Comfort measures during labour

For some lucky women, labour is less challenging. For others, it can be very uncomfortable and painful — but it doesn't have to be. There are lots of ways to make yourself more comfortable during labour. You can learn and practice natural pain-relief techniques prior to labour, and you can try others as your labour progresses. Drugs and medical procedures are also available as needed.

You'll want to weigh the benefits and risks of each before deciding which measure or combination of measures to go with on the big day. Here are your choices:

Non-medical Pain Relief

• Relaxation techniques. Childbirth educators, nurses, and women who've used this approach recommend it more than any other as a noninvasive way to reduce muscle tension and pain in childbirth. Progressive body relaxation – taking a tension-reducing ""walk"" through your body – is something you can learn and practice ahead of time so you'll be comfortable using it in labour.

• Massage. Have your partner massage your arms, legs, or back during labour to help you relax and to decrease tension and pain.

• Rocking. Spend as much of your labour as possible in a rocking chair, gently moving back and forth as you breathe and relax.

• Walking Walking, or even just pacing right by your bed, decreases discomfort while helping your contractions become stronger and more regular.

• Changing positions. Don't stay in the same position for more than an hour, and don't lie flat on your back. Instead, try sitting up in your bed or a chair, lying on your side, squatting and rocking on a birthing ball, or leaning forward over the back of a chair or your birthing bed.

• Hydrotherapy. Try sitting in a shower with a jet spray against your back, or lying in a Jacuzzi tub. Not all birthing centers or hospitals have a tub or shower in the room, so if you want to use this method of relaxation during labour, make arrangements beforehand to give birth at a facility that offers it.

• Application of heat or cold. A heating pad or ice pack placed against your back can reduce muscle tension, improve circulation, and numb pain.

• Paced breathing. Specific patterns of breathing help keep you relaxed and focus your attention on something other than pain during a contraction. Three techniques (slow, modified, and patterned) are used as labour progresses.

• Music. Make sure you have your favorite, relaxing songs on your phone, iPod, or laptop. Don't forget your headphones or earbuds.

Many of the above measures are taught in Lamaze classes or childbirth courses.

Medication and Anesthesia

• Relaxant medication. Drugs can be given as a shot to help you relax if you're feeling tense, although they can make you drowsy. They can be used at any time during labour. Sometimes, a relaxant, along with the nonmedical techniques listed above, is all you need to get you through the contractions.

• Epidural anesthesia. An epidural—an injection of medication into your spinal column—removes most sensation of your contractions. It takes effect in about 30 minutes. While epidurals offer nearly complete pain relief to most women, there are risks: if given too soon, before you're in good active labour, an epidural can slow down or stop labour, requiring other interventions to keep things progressing.

An epidural may cause your blood pressure to drop, and it increases the chance that your provider might need to use forceps during the birth, due to increased abdominal relaxation and your diminished ability to push. This diminished ability to push and abdominal relaxation may even result in the need for a cesarean if progress in labour is blocked.

Epidurals may also raise the mother's temperature, requiring that she be separated from her baby following birth until infection is ruled out. Be sure to discuss the pros and cons with your provider before labour begins.

It's hard to know in advance which nonmedical comfort measures or medical pain relief you will want to use. Once you're in labour you can make decisions as you go, according to the intensity and length of your labour. The important thing for now is to do your homework. Find out all you can about your options, talk to your healthcare provider and trust yourself to make the right decisions.