Pain Relief Efforts
Cheyenne County Hospital
Childbirth Class
Candi Douthit, BSN, RN
Causes of Pain in Labor
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Pain comes several sources in labor,
emotional, functional, and physiological.
Knowing what is causing the pain can better
help you deal with it.
Know that a certain amount of pain in labor is
functional, telling the body what is going on
and allowing you to help yourself.
Causes of Pain in Labor
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Emotional-cause may be fear, lack of knowledge,
fear of unknown
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Can actually cause and intensify pain
Education/knowledge of what is coming helps
Functional-cervical dilation, contractions, descent of
the baby, position, procedures
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Muscles are working and may cause pain. Can be reduced
with relaxation techniques
Holding breath and fighting contractions-hinders
progression; lessens oxygen to the muscles
Causes of Pain in Labor
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Functional-cervical dilation, contractions, descent
of the baby, position, procedures (continued)
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Position is very important; change positions to find
comfort
Procedures; can cause pain by mechanism, fear,
anxiety, limiting mobility
Physiological: derivations from normal
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Back labor, arrested labor, different baby positions,
history of back injuries
Coping Styles: What Comforts You?
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Childbirth is a challenging experience, both
physically and emotionally
Reflecting on things that help in other
challenging situations can give you ideas for
what kids of support will be most helpful to
mom in labor
Normal Coping Mechanisms
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Ask Yourself:
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When you are mentally, physically, and
emotionally exhausted, where do you find new
energy?
When you want to help someone, but feel like you
don’t know how to help, how do you cope?
Why are coping and relaxation so
important during labor?
The Triangle: When fear decreases, muscle tension
decreases, and pain decreases, etc.
Gate Theory of Pain
Nerve messages from the organs in the belly
travel to the brain more slowly than
messages from surface nerves, like those in
the skin, and sensory organs. By sending
lots of pleasurable messages to the brain on
these fast pathways you help to keep the
brain too busy to focus on the pain!
Learning Styles
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Visual Learner: Tend to respond to comfort
techniques that work with visual images
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Auditory Learner-prefer sounds
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Focal points, attractive surroundings, familiar objects,
visualization
Music, being read to, encouragement
Praise, singing, being sung to
May help to vocalize through contractions
Kinesthetic Learner- movement and touch
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Changing positions, walking, rocking
All forms of massage
Personality Styles
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Introvert/Introspective
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If normally quiet and reflective, and is likely to turn
to inner resources, will probably do likewise in
labor
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Sit quietly by her
Create a quiet, dark, safe, relaxed environment
The goal is to minimize interruptions, support her
in her own way of working through labor
Personality Styles
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Extrovert/Active Types: If normally loud and
outgoing, turns to friends for help, needs to
“do something” to solve problems, will do
likewise during labor.
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Try movement, massage, breathing, focal points
Distractions are key. Support people are her
coaches.
© Janelle Durham, 2004. www.TransitiontoParenthood.com
Ways to Cope with Labor
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Environment:
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Environment is something you can control. Make yourself
comfortable, will aid in your ability to relax and focus on the
job at hand
Lighting-lowering them can make you relax
Quiet-not being asked questions/talking during contraction,
use hushed tones
Support-can be your spouse, support person, friend, etc.
Knowing you are not alone having people with you
physically to help you with massage, providing information,
performing tasks, etc
Music
Aromatherapy-lavender, eucalyptus, orange-energy
Ways to Comfort a Laboring Woman
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During labor many of us feel helpless when it comes to
comforting the laboring woman.
Massage her face to help release stress and relax her.
Remind her to go to the bathroom every 1-2hrs. A full bladder
is not only uncomfortable but can stall labor.
Try cool compresses on her neck and face. Even lightly
washing her face can feel good when she is working so hard.
Encourage her to drink fluids and eat to comfort if allowable.
Eating and drinking restore her energy for the marathon of
labor.
Ways to Comfort a Laboring Woman
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Help her change positions. Some positions
will provide pain relief, others may feel more
painful. Do what works for her
Counter pressure with contractions to the low
back can feel very good with back labor. She
can tell you where to push.
Be there for her, even if she says she doesn’t
want to be touched, being there for her is
very important.
Ways to Comfort a Laboring Woman
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Try the shower or tub. Water is relaxing and
provides alternate sensation distracting from
the pain.
Use a heat pad, ice sock or warm blanket to her low
back, limbs or perineum to help her
Remind her of why she’s doing this: the baby!
Don’t take criticism or harshness from her personally.
You are her “safe person” who she can express her
pain and frustration to. Sometimes it really hurts, but
know she is just trying to manage her pain, not be
hurtful to you.
Massage Techniques
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A good backrub is
welcome anytime, but
particularly when
pregnancy makes your
back HURT!
During labor, massage
can really ease the pain
and also increases the
pleasurable sensations
to lessen the pain.
Basics of a Massage
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Lightly stroke the back on either side of the spine,
working from the shoulders downward and back up
With your thumbs on either side of the base of the
neck, stroke outward, and back along the shoulders.
Stroke down one side of the back using deep
pressure with the palm of one hand, followed by a
light stroke with the fingers of the other hand. Glide
your hands upward and repeat on the other side of
the back, ending at the buttocks.
Basics of a Massage
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Rotating your thumbs on either side of the
spine, move your hands up the back from the
buttocks to the shoulders, then let your
hands glide down to the buttocks.
End by repeating step one in the reverse
direction.
Massage
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It helps keep a constant,
soothing rhythm and to keep
at least one hand in contact
with the back at all times.
Use cream or oils to help the
hands slide on the skin.
Stop all or part of the
massage if it hurts.
Hand massagers will be
given to you when you arrive
at the hospital.
Words of Encouragement
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Hang in there! A note of support without pressure
You’re doing a great job! She may not believe you even if it is true.
Her experience is what is going on inside. She may feel out of control
even if she isn’t showing it on the outside.
I love you.
Think of the baby…
You are going to be a great mother. Some laboring women have fears
they won’t be a good mother (question themselves, if I can’t even get
through labor, how will I be a good mom)
Keep going! A nod of approval during a long labor, as in “I know you
are tired, but you’re doing great, so let’s keep going”
Just a bit more. Be sure it is just a bit more, otherwise you lose
credibility
I am really proud of you.
Things NOT to Say
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This is taking so long. If you are feeling, tired, achy, hungry,
annoyed, just think about how she is feeling. Don’t verbalize it
to her.
That’s going to be a big baby. A doctor walked in when a
woman was pushing, this comment made the mom question for
the 1st time whether she could do it or not.
Here comes a contraction Mom usually know they are coming,
doesn’t need commentary. Also don’t say how big they are, she
is feeling how painful they are
This is why men don’t have babies. Not really helpful in labor
and delivery
I wonder what’s on TV Don’t pay more attention to the TV than
your wife.
Husband/Support Person’s Role
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Reduce fear through information, reminders
about what you’ve learned, and by showing
her you are calm, confidence and faith in her
ability to do this.
Reduce tension through breathing, relaxation
techniques, and stretching to loosen up.
Reduce pain through movement, reminders
to go to the bathroom, massage, heat, etc
Husband/Support Person’s Role
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Be creative with lots of low-key pleasant
sensations.
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Touch: massage, light touch, stroking. Holding
hands, shower
Hearing: music, encouragement
Visual: pretty things
Smell: aromatherapy, familiar smells
Taste: comforting snacks, drinks
Husband/Support Person’s Role
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Know your loved one’s coping mechanism
and support that…work to provide what they
need to help them cope with labor
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Encouragement
Coaching
Massage
Talk through hopes and fears
Update friends and family
Reassure her that you are in this together
Relaxation and Breathing Techniques
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Our brains will only perceive what we are
concentrating on, everything else is a
distraction
“With relaxation and breathing techniques,
you can consciously choose to make yourself
think about them and not the pain of the
contractions. (CC, 1997).”
Relaxation
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Purpose of Relaxation Techniques
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Relaxation is an active, conscious release of
tension
Doing physical relaxation techniques which
release the voluntary muscles helps to reduce
physical tension, reducing pain
It can also lead to a feeling of emotional wellbeing
and security; this in turn reduces anxiety, which
reduces our sensitivity to pain
Relaxation
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During early labor, it is easy to remain
relaxed. Use this time to develop a good
pattern that will stay with you as labor
becomes more intense.
Relaxation Techniques
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Tension Hold and Release: Beginning with
your toes, moving up to the head, flex each
muscle in turn, making it as tight as possible,
then relax it completely.
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Allows you to feel and recognize tension, and feel
the relief of releasing tension.
Relaxation Techniques
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Passive Relaxation
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Focus attention on your toes and feet. Just let go.
Think how warm and relaxed they are. Focus on
ankles and calves, think how loose and
comfortable they are, and so on, up to your head,
relaxing and releasing tension. Do deep,
abdominal breathing.
Relaxation Techniques
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Roving Body Check Breathe in, choosing a
muscle to focus on. Breathe out, releasing
all of the tension in the muscle with the
exhale. Breathe in, moving your attention to
another muscle. Exhale and relax.
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Can be done with your partner calling out the
muscle to focus on with each breathe
Good quick relaxation method to use between
contractions.
Relaxation Techniques
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Touch Relaxation: During labor, it’s
wonderful if the partner can see where the
mom has tension and encourage her to
release that (touch or verbal)
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Most effective if practiced in advance
Practice tensing the muscles, then having him
touch the muscle. You release the tension,
imagine that it’s flowing out of your body through
his hand.
Breathing Techniques
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Relaxation tips to ease labor pain |
BabyCenter
Purpose of Breathing Techniques
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Provide oxygen to mom and baby. If muscles are
well oxygenated, function more effectively, less pain.
Relaxation: rhythmic breathing promotes physical
relaxation by reducing muscle tension, and promotes
emotional relaxation by reducing anxiety
Distraction: breathing techniques provide a means
for distracting the woman from her pain of labor,
giving her something to focus on other than
contractions.
When to Use Breathing Techniques
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No special breathing techniques are
necessary in early labor. Begin using when
you can no longer walk and talk during
contractions.
Always use the most basic technique
possible, using the least effort required to
manage each contraction.
The Cleansing Breath
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How to: At the beginning of each contraction,
take a deep breath in through your nose,
then exhale through your mouth. When
contraction is complete, take another deep
breathe, stretch or yawn to release tension
Benefits: distraction, good oxygenation to
mom and baby, informs others when
contractions are beginning and ending
Slow, Relaxed, Abdominal Breathing
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How to: Inhale slowly through your nose, allowing
your belly to expand first, then your chest. Exhale
slowly through your mouth, pursing your lips.
Breathing should be slow and relaxed, about half
your normal rate
When to use: use it through as much of labor as
possible. Some women use it for their entire labor.
May get to a point where you can’t relax this much.
Benefits: Relaxing, slow, and effortless. Many
women find that breathing slowly can induce a sense
of peacefulness and safety that helps to release
tension.
Light Breathing
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How to: Inhale and exhale through the
mouth. Lips are relaxed, with a slight smile.
On exhale, make a soft “hee” sound. Avoid
hyperventilation. Relaxed shallow, rapid
breathing, slower exhale.
When to use: when deep breathing is no
longer effective with contractions
Benefits: Helps with relaxation, distracts
attention from contractions
Conclusion
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Labor is a process, the more you are able to relax
through it, the more you can work with your body to
accomplish your goal of having the baby.
Take time before labor to consider which of these
interventions will be most helpful to you.
The staff will remind you of these interventions
throughout labor, so don’t worry if you forget.