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Move, Mama, Move!

Pregnant mamas everywhere inevitably think, “Will there be pain in labor?  How will I cope?”

Maybe you are wondering how you will experience labor and what it is going to feel like.  Perhaps you are imagining what you will do when contractions come, or how you will handle them.  You are not alone, mama.  Thinking about the pain in labor and how you will deal with each contraction is a very common concern amongst pregnant women, whether its their first baby or fourth.  

 Labor, the actual work of your body to facilitate delivery of your baby, is divided into three stages: first, second and third, and the first stage is where the dilation of the cervix takes place.  The cervix needs to open and thin and that happens through contractions.  The contractions will come intermittently, meaning they will come and go, getting longer and stronger as time goes on.  

The contractions you will experience have purpose, they are not in vain, (like hitting your thumb with a hammer!).   They will bring you baby closer and closer to you!  Trying to imagine them though, can be very difficult to do, especially if you have never had a baby before.  Often women describe them as “menstrual-like”, “crampy”,  or  as feeling “intense pressure.”  They will start out farther apart, giving you lots of time in between them to figure out your strategy. 

Whether you plan on receiving all the pain medications in labor, none of the medications, or a mixture of the two,  there will be a time when you will experience pain and pharmacological alternatives will not be available. For instance, when you are home working through those early labor hours, driving to your birth facility, or even while waiting for the staff to provide you with some pharmaceutical relief.   Having a plan to help you maneuver your way through these times is important.  

Your body is made to move.  So, in labor, that’s exactly what you should be doing, for as long as possible.   Ask any woman who has just given birth, and they often will account that lying in the bed was the most uncomfortable position.  Being upright, or squatting gets the weight of the baby off of your back and the supporting structures.  Changing positions frequently assists the baby in navigating its way through the pelvis more easily.  Rhythm and movement bring a sense of control and calm, knowing that you can find a position that is more comfortable, whatever that position is.  The World Health Organization, (WHO), recommends that women be allowed to move freely in labor and birth, and that doing so increases birth satisfaction and positive birth outcomes.  

Here are some ideas for managing pain relief, non-pharmacologically:

  1.  Slow dance: with your partner or swaying back and forth while standing with your feet shoulder width apart.  If with a partner, lean into them.  Sway back and forth together.  Let your partner rub your back or turn yourself around backwards against them and let them rub your belly.  Either position is comforting and allows gravity to do its work. Remember, gravity wants everything downward towards the floor.
  1. Sit on an exercise ball or birth ball.  This is a great tool to rock side to side on, (or lean onto if elevated to on top of the bed), and it simulates a squat while you are sitting on it, which can allow up to 30% more expansion of your pelvis, (this is an excellent position if you think you have a larger baby, too).
  1. Utilize water: either in the shower with a handheld shower head on your belly or back, or in the jacuzzi that the hospital/birth center may have….water aids in relaxation.  The sound of the water, the feel of the warmth and the buoyancy in a tub can assist in you relaxing and letting your uterus do its work.  Please remember that if you amniotic sac has ruptured, you cannot get into a tub bath, unless at the birthing facility in their properly disinfected tubs. If your water has broken, and you are at home, you can still shower.
  1.  Sit on the toilet.  Sitting on the toilet naturally relaxes your bottom and your pelvis is allowed to flex, as in a squat.  Remember to urinate at least once an hour, as well, to allow the baby to move down and through the pelvis without a full bladder in the way.
  1. Change positions often, every half hour to hour is best.  Lie on your side.  Get on all fours, lean over the back of a chair or the hospital bed.  Move your body!  I have had patients dance, rock in a chair, one mama even wore a dinosaur costume while moving around the room in labor.  
  1. Use heating pads, (or rice sacks that are chilled or warmed),  and massage your belly or back.  Have your partner apply gentle pressure on the lower part of your back, or wherever you feel pressure, during contractions.  
  1. Breathe.  Simply breathe in through your nose, and out thru slightly open lips.  Think of your breathing as “circle breathing” and find the rhythm of your air moving in and out of your body.   Take nice, deliberate, slow breaths for the duration of the contraction.   Breathing in this way gives you oxygen and tells your body “I am ok”.  Slow breathing is a strategy used for many types of yoga, meditation and exercise, as well. 

Hopefully these tips on moving while in labor, and working with your body and gravity, generate ideas as you imagine what working with your contractions will be like.  Try them all or use one or two that become your favorites.  In labor, contractions are 30 seconds to 1.5 minutes long, (as labor progresses they become longer). In between contractions you can change position, use the restroom, drink some nourishing fluids, eat a light snack if permitted and reassess what is working and what isn’t. 

 All of these comfort measures can help you work through your contractions and when the contraction is over, you can resume whatever activity you were doing.  Listen to your body and trust that it knows just what to do.  

You can do this mama.  Move, Mama, move.  

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