Comfort Measures | Tips for Doulas

Originally posted May 2011, updated December 2015.

Notes from the book & my own thoughts in addition to help laboring mommas from The Labor Progress Handbook,

- Change positions every 30 minutes. Even something as simple as switching sides if laying in bed can make a difference in helping the baby to descend into the best position. (If mom is laying down, don't forget the peanut ball!)

- Rhythm movement, swinging, rocking, sitting on the birth ball, and a rebozo can also help baby get into a better position for a smooth exit.

- Counter pressure on the lower back or against the hips can alleviate discomfort. This can be done with the partner's hands or a rebozo wrapped around mom's hips.

- Hot packs: try a hot pack on the lower back, warm wet cloth, warmed blanket, hot shower. Parents can bring their own rice pack or I bring a hot water bottle that I can easily sanitize (and if I'm organized, I have individual rice packs I've sewn for families.)

- Cold packs: cold wet washcloth, crushed ice, water bottle, frozen gel pack often on the upper torso, back of the neck, and forehead. (I carry a small cooler bag to fill with ice water for this reason, dipping wash cloths in and wringing them out quickly as mom warms them up! This is something many moms love in transition.)

- Shower or tub (hydrotherapy) if available at the birth location. You can also place a birth ball into the shower for mom to rest more comfortably, and her partner can hold a hand held shower head against her lower back.

- Focused relaxation, guided breathing (self or other), meditation, visualization may all be comforting. Try these out during prenatal visits to find the right "script" that fits mom's needs.

- DOULA. Get one of these. 😉

- Massage: hands, feet, back, legs, etc. During labor mom's nerves may feel more sensitive, so while she may normally like the soft, light touches in labor she may prefer deep pressure and stronger touches and light touches may tickle or feel irritating. She'll give you feedback!

- Food & fluids as she desires! In birth locations specifying only "clear fluids" consider broth, juices, popsicles, or honey sticks.

- Music the woman likes, such as a playlist of slow/soothing songs & a separate playlist of more active and energizing songs depending on her mood and stages of labor.

- Dim or brighten lights as mom desires for ambiance. Opening the blinds and turning the lights on after a long night of labor in the dark can help recharge the mood for the parents and the entire birth team.

- Make heart tone checks audible if mom is reassured by sound. (Turn off if she prefers to not hear the extra noise.)

- Verbal affirmations: You're doing so well, You are so strong! Whatever she is doing that seems to help her feel better, encourage her and remind her she knows her body best. However, too many people speaking too much at once, especially during the pushing stage, can overload a mom. Her care provider (OB/midwife) may be giving directions during pushing, and her partner should be her primary verbal support if they both desire. Otherwise, be careful about how much you add to the verbal "noise" if many people are talking at once!

- Limit people in the room if mom desires, and if any guests/family are making her anxious then give them tasks to send them away/keep them busy (IF she desires, this is something important to discuss in prenatal visits - who will be attending the birth, and any issues there may be with that relationship.)

- If mom is self conscious about vocalizing then you can vocalize with/mirror her (if she desires) or turn on some white noise or music. Also reassure her that noise is okay!!

- If mom desires privacy then encourage her (and partner) to retreat into bedroom (or bathroom) and close door. Some moms can relax better if on toilet, just make sure she doesn't start pushing there! You can also encourage them to shower or get into tub together. (Partners may want to bring a swimsuit to the hospital/birth center and a change of clothes in case mom requests this.)

Quotes regarding some of these comfort measures:

"Heat increases local skin temperature, circulation, and tissue metabolism. It reduces muscle spasms and raises the pain threshold. Heat also reduces the 'fight or flight' response..."

"Cold numbs the area by slowing the transmission of pain and other impulses over sensory neurons (which helps to explain the often noted numbing effects of cold.)"

"Hydrotherapy reduces muscle tension, pain and anxiety dramatically for many women. Immersion in water also provides buoyancy (reducing the effects of gravity on the woman, not on the fetus), even distribution of hydrostatic pressure over the immersed portions of the woman's body, and warmth, all of which often bring pain relief and more rapid active labor progress."

What are some of your favorite comfort techniques you used for your own birth, or you suggest as a doula?

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