When you're not medicated or tethered to a monitor, you can try a variety of positions during labor, including standing or leaning on your partner, sitting, and kneeling (either upright or on all fours). You may find movement comforting, too, and want to try walking or rocking in a chair or on a birth ball. Moving around can make you feel more in control, thus lessening your anxiety and pain. (Some high-tech hospitals have wireless monitoring systems, so even if you have complications that require continuous monitoring you might still be able to move about freely.)
During the pushing stage, an upright position may help your baby descend, and squatting or kneeling may help to open your pelvic outlet. That said, the differences aren't that great — so feel free to try a variety of positions and settle on the ones that make you most comfortable.
Massage, touch, and hot and cold therapy
Massage promotes relaxation, soothes tense muscles, and may reduce your perception of labor pain. You can get a massage from your doula or other support person, or from your partner — a loved one's touch can be very reassuring if you're feeling anxious. You may be comforted by light stroking (called effleurage) or you might prefer a stronger touch.
If you're having back labor, you'll probably want firm massage or steady counterpressure applied to your lower back. At times during your labor, though, you may find that massage is annoying and will need to communicate that to your support team.
Many women also swear by warm compresses or a hot water bottle used on an aching lower belly or back — or anywhere else they're feeling discomfort — to help them relax and reduce pain. Some find cold packs more soothing, while others prefer alternating hot and cold. It's worth giving both a try. Just be sure to protect your skin from direct contact with heat or cold.
Hydrotherapy involves using water to help ease the discomforts of labor. Soaking in a bath at home during early labor is an example of hydrotherapy. Most birth centers and some hospitals provide extra-large or Jacuzzi-style tubs for laboring women, or they may let you bring your own.
Like other drug-free options, hydrotherapy allows you to remain alert and in control. The soothing and pressure-relieving effects of the water promote muscle relaxation and may reduce pain, anxiety, and the need for medication. (As many women who have been there will attest, a warm shower can be soothing during labor, too, though there are no real studies of the benefits of showering.)
One study suggested that continuous soaking in early labor may slow labor a bit, so some caregivers recommend limiting the length of your baths early on or waiting until labor is well established before settling in for a long soak. (That said, a warm bath is a great way to deal with false labor pains.) Make sure, too, that the tub water is at body temperature (98.6 degrees F) or cooler, because anything higher can raise your temperature — and your baby's temperature and heart rate.
Not all women are good candidates for water therapy during labor, though. It's clearly not an option if you have complications that necessitate continuous monitoring, for instance. And most caregivers advise against immersion if your water's already broken, because of the risk of infection from bacteria lurking in the tub, water jets, or hosing. (A shower is fine, though.)
Acupuncture, used for centuries in traditional Chinese medicine, involves inserting and manipulating fine needles at specific points on your body. There's evidence that acupuncture is useful in relieving things such as dental pain and low back pain, but there are fewer studies about its effectiveness in labor. Most experts agree that more research is needed, but the evidence suggests that acupuncture may work for some women — promoting relaxation, alleviating some pain, and reducing the need for medication.
No one really knows how acupuncture works to reduce pain. Two common theories are that the technique either blocks certain pain impulses to the brain or stimulates the release of natural pain relievers called endorphins. The acupuncture points commonly used in labor include spots on the hands, feet, and ears.
The downside of this technique is that it requires a skilled practitioner, and few doctors or midwives are trained acupuncturists. If you're interested in trying this method and are having your baby at a birth center or at home, you may be able to arrange for a certified acupuncturist to be on hand.