping strategies that we use in our day to day lives. You might like it to be dark and quiet when you have a headache. You might like getting in bed if you feel anxious. You might like massage or distraction when you are in pain. You might love a hot shower or a bath to relieve stress. Taking stock of how you already cope with challenges in your life is a really helpful starting point for thinking about how you will cope with labor when it happens."
For early labor, Gilliland recommends "Relaxation, distraction, get up and move," which she notes is also a helpful strategy for other painful situations. Strain suggests "practicing basic relaxation techniques such as breathing and visualization." Learning as much as you can about the process of labor is helpful because "for many people, knowing more about what to expect and what is normal is really helpful in labor. If you spend a lot of time in labor feeling worried, afraid, or anxious; that is likely to make it much harder to cope with the contractions," Davidson tells Romper. That's why taking a childbirth class is a great way to prepare for labor.
3. Take A Childbirth Class
I went to a birth center for my prenatal care, which included classes on childbirth, breastfeeding, and the first days at home. If childbirth education isn't already a mandatory part of your prenatal care, you can Google "childbirth classes near me" to find local options. Gilliland emphasizes the opportunity to practice coping skills that a class provides and says, "This is not wasted time as you will use all of those skills in recovering from childbirth and parenting." Strain adds that it's helpful to "learn as much about the birth process as you can because knowing what to expect can help allay fears."
Reading about labor and delivery is another helpful way to educate yourself on what to expect. There's no shortage of books available on the topic, but Howell recommends Ina May's Guide to Childbirth by Ina May Gaskin and Penny Simkin's The Birth Partner. Another helpful way to learn about labor is to talk to other women who've experienced it.
4. Read & Listen To Other Birth Stories
Howell says, "The best we can do to overcome the fearful images of childbirth we've been fed is to collect new images of what labor and childbirth could be. When I got pregnant with my son, Silas, I asked everyone I knew who had given birth to tell me their stories from beginning to end. I realized I was mostly afraid of the unknowns. When will labor start? Will I know I'm in labor? What will it feel like? Will I have time to go to the birth center or hospital? I had a lot of coffee/tea dates that fall, and I heard a lot of stories. And I started imagining what my own experience could be — not as a definitive, but as a fluid and flexible thing. A story with a lot of variables that would require courage and a spirit of adventure. Fear and excitement are so close on the emotional spectrum."
Talk to your friends and relatives. Look for a new mom's group (I joined one while I was still pregnant and found it helpful to hear what the other women discussed). The internet is, of course, full of birth stories of all stripes. A good place to start is Romper's "11 Birth Stories To Read If Giving Birth Terrifies You." Most doulas are mothers themselves, so if you decide to work with one you can ask her about her labor and birth experiences, too (in addition to other helpful topics).
5. Hire A Doula
"Romper's Doula Diaries" video series provides real-life examples of the important work doulas do to support women during pregnancy and childbirth. I can also personally attest to the value of having a doula. During my first pregnancy, my wonderful doula Kate educated me on the stages of labor, soothed me in the final days of pregnancy when I was ready to be done, checked in on me all day as I experienced early contractions, and was by my side throughout my labor and delivery at the birth center. She also visited me during the postpartum period to see how breastfeeding was going. I asked the doulas interviewed for this article to share their perspective on the benefits of having a professional birth support person.
Strain says, "During pregnancy, a doula can help with answers to questions and resources to learn more about pregnancy and childbirth, reassurance, and encouragement. During labor, your doula has a 'bag of tricks' (literally and figuratively) to help with pain management. Physical techniques such as counter pressure, the double hip squeeze, hot or cold packs, tennis balls, fans, and suggestions for position changes as well as guidance through breathing techniques and visualizations. Doulas help facilitate communication between the birthing family and their care provider, reminding them to ask any questions they have and also reminding them that unless it is an emergency, they can ask for some time alone to discuss their options before making a decision."
Davidson adds, "It really helps to have extra support to help guide you in breathing and position changes, to offer massage if you’d like, and to keep every one calm and more confident."
Finally, Gilliland tells Romper that doulas "know a lot of little things to help in the moment and labor is just a string of moments to get through until you are holding your baby!"
Basically? Hiring a doula is mega helpful.
6. Stay As Active As You Can During Pregnancy
In the end, while mental and emotional preparation for labor are important, childbirth is a very physical event. Exercising during your pregnancy can help you prepare for a less painful labor. Of course, everyone is different, so talk to your provider first about the right level of physical activity for you. There are many options to choose from, and experts generally recommend sticking with activities that worked for you before you got pregnant. Personally, I found prenatal yoga to be very helpful for physical as well as mental preparation.
Howell agrees, telling Romper, "The greatest gift of prenatal yoga is that it's an opportunity to practice, every time we come to the mat, to stay with intense sensation and to breathe into discomfort... we experience discomfort when we stretch tight muscles or when we challenge our strength or balance. We may start to feel weak; we may feel that we can't go on. In the midst of sensation, we may feel anger (Why is the teacher making me do this?!) or fatigue and self-doubt (I knew I shouldn't have come to class today!). So we practice watching the feelings arise and staying with the sensation nevertheless. And we learn through experience that we were able to endure the pose long after we heard the voice that said 'I can't go on!' During labor, we may experience intense sensation and have an instinct to make it go away. We may hear a voice that says, 'I can't go on,' and we may be tempted to give in. But the practice of yoga has taught us, that we can experience the sensation and breathe with it."
If you can't make it to a class but want to try prenatal yoga at home, here are the poses Howell recommends:
- Hands and knees is a great starting position to encourage baby to shift into the "hammock" of mom's belly, which is preferable to the alternative of having baby settle with his/her spine towards mom's low back.
- Cat/Cow Sequence, or tilting the pelvis forward and tucking under, encourages mobility in the pelvis and during labor, this mobility will be necessary to allow baby to move through the openings of the pelvis.
- Poses that change the diameter of the openings of the pelvis, like Side Lunges. From hands and knees, put hands on yoga blocks. Step R foot to the outside of the R hand. Pivot to left side of mat so hip points are open to L side, walk blocks to L side. (Repeat on L leg forward).
- Poses that stretch inner thighs like Malasana (Squat): practice with sitting bones on 2 stacked yoga blocks or a stool for support. Or Badhakanasana (Bound Angle): seated with soles of feet touching and knees wide. These are also good postures to practice breathing and consciously relaxing the pelvic floor muscles.
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