Coping strategies during labour

In the previous edition of Pregnant, Lillian Karanja, a Lamaze instructor at Aga Khan University Hospital discussed how a pregnant woman can tell when labour sets in. In this issue, she looks at coping strategies that help the pregnant woman successfully go through the labour process.

One Lamaze philosophy that strongly supports these strategies is that women have an inner wisdom that guides them through the process of labour. Their bodies know what to do and how to respond.

Position
In Lamaze, it is recommended that a woman in labour be allowed to take a position where she feels comfortable. A position that will help the mother use gravity as much as possible would be more appropriate. Upright positions are the most recommended as they help in the descent of the baby’s head easily. The mother can stand, stand and lean forward or she can even decide to squat. All this is a natural body response to labour onset. Since the journey for delivering the baby is not a smooth one, and the pelvis is not straight, when the woman stands and leans forward, gravity helps the baby to move down the pelvis smoothly.

Alternatively, the woman can squat. This she can do on a birthing stool, ball or chair. If the mother decides to lie on the bed, the baby will still find its way down but then she will take a longer time in labour. She may also experience more back pain. During the labour process, the woman may want to lean or hold on to something. It can be the birth partner or any object as long as it is firm.Naturally, women have a ritual that they perform. You will not find a mother in labour who just stands idly doing nothing. They will mostly do a sideways rock or a small dance. This is the inner wisdom telling the woman that if she moves this way the baby’s head is going to descent down further. There comes a point when the baby is coming down and it needs to make a rotation on its way out. At this point, it may require the woman to kneel down on all fours or squat so as to encourage gravity for the baby’s descent. She can also lie on a bed for a brief rest.

Birth companion
Usually during contractions, a pregnant woman is not in good control of herself. Thus a birth partner should help her adopt a position she is comfortable with. (Benefits of a birth companion was discussed in Pregnant Issue 13. Pg.50)

Environment
The environment should be calm for the mother. That will make the labour process easy and smooth compared to a chaotic and noisy environment where people are walking in and out of the room.

Focal point
This means creating a positive mental image that will disrupt a woman going through labour to forget her pains. When a mother is relaxed, the labour process is likely to be calm. The focal point could be a portrait in the room that reminds her of something good, or even music. All this is meant to disrupt the lady from focusing on the pain of the contractions. If it is music, at Lamaze we recommend classical as opposed to music with words.

Massage
In most labour situations, a woman builds a lot of fear in her which results to tension. In turn, she is likely to experience more pain. It then becomes a vicious cycle of fear, tension and pain. Under these circumstances, the labour may not go on smoothly. It also happens that when a pregnant woman is in pain her body produces a hormone called endorphin. This is a natural pain relief medication that nature produces on its own to calm the pains. Thus, when artificial labour pain relief medication is administered, the body stops producing the endorphine.

But, to facilitate more production of endorphin, we need to help the lady relax by massaging the middle part of the palm. In turn you help the woman forget her tension and in turn forget the pain. This is done through massaging the acupressure palm points of the hand where tension tends to build. You will notice that when a woman is in labour, she will most likely hold on to anything, be it an object or even her partner.

So when the mother has a break during her contractions, the birth partner can massage her palm. You massage from up the heel of the palm down to the fingers. Therefore tension is reduced and the lady is relaxed. Her pain perception will come down and the cycle is broken down by the massage. So this means artificial pain relief medication does not have to be administered. Touch also communicates a lot. It lets the woman know that someone is there to care for her. It is much more than just a physical touch.

*In the next edition we shall discuss more labour coping strategies.

END: PG19/48