Managing Pain During Labour

Whether you choose to deliver at home or in the hospital; with an OB/GYN or with a midwife; what your birth plan involves and how you plan to manage your pain and experience varies.  However well prepared you may be, do be ready for the unexpected because sometimes things do not go as planned (as was the case for my first child .... water broke at OB/GYN visit, walked over to the hospital for induction, limited allowance to move as I was on the monitors, many hours of contractions and labour, only to end in emergency C-section and eventually under general anesthetic).

Pain during labour may seem like an unavoidable component during this experience we call childbirth, however there are things that can put you at ease about this concern.

Here are some tips to alleviate some of the pain and consider adding to your birth plan, from a physiotherapist's, and mom's of two active boys, point of view, to make this experience less stressful and more manageable.  

Here are a few EXERCISES you might find helpful ...

1. Child’s pose
   1. This exercise/stretch is performed in order to lengthen the spine and pelvic floor muscles, which in the end ease any discomfort.
   2. In order to do this you must be on all fours (hands and knees), then rock your hips toward sitting on your heels, as you lower your body to the floor.
   3. Your arms end up stretching outward, above your head (or may be bent to support your head).
   4. Stretch out and breathe deeply, holding for a few breaths.
2. Cat/cow pose/movement
   1. This spinal movement exercise is performed on your hands and knees in sync with your breathing.
   2. As you exhale curl/round out your back and bring your chin towards your chest.
   3. With your inhale, slowly arch your back (stick chest forward) and look up towards the sky.
   4. This exercise reduces lower back pain, as it stretches and moves your joints and tissues.
3. Exercise ball exercises
   
   1. If available, sitting on a large exercise ball is great, not only for posture, but also in order to align the pelvis. But you must avoid leaning back and sitting/lying on your tail bone. While on then ball you’ll be stabilizing the pelvis and strengthening the core.  
   2. While on the ball - rock your hips/pelvis (side to side, front to back, even circles).  
   3. An exercise ball can also be used for - wall supported squats, stretches (child pose and many more).
4. Butterflies
   1. Sit with your knees apart, connecting the soles of your feet together.
   2. Move your knees up and down, as though fluttering your ‘butterfly wings’.
   3. This will help your hip and pelvic floor muscles.
5. Squats
   1. Yes! Squats ... they can stretch the perineum and relax pelvic floor muscles.
6. Modified child's pose / low back stretch
   1. Leaning forward on counters, or even on that exercise ball can prepare your lower body for the work it will endure. 

OTHER TIPS ...

1. Consider a TENS machine to help manage pain.
   1. TENS = Transcutaneous Electrical Nerve Stimulation. This machine is a form of therapy that occurs by applying electrodes (powered by low-voltage electrical currents) onto an area of pain or pressure point of the body, in search for pain relief. Although many people are familiar with this pain management tool, for in clinic and home use, many are surprised to hear it is a great option during labour for alternative pain management!
   2. In a March 2014 survey done by UK consumer choice magazine reported that out of 1,200 women who gave birth, 22% of the women used a TENS machine and 68% of them found it effective in reducing pain.
   3. Consult with your physiotherapist the appropriate wave lengths and duration before purchasing your own in order to have optimal results.
2. Massage (self, or by partner).
3. Hydrotherapy (water/bath).
4. Music, or other means of distraction and relaxation FOR YOU!

For more tips on how to carry out daily movements with less pain such as walking, pushing a stroller, cleaning and so much more check out the FREE app called "Rost Moves Mama" created by Cecile Rost, a Dutch physiotherapist who has completed research using pelvic symmetry techniques that help women during pregnancy and postpartum who experience pelvic girdle pain.

In the end it is important to be patient. Things do take time and sometimes don’t always go as planned. All you can do is be prepared and be ready for change.  Having a supportive labour team goes a long way!