Simple techniques such as massage and movement go a
long way in making these labour hours peaceful

ONE effective way of reducing ‘pain’ in labour, is touch and massage. One can apply deep circular pressure, or a kneading action on the back. Or just hold a woman’s hand firmly to reassure her of your support.

Doing light feather touch strokes on a labouring woman’s abdomen can also help. It is from this region that massages of strong sensations reach the brain. If we give light strokes, the brain registers both the strong and light massages. In doing so, the concentration on massages of strong sensation is diverted, resulting in one feeling less pain.

The brain can similarly be pre-occupied and distracted from strong contractions when a woman concentrates and breathes rhythmically by taking deep breaths or doing a shallow pant in labour. This concentration on the breathing distracts the brain’s attention towards the breathing, so that a mother feels less discomfort. This would be similar to not feeling the full intensity of a headache when pre-occupied with work. The same headache can come on really strongly if one focuses on it entirely.

Applying warmth can also give relief. During a contraction, one can apply a hot water bottle or hot towels on the lower abdomen, groin or back as required. Or else one can place a warm blanket or shawl on the area.

The movement of a woman in labour may be restricted either due to hospital policy or a drip, an electronic fetal monitor or medicines that make her groggy. However, when women are not restricted in labour and allowed to move about, they often automatically adopt sitting or standing postures, or walk about, preferring to lie down only in advanced labour.

Women who have been mobile in labour often talk of how they felt less pain when they were moving about. When a mother changes positions, she alters the relationship between gravity, the fetus, the womb of the mouth and the pelvic structure, this can enhance the progress of labour.

Movement is imperative not only for pain, relief, but also for more efficient labour. Even with a drip, a woman can have her bed adjusted to a sitting position and lean forward on the food trolley when a contraction comes. This moving forward allows greater space for the baby to exit through the pelvic outlet, as the flexible tail bone, which is no longer being set upon, moves up and away as the baby descends.

Another option a woman with a drip has, is to get off the bed and sit on the footstool. When a contraction comes she should spread her knees apart and bend forward from her bottom, not her waist, so that the tail bone is free to move out of way of the baby as it descends during a contraction in order to be born.

Even with the electro rite fetal one can sit up without disturbing the monitor. Sitting up takes the weight off a major blood vessel feeding the heart and running along the backbone.

When a woman lies on her back she compresses this blood vessel and can cause fetal distress or heart abnormally, or oxygen deprivation to the baby. If one has to lie down, it is better to lie on the side.

Not lying down also encourages the baby to descend with the aid of gravity. Gravity pulls everything down towards the floor. In accordance to its weight, so that a heavy stone will thud to the ground, whereas a rubber will gently fall to the ground.

The average Indian full term baby weighs approximately three kilos, and this weight encourages it downwards towards the birth passage when the mother is not lying down, but is in an upright position.

There is one exceptional circumstance when the mother should not remain upright – if the baby’s head does not fix, engage or descend approximately four weeks before labour begins and the water bag bursts before the contractions start.

However, if the head does not engage and the water bag does not burst, being upright will encourage the baby’s head to engage and descend.

Women would do well to take it upon themselves to move about in labour, so that they can be more comfortable and at the same time be doing what is best for the baby.