8 options for a more comfortable labor

Many expectant moms worry about how they will cope with labor pain. Images on television and in movies don’t help ease those concerns.

“When you start to panic about how you will actually get this baby out of you, remind yourself that your body was made to grow and birth a baby,” says Lisa Chorzempa-Schainis, MD, an obstetrician-gynecologist (OB-GYN) with Elmhurst Memorial Medical Group. “It’s a natural process that women have been doing for centuries.”

Dr. Chorzempa-Schainis recommends being proactive to know what to expect during labor, including reading, attending childbirth classes and/or going on a hospital tour. She says the next step is to pick the right place to have your baby.

“Choose a hospital that meets your needs, with a balance of expertise and amenities, such as private birthing suites, and pain relief and alternative comfort measures, as well as prompt access to anesthesia services, if necessary,” says Dr. Chorzempa-Schainis.

Most importantly, plan to have someone there for support. Continuous emotional and physical support during labor, such as by a spouse or partner, family member, friend or doula, is associated with improved outcomes.

In addition, a certified nurse midwife (CNM) can offer significant benefits for expectant moms who want a positive, comfortable experience, according to Mary Saracco, CNM, MM, APN, Elmhurst Clinic.

“As advanced practice nurses, CNMs are trained and licensed in ways to help laboring women have a healthy birth using their own natural physiology, while avoiding unnecessary procedures that may interfere with that process,” says Saracco.

When the big day arrives, there are a number of ways — natural and pharmacological — to reduce pain and improve the labor and delivery experience:

• Use attention-focused and relaxation techniques. Rhythmic breathing can help release tension and distract you from pain. You may also find comfort during and between contractions from a gentle massage on your hands, feet, shoulders or back, acupressure, music, aromatherapy and/or hypnotherapy.
• Use warm and cold packs. Try a warm gel pack, hot moist towel or warm blanket in your low abdomen, low back or shoulders. The application of cold, such as an ice pack, frozen gel pack or cold moist cloth, can also help to reduce pain.
• Take a shower or bath. Bathing in warm water during labor is a great way to relax and help relieve pain. Sit on a stool and direct a hand-held showerhead on your front or back. Through its midwives, Elmhurst Hospital offers hydrotherapy or warm water immersion for labor and birth.
• Try giving birth in alternative positions. It may be more comfortable and less painful for you to give birth in upright or side-lying positions rather than on your back. You may consider pushing when squatting, on your hands and knees, or lying on your side.
• Move around and change positions. Moving during labor has been found to enhance comfort and reduce pain. It can also help labor progress by gently moving the baby through the birth canal. Try walking, rocking, swaying, kneeling over a birthing ball or sitting backward in a chair.
• Consider nitrous oxide. Unlike systemic drugs that can cause unwanted effects, nitrous oxide (a tasteless, odorless gas inhaled through a mask) is considered safe to use during labor and can provide relief from pain and anxiety. It also has a quick onset and quickly exits both the mother’s and baby’s system. While alternative comfort measures are encouraged, Elmhurst Hospital is the first in DuPage County to offer this pain relief option for women in labor, and it has been adopted by both the hospital’s OB-GYNs and the Elmhurst Clinic midwives.
• Try other pain medications. Some women prefer opioids to “take the edge off” of the pain instead of an epidural, since this option doesn’t interfere with the ability to push during labor. Pain medication can be given as a shot, intravenously (IV) or through a patient-controlled analgesia (PCA) pump, usually during the early stages of labor to avoid side effects for both mother and baby.
• Choose an epidural. Epidural anesthesia is used by more than half of women giving birth. While it is the most effective form of pain relief for labor (as it “numbs” pain), an epidural has some disadvantages. Talk with your physician to determine if this option is right for you.

“Keep in mind, having continuous support is key to comfort in labor,” says Saracco. “The more personal attention and nurturing you can get, the more positive your experience will be and the better your chances for a safe, healthy birth.”

To learn more about Edward-Elmhurst Health’s pregnancy and baby services, and benefits of a certified nurse midwife, visit www.eehealth.org/services/pregnancy-baby and www.eehealth.org/services/pregnancy-baby/midwifery,

To find an OB-GYN or midwife, visit www.eehealth.org/services/pregnancy-baby/care-team.