How to Help a Woman in Labor

7 Dec

All Photos by Lena Pettus Photography

Should I Buy a Heating Pad?

I think so. One of the things I use most for moms in labor is a large heating pad. This is especially helpful in early labor when the mother has contractions that feel like menstrual cramps. A heating pad is also great to use on mom’s lower back if that area is hurting during labor. I prefer a heating pad over a rice sock because a heating pad stays consistently warm. An added benefit is that I don’t have to leave the laboring mother to heat it up in the microwave for five minutes. Though it could be a good idea to have an extension cord in your hospital bag if you plan on using it where you birth.

I’m waking in the middle of the night with mild contractions. What can I do?

I tell moms if they wake in the middle of the night contracting to ignore it till they can’t ignore it anymore (unless your water breaks, then you need to notify your care provider). Go back to sleep if you can. There’s no use in staying up all night timing contractions, the better thing to do is to rest and sleep while you can. If you’re too uncomfortable to get back to sleep, go ahead pull out the heating pad and place it on your tummy. If contractions are strong enough to keep you awake and you can’t rest sometimes getting in a DEEP, full bath works wonders to stop false labor (I like to call it practice labor) long enough for you to get some much-needed sleep.

What about dealing with back pain in labor?

I use a paint roller with a good handle to apply counter pressure on mom’s back. The paint roller is cushioned so it prevents bruising and when applied to the lower back in a firm rolling motion it can offer some relief.  Typically, I use the paint roller over the heating pad placed on mom’s back. Plus, you can also use the paint roller in the shower or tub, which is nice too.

For a comprehensive PDF file filled with suggestions for comfort in labor please go here: http://www.childbirthconnection.org/pdfs/comfort-in-labor-simkin.pdf

I’ve heard that I’ll work up a sweat in labor. Is this true?

Yes, you will likely sweat once you are in active labor, and you might even get downright drenched in transition. It’s a sign that your body is working hard. I ALWAYS use a hand-held, battery-powered fan. I keep it near mom’s face especially during transition or when mom is pushing. It’s not a bad idea to have a small bucket with chilled ice water and a wash cloth to place on mom’s forehead or the back of her neck if she needs it, too.

What about that big ball I’ve seen pictures of, should I have one too?

Yes, we ALWAYS use the ball in labor, it’s an excellent tool for coping. If you don’t have one yet, you can get one at Target or Wal-Mart in the fitness section. It’s a good idea to have one at home that you can use before you head to the hospital. In fact, when you go to the hospital, place the ball in the back seat and lean over it during your drive. And bring it into your hospital room so you don’t have to worry about whether or not the hospital will have one for you.

For a comprehensive PDF file filled with suggestions for comfort in labor please go here: http://www.childbirthconnection.org/pdfs/comfort-in-labor-simkin.pdf

When should we leave for the hospital or birth center?

Keep in mind that the longer you are able to labor at home your odds of having a successful, un-medicated, vaginal birth will increase. However, if your water has broken, you will need to check with your care provider about when to come in. Especially if you are GBS positive.  Most of the time, you want to leave for the hospital once you are in active labor. Active labor usually presents itself with signs like this:  you are not laughing or talking in between contractions, the contractions are lasting about a minute long and are coming every 5-3 minutes and have been for about an hour, and the contractions are getting progressively stronger and longer.

What’s going on ‘down there’ while I’m in labor?

Once you’re in active labor you’ll have lots of birth goo leaking out of you. Especially with your contractions. You will also have some light bleeding called bloody show. Don’t freak out about this. As long the bloody show  is pink and light and not looking like more than a period, spotting in labor is normal. Bloody show is a result of your cervix dilating and thinning out, the blood vessels get aggravated near your cervix and bleed. So, it’s a good sign, it is a signal that your cervix is changing. With that in mind, I like to encourage my clients to wear Depends while in labor. They work like a charm.

What should I do if my labor stalls when we leave for the hospital? Why does this happen?

One thing that is helpful is to bring your favorite music, fragrances and massage lotions with you to the hospital. They’ll help you make the transition from home to hospital, which often causes a mom’s labor to slow down. Labor stalls because of the adrenaline effect. We get excited that we are finally going to have our baby, this is really happening, we get nervous, we’re leaving our cozy environment at home to go to our place of birth and we have a surge of adrenaline. Adrenaline is known to slow labor. In the hospital, Terbutaline, which is a drug used to slow or stop labor, is almost identical to our body’s natural hormone, adrenaline.

Likewise, Pitocen, which is the drug used to increase the power of our contractions, is almost identical to our body’s natural hormone, oxytocin, which keeps our labor strong and active.  So, when you need to ward off your adrenaline … soothing music, familiar scents and low lighting help reduce its effects. However, keep in mind if your labor starts to slow down after too much calm music, switching up the music with a good, strong beat can also help get your labor energized again.  Also, it’s good to remember, if you’ve stalled out, use of your breast pump in labor helps to increase your contractions if they’re slowing down.  Nipple stimulation releases oxytocin.

What’s the best way to breathe in labor? 

There is no one right way to breathe in labor. In fact, there are many ways to approach your breathing. However, what we have found is having a rhythm in our breathing is a key to coping well. One type of coping tool that I have seen work with a lot of moms is called “breath awareness” basically that’s a fancy term for focusing on your outward breath through a contraction (like your life depends on it). I often tells moms to “push out the pain with your breath.”  Or “make your outward breath stronger than the contraction.” If you can manage to stay on top of the contraction through your breath you’ll do just fine.

Can you tell me more about rhythmic breathing?

I’ll count in rhythm with the laboring mother’s inhalations and exhalations through a contraction. We’ll count to four. This way all mom needs to focus on is getting to four. That means we’ve just broken up her contraction into smaller bites of four seconds. Usually, I’ll count very slowly like this, “One and two and three and four…” keeping my eye contact strong, my head the same level as hers, nodding my head in unison with her breathing. A lot of moms respond really well to this. I will also pat on her leg or arm through the contraction in rhythm with her inward and outward breath and or have her pound on something in rhythm with her breathing. For example, in my second labor with my son, I clung to my husband and swayed back and forth in rhythm with my breathing while pounding on his back a beat that matched the pace of my exhalations.

What’s the best thing do to with my body in labor?

Whatever makes you feel the most comfortable.  Your body will tell you how to move and what positions to get in. However, you want to remember is to keep your body soft throughout your contractions. Which means, lower your shoulders, keep your jaw loose and your legs limp, and if you’re standing keep your hips wide and rocking. An open, soft body, especially at the top of your body, somehow allows the bottom of your body to stay soft and can help your cervix open faster and baby to descend quickly.

What should I do in between contractions?

Drink sips of clear liquid and or take small bites of easily digestible food, like non-acidic fruit. Did you know that woman in labor should drink about 4 ounces of fluids an hour?  Also, be sure to empty your bladder if you have the need- an empty bladder will lessen the pain of the contraction and give more room for baby to descend when pushing. However, once you’re in heavy labor, often none of that sounds appealing, that’s when it’s good to avoid thinking about the next contraction or the last one. I encourage mothers to let their bodies go limp and sink right into the tub, bed, ball, partner’s arms, etc. I remind the mom to let go in between contractions, breathe out any remaining tension from the last contraction and simply focus on her baby. I encourage her to shut her eyes and slow her  breathing down. Now is the time to go inward. Deep breaths in through the nose and out of the mouth. This is when I tell moms to “breathe all the way down to your baby, let your breath bring strength and life to your baby.” Sometimes we forget that our baby is going through labor with us, so this helps us stay connected and purposeful in our labor.

What if I make loud noises in labor?

Vocalizing in labor is a wonderful tool for coping. If you make noise during labor, as most of us do, remember to let the noise be low and loose. Typically it is best to avoid high-pitched, tight sounds, as these normally can keep your body tense. (There is always the exception to the rule, though). A good goal is to keep your jaw as loose and soft as possible and allow the sound to come from lower part of your throat – almost as if you’ve swallowed a large apple and it’s sitting in the back of your mouth. If you are already vocal person, it’s likely that you will be vocal through your labor so, don’t be afraid to use this wonderful coping tool. Just remember a low sound doesn’t mean it has to be a quiet sound. I yelled in my labor with my son, I mean threw my head back and yelled out like an animal bellowing, but my sounds were low and almost primitive – roars. They were not distressed sounds. I think it helps practicing making low grumbling noises from the back of your throat to get an idea of how that sounds so you’re ready to go there in labor.

What about being relaxed in labor? Is that even possible?

Yes, relaxation is a place of the mind, and our minds have a great impact on our body during labor. When we keep our mind free from fear our body will follow suite. Sometimes, though, we need a little help getting our bodies to stay relaxed. That’s when I very gently and respectfully touch a mom’s cheek and remind her to “soften here” or I lovingly place my finger tip on her furrowed brow and say “release here” or I rest my hands on her shoulders and say, “loosen here.”  Those words make so much more sense in labor than “relax.” Saying, “Just relax!” can really can frustrate a woman when she’s laboring. I encourage moms to discuss with their support team ways that already help them remain in a calm, peaceful place. We have found that often the tools that  help us stay peaceful in everyday stressful situations are the same tools that we will use to cope in labor. Is it touch? Is it words? Is it music? What do you already use to cope with pain or stress in your life? Make sure that your partner knows what tools you like best.

What else can my partner do to help me?

It’s not rocket science, simply be present. That’s the key. Support people should stay away from the phone, TV or computer (unless asked otherwise). They should remain close and connected to the laboring woman. They should watch her and respond to what they believe she may need. A strong touch, a loving word, a calm presence, eye contact, a hand to squeeze, a back to pound, a quiet presence of love and safety. Also, don’t wait for a the laboring mother to ask for things like a drink, place a drink in front of her mouth with a straw, and suggest she take a sip if she wants to (in between contractions). Offer her chap-stick if she’s been breathing forcefully. Suggest position changes if she’s been in one longer than 30 minutes. Also remember, the less questions we ask the laboring mom, the better. The last thing a woman in serious labor wants is someone to ask her, “Do you want the apple juice or the ginger ale?” Or “Hey babe, do you want Michael Jackson or do you want Reba?” Don’t interfere with a woman’s concentration once she has gone inward, simply be there to watch and cover her sacred space.

Is there anything about the pain of labor that I should be aware of? 

Keep in mind that coping techniques never fully remove the pain – they simply help you cope with the pain. The truth is when we think there is a way around the pain of labor rather than through it, we set ourselves up for disappointment. Thinking that we can escape the pain by just doing something right in labor can leave us feeling defeated during labor, which is not what we want.

I’m scared that I can’t do it.

I actually prefer working with moms that are afraid that they won’t be able to manage the pain of childbirth rather than a woman who thinks that she’s got it in the bag already. What I sometimes see with the over-confident mom is that she tends to get upset and angry with herself quickly if she doesn’t think she’s coping well and this can cause her to be overwhelmed by the pain (which she didn’t imagine would be as big as it is). This distraction can cause the rhythm of labor to be lost. The mother that has a healthy respect for the reality of the pain of labor tends to dig a little deeper in search of ways to cope with labor before hand. She often has a better understanding and acceptance of herself if she freaks out and tends to reach out and seek help from others in labor faster and gives herself room for loosing it in labor.

What do if I decide I want an epidural?

It’s a good idea to have a code word in place that you can use if you truly get to the point where you are laboring where you are no longer coping with the pain, but you are suffering. Penny Simkin, the founder of DONA, says it best, “No one wants a woman to suffer during labor. On the other hand, no supportive person wants a woman to have pain medication that she had hoped to avoid. A previously agreed-upon “code word” provides a safety net for a woman who is highly motivated to have an un-medicated birth. She says her code word only when she feels that she cannot go on without medical pain relief. The code word frees the woman to complain, vocalize, cry, and even to ask for medications, but her support team knows to continue their pep talks and encourage her to continue, and suggest some other coping techniques. However, if she says her code word, her team quits all efforts to help her continue without pain medications and turns to helping her get them.

Why is a code word better than continuing to help her cope without medications when a woman (who had felt strongly about avoiding them) says she can’t go on, or vocalizes her pain loudly? It’s because some women cope better if they can express their pain than to have to act as if it doesn’t hurt. It also guides the team much more clearly than her behavior. As one woman said, “I shouted the pain down!” It’s really important for the nurse to know and understand the purpose of the code word, or she’ll feel the team is being cruel. If a supporter wonders if the woman forgot her code word, he or she can remind the woman, “You have a code word, you know.” One woman, when reminded, asked herself, “Am I suffering?” She decided she wasn’t, and went on to have a natural birth. Of course, a code word is unnecessary if the woman plans to use an epidural.” SOURCE

What things should be said to me in labor that will help me?

Well, that really depends on what you respond best to. However, I like to remind moms in labor that they are “stronger than this is hard.” I like to focus on what they’re accomplishing and how powerful their body is. And, when they are pushing, I prefer not to say “push harder” I like “push as strong as you are.” Sometimes little things like that can make a difference. During the pushing stage, your support person should remind you to keep your chin to your chest, gently supporting your head for you, reminding you to let your body make a “C” shape around you baby. This is when you should envision the power of your push taking the shape of a “J” down and out of your body. However, some of this may not apply if you are pushing on all fours and or squatting – which are wonderful positions to push in.  But I got a little distracted. Back to the question at hand, at some point you will likely say things like, “This hurts so bad.” That’s when it’s a good idea for your support team to respond with, “I know it does, labor is hard work, but you’re stronger than this is hard and you can do this.” Or when a mom says, “I can’t do this anymore.” I tell her, “But you are, we are watching you do it, and you’re doing beautifully.” I like to remind mom that the contractions are bringing her one step closer to holding her baby in her arms. Your support team should always appeal to your strength and not your weakness.

My mom/sister/friend wants to be with me while I labor/give birth.

Keep in mind that if your mom is going to be your support person in labor (or sister, etc) that sometimes it’s hard when we are emotionally involved with those who are laboring to see them go through the pain of labor and not get scared. When someone in the room get’s scared, the emotional atmosphere in the room changes, and the laboring mother responds to it poorly. It’s best to remember to have compassion towards the laboring mom, but not feel sorry for her or get scared by the intensity of her labor.

Also, this is not the time to have your friend in the room who has never seen a baby birthed naturally and wants to have a new experience to tweet about. Everyone who is present with you in the birth room should have a supporting role and or job to do (they would also do well to have seen some video clips of birth if they’ve never seen real birth before.) Your support team needs to be those who fully support your choices in labor. Your support people should have realistic expectations of what labor looks like and how long it can take. They are there to serve you. If they aren’t doing that, they do not need to be in the room with you. This is the time for you to be selfish and not distracted by those around you. Be very selective of who is present with you when you labor. Talk about this before hand with your family so that no one is surprised on labor day who is and who isn’t in the birth room with you.

What else can you recommend?

I like to tell moms and their support person to have a phrase that they can say to themselves or to the laboring mom to get through labor, like a mantra or a confession of faith. In both of my labors mine was, “My body is created to do this, I have nothing to fear.” Find something that works for you, words that inspire strength in your heart and mind. Sometimes you can write them down ahead of time and have your support person read them to you while you are in labor to give you a fresh perspective, or speak them over your body while you labor. Our words hold great power and connection to our bodies and what better time to use that power than in labor!

For other tips and suggestions on labor, please read these other topics I’ve written on:

How to Tell if it’s Labor and other Tips

Pushing and Beyond: Tips for the second stage of labor

The Birth of the Placenta: Tips for the third stage of labor

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14 Responses to “How to Help a Woman in Labor”

  1. Tracey December 8, 2011 at 8:46 am #

    Have I told you yet how wonderful you are? Lol I was so lucky to have you as an educator in my birth class! I am pretty sure I used all of the techniques above in my labor and they definitely helped me cope. So thanks! I will share this post with all my prego friends :)

  2. Joy December 8, 2011 at 12:30 pm #

    You’re so sweet, Tracey! Thanks for the love.

    • Christina April 1, 2013 at 9:57 am #

      During my labor, I had compound contractions (I was having two contractions a minute, each lasting 25 to 30 seconds) and really wanted to scream but the nurses kept telling me not to make any noise. It really annoyed me and I would lose my breathing rhythm. They also told me to keep quiet while pushing, which just made me very angry and made pushing very difficult. I still don’t understand why they would tell me not to do what came naturally, especially when it only made things worse.

      • Christa June 2, 2013 at 10:28 pm #

        The nurse I had yelled “you stop that!” like I was a 2 year old throwing a tantrum during my 8cm contractions! She even withheld giving me my iv because I wouldn’t stop yelling through the contractions… I was actually coping well considering, but because of her I felt I lost my coping mechanism and got an epidural which was permanently ruined my back… I never wrote a complaint but I should have, or punched her, either or would have sufficed!

  3. sarah February 24, 2012 at 1:26 pm #

    I am so thankful for this article. Thank you for such well written, practical advice.

  4. lamers120 April 5, 2012 at 1:04 am #

    Reblogged this on Our Family Adventures.

  5. Hilary April 28, 2013 at 5:44 pm #

    I read this a few days ago while coping with the frustration of what I thought were several episodes of false labor. I ended up barely making it to a hospital (not even my planned place of birth) and being 9cm in triage and complete by the time they could rush me upstairs to a birthing room. I left home for Wal-Mart to walk and try to “get things going” with no contractions at 8 and gave birth at 10:29. I had a completely unplanned natural birth, and the “you are stronger than this is hard” mantra and breathing all the way to my baby are what got me through the experience without caving to the pain or my fear of a delivery I was beforehand not even sure my body was capable of. I’m so glad I happened to come across this page when I did! A million thanks to you!

  6. Ann-Krestene Bazan November 11, 2013 at 11:41 am #

    Beautifully written article. I am preparing to help my friend through her (3rd child) first natural, and out of hospital birth and these words really spoke to me. Having also birthed both my children unassisted medically and my son (who weighed in at 10lbs 12oz) in water and at home I am a true believer in the power our bodies posses. Thank you for putting in words what I believe ‘We are stronger than this is hard.’

  7. J November 28, 2013 at 9:33 pm #

    Thank you for sharing this! I’m getting ready to deliver my second and have been feeling very anxious. I love the part where you encourage mom that she’s strong enough to get through one more contraction!

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Trackbacks/Pingbacks

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