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| Home > Preparation for Child Birth > Comfort Measures for Labor
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| | Comfort Measures for Labor
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 The response to labor varies from women to woman. This depends on is the nature of their labor, their sense of readiness, their coping styles, and their goals and expectations. You have tried various comfort measures while preparing and practicing for labor as well as adjusting them to suit you. Explore yourself and use this knowledge to develop your own style for labor. Decide what helps you relax. Is it some soothing music, massage, soothing voices, meditation, a bath or shower, or thinking about pleasant places and pleasing activities?
Every woman has a particular way of coping with pain. Find out how you cope with pain. Is it by "tuning into it" that is focusing on it, thinking about it and tailoring your responses to it. One way of reducing the pain is by accepting the pain as a positive component in the process of pregnancy. Others prefer to keep their mind off the pain through diversion techniques like concentrating on outside stimuli.
Many women effectively use both the techniques tuning in and distraction in various stages of their labor. In some cases they relax, breathe slowly and easily throughout their contractions, close their eyes and imagine the uterine contractions opening the cervix and pressing the baby downward. As contraction intensifies, some continue in this way; others lighten and hasten up their breathing. Then, as they proceed to the final stage they focus outside (some objects in the room), and follow outside directions from their caregiver or partner, guiding their breathing. (Sometimes more complex breathing patterns are more helpful).
The comfort measures listed below are centered on relaxation. Learn and familiarize with them to control painful labor.
Focal Point
Focus your attention on a fixed object during labor contractions. Your attention should not waver. It can be an external focal point such as your physicians face. Some people focus on the same thing for many contractions; others change focal points often.
The focal point for some women may be an imaginary one like a point, a beach etc. They need to keep their eyes shut for this. Others concentrate on the actual process that they are going through that is contractions of the uterine muscle the opening of the cervix with the baby pressing down and trying desperately to push the cervix open and freeing himself from the confined space. Music, soothing voices or other pleasing sounds can all help you maintain your focus.
Massage
Do not forget to try the focal point as told above, as you practice breathing and relaxing together through mock contractions. You adopt the one that suits you, but be prepared to use alternate focal point if it does not help you in labor.
Effleurage is a light, rhythmic, stroking massage of the abdo-men, back, or thighs. This can be a tool for relaxation and pain relief when done on uncovered skin by your physician.
The pressure applied while stroking varies from woman to woman. Some may prefer an extremely light, even "tickly" stroking, while others find a firmer contact more soothing. You try to find out the most appealing stroke by varying the pressure and rhythm of effleurage, as you and your partner prepare for the birthing process. Keep practicing in this position until labor. The most popular Effleurage position is over the lower abdomen tracing the lower curve of the uterus. Some feel that they are stroking the baby`s head. Others prefer stroking the abdomen in circular motion.
Effleurage is used by many women during contractions in labor. Application of Cornstarch or powder will help in free movement of your hands. The massage should be rhythmic. Time it with slow breathing. In case your skin becomes extra sensitive with the intensification of the contractions, you might try effleurage in a different area or discontinue it.
Firm stroking or kneading (squeezing and releasing a part), is the second type of massage. It is soothing and relaxing both during pregnancy and during labor. Massage of the various parts of the body like face, neck, shoulders, back, thighs, feet and hands can be very soothing. Identify the areas of your body where massage is most helpful and plan to use it in labor. Work together in massaging the body.
The third type of massage for labor is known as counter -pressure, used mainly over the low back during contractions. This type of massage is especially helpful for backache during contractions. Your partner simply presses with his fist or the heel of his hand on a spot in your low back or sacrum. One needs to press substantially hard with one hand, while holding your hip-bone with his other hand to give you support. He has to find the exact spot, under your guidance, as it varies from woman to woman and changes during labor. You won`t believe that you may need a surprising amount of pressure, making your partner physically exhausted after a few hours. It is worth the effort, however, because of the relief and comfort it brings. Your partner can alternate with another person or the nurse to get some rest.
Perineal Massage
The purpose of perineal massage is different. This massage helps in softening the tissues around the vagina and increases the elasticity of the perineum. As the hormonal changes loosen connective tissue in late preg-nancy, this massage helps you to relax the pelvic floor muscles when there is pressure just like there will be during birth. This massage reduces the chances of an episiotomy or serious tear.
You need to massage the perineum daily for about six weeks before your due date in order to avoid an episiotomy. Your physician should be aware of the reasons for the massage. The concept of Perineal massage is unusual and are not known to many. Some women or couples find it distasteful and will not try it. Others feel it is worth trying since the chances of episiotomy are considerably reduced. Some find it enjoyable, especially after doing it for a while and learning to relax.
Perineal massage is not advisable if you have vaginitis, herpes or other vaginal problems as it could worsen the condition.
What to Do
Either you or your partner can perform the massage. Take a mirror and identify your perineum so you know what you are doing. Some precautions are to be taken like cutting your fingernails, using disposable rubber gloves (in case of rough hands) and washing your hands before beginning.
Starting position: Make yourself comfortable, in a semi sitting position or squatting against a wall or sitting on the toilet or stand-ing with one foot up on the edge of the tub or a chair.
Massaging:
Lubricate your fingers well with oil or water-soluble jelly. Wheat germ oil available at health food stores is recommended because of its high vitamin E content. Other vegetable oils or water based lubricants such as K-Y Jelly are equally good. The use of mineral oil or petroleum jelly is not recommended. Wash your hands before dipping into the lubricant for second application.
Apply enough oil or jelly into the perineum to allow smooth movement over the tissue and lower vaginal wall.
If can use your thumb for massaging Your partner can use his index fingers. Insert the fingers or thumb deep inside the vagina (up to the second knuckle); rotate your thumb upward along the sides of the vagina in a rhythmic U or sling-type movement. This movement will stretch the vaginal tissue (mucosa), the muscles surrounding the vagina and the skin of the perineum. You can also massage by holding the skin of the perineum between the thumb and forefinger and gently stroking it. The tissue will be tight in the beginning, but with time and practice, the tissue will relax and stretch.
Relax your muscles as you apply pressure. As you gain practice, increase the pressure just enough to make the perineum begin to sting from the stretching. (This same stinging sensation occurs as the baby`s head is being born.)
Massage for about five minutes. Talk to your physician if you have any doubts.
Unfortunately the benefits and risks of perineal massage has not been studied at length so it is difficult to vouch for the benefits, Therefore, you need to decide whether perineal massage works for you or not.
Water
 Most laboring women find warm water bath, hot shower or hot wet compresses to the low abdomen, low back, or perineum and groin very comfortable .The pain of Contractions reduces if you are immersed in water waist downwards. The buoyancy of the bath water or gentle massage provided by the shower helps you relax better. Enquire if you will have access to a bath or shower during labor. In the shower, lean against the wall or sit on a towel -covered stool so you can rest. The water should be sprayed where it hurts most. In the tub, lean back against a bath pillow or folded towels and relax. You should not get into the tub if your membranes have ruptured. The partner can accompany the laboring woman into the shower in some hospitals. Hot compresses are washcloths or small towels soaked in hot water, wrung out and applied where it hurts the most. You may replace them as they cool. Applying hot water bottles provide marvelous relief in a painful labor, as they retain heat longer.
Cold
A cold pack like an ice bag or even a rubber glove filled with crushed ice, a hollow plastic container filled with ice, provide a great deal of relief. A cold pack can reduce pain and swelling when placed on the position of the pain during labor or on the perineum immediately after birth. A cold pack always feels soothing.
Movement
 Locomotion during labor is another extremely useful comfort measure. Frequently changing your position, from sitting to standing to lying down to walking on all fours after a gap of a few minutes will help relieve pain and provide the benefits of gravity. The changes in the alignment on the pelvic joints due to movement improve the pattern of labor. Walking may speed up the slow progress of labor. The upright position empowers you with a greater sense of control and active involvement than lying.
Liquids
Most laboring women may lose their appetites when they begin active labor, but their thirst for liquid remains throughout labor. Liquids are therefore essential for you, either by drink-ing or by an intravenous drip. Normal labor allows you to drink water, tea or juice, or suck on popsicles between contractions. You are also meeting your body`s requirements for fluids by quenching your thirst. If your labor is prolonged or if you are nauseated, you probably should receive fluids intravenously, if you doctor does not allow you to drink. Your movement is not restricted if you receive intravenous (IV) fluids and the IV unit is placed on a rolling stand. Urinating hourly will increase your comfort during contractions. If oral fluids are denied to you, you may have a very dry mouth so suck on ice chips, a wet washcloth or a sour lollipop. Rinsing your mouth and teeth with cold water and a tooth-brush also helps to prevent a dry mouth.
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