Labor Positions + Comfort Measures

Updated: Apr 30

Comfort isn’t the same for everyone, so that’s why as I doula, I come prepared with a plethora (like the word didn't you!) of comfort measures to help keep my clients relaxed and engaged during their birthing experience. In this blog I will cover a few of my favorites, but this isn’t my whole list, just a few easy peasy ones I know most folks will be able to do.




We will learn:

Feel free to click on the titles above to jump ahead and skip to the section you need!

Hi, I’m Charda, a Black mom, doula, childbirth educator, prenatal/postnatal yoga instructor and lactation consultant in San Diego, California. I love teaching families how to have a more healthy and positive pregnancy, birth, parenting & breastfeeding experience! My focus is on empowering Black moms, babies and families to be resilient, informed and protected on their life journey.


What are comfort measures?

Comfort measures provide direct or indirect pain relief which can be very effective during labor and birth. Methods such as hydrotherapy, hypnobirthing, patterned breathing, relaxation, and visualization can increase the production of endogenous endorphins that bind to receptors in the brain for pain relief. Try to create a warming, private and peaceful environment for your birth to remain calm and present during this amazing experience. You can increase your own comfort by walking, slow dancing and rocking your pelvis, using pillows to position for comfort as well as sitting or swaying on a birth ball and lifting the abdomen gently and rocking while supporting the belly. These are all proven to provide some level for comfort and relief during the process of birthing. Let’s dive in deeper!


Water Therapy:

We immediately think of a birthing pool, and home birth or birth center but that’s not the only way you can use water as a form of hydrotherapy for pain relief. Having a bath, shower or warm water on parts of your body can provide the same desired effect. If you are at home this will be easier, some birth locations like UCSD Jacobs medical center in La Jolla, CA will allow you to use the tub for comfort measure relief but you will not be allowed to give birth in that tub. The tub itself however is there for your comfort during your trial of labor so try it! The water should not be warmer than your body temperature, ask a trusted member of your care team to help you get the water ready and get in to relax!


  • Reduces stress which allows your body to release more oxytocin

  • Decrease pressure on your abdominal muscles

  • Reduced need for an epidural

  • Shortens duration of labor

  • Lowers your blood pressure

  • Relaxes perineal tissues which prevents risk of tearing

  • Decreases risks of interventions and increases your relaxation


Hot + Cold Therapy:

Focuses on using different tools that can be heated or cold to be used throughout all stages of labor to provide relief and soothe back pain by decreasing the level of sensation felt.


Heat


Cold

  • Store bought cold packs

  • Wrap frozen items in a thin towel or paper towel or bag

  • Cold or damp washcloth soaked and squeezed in ice cold water



Birthing Ball

Studies have shown that use of a birth ball can help with relief of uncomfortable sensations during labor, which gives us a sense of control over our body’s pressure, balance and coordination at a time when some of us birth givers may feel super out of control or out of body.


Birth Ball

  • Bounce gently on the edge of the ball

  • Place ball on a surface like floor or hospital bed and lean over the ball

  • Rock pelvis back and forth on ball

  • Lean over your front half while on the ball


Peanut Ball

  • Can use for pushing phase of labor

  • Use it if you have an epidural

  • Use it for KICO positions (Knees In Calves Out)

  • Mermaid pose (flying cowgirl)



Twerk it out!

This is your time to be in your feelings, emotions and spirit, you have made it to this birth!

Praise yourself and your baby, be in the moment and dance it out if all else fails. Evidence shows that dancing during the early phases of labor can decrease the duration and intensity of labor and increase your overall satisfaction of your birthing experience. As a birth worker and former professional dancer (one time super bowl dancer, ballerina, jazz, modern, gospel/praise and hip hop) I approve this message!


Dancing helps:

  • Encourages upright positioning and movement

  • Speeds up dilation and releases oxytocin

  • Helps boost your mood and puts you in good spirits

  • Less likely to have an epidural and overall lower pain intensity

  • Decreases your chance of a surgical birth

  • May shorten the duration of your labor


Positions to Prepare for a Smoother Birth

I highly recommend birthing folks stay as active during labor as possible by moving frequently throughout the process about every 30-60 mins until you give birth or unless you are resting for a nap, but even then a doula or partner can make sure to remind you to switch you sides in the bed while resting. It can be difficult for some to move during labor just from the heaviness of baby being low in the pelvis, ask for help when needed for position changes. Try using the bathroom once an hour to ensure you create space by keeping a relatively empty bladder and to ensure you move your body by walking to the bathroom. Sitting on the toilet also helps, I recall sitting on the toilet for almost an hour during my first birth just because it felt the best to sit with my body open in that way.


Birth positions can:

  • Ease your labor and contractions, waves or surges

  • Creates a more positive childbirth experience

  • Shortens the length of labor

  • A better sense of control over labor

  • Please try to avoid laying on your back for birth giving or laboring, as it will stall your labor and put the baby in a poor position for entry. If you must be lying down, keep your legs and pelvis open with a peanut ball or pillows.


Check out my TikTok Video HERE on Labor Positions to help with comfort


Check out my TikTok Video HERE on Labor Positions to do with an epidural


Doula Magic

There are many types of doula, a birth doula is probably the most common. A doula is an individual educationally and physically trained on the process of childbirth. A doula provides a non medical approach to providing a birthing person with emotional, physical, and educational support during pregnancy, labor and birth, regardless of the type of birth. Doulas are proven to shorten the duration of labor, decrease the intensity and improve satisfaction level with overall birth experience. As a doula, my natural nurturer role is fulfilled outside of being a mother as I get to support folks like me which is awesome and rewarding.


Doulas provide:

  • Reduced need for painkillers or epidurals

  • Decreases risk of surgical birth

  • Reduces risk for the use of instruments like forceps or vacuums on your baby

  • Increases overall satisfaction of birthing experience

  • Black Doulas improves birth safety and comfort for Black birth givers

  • Reduces rate of medical or scheduled induction

  • Increases breastfeeding rates


Doulas love partners too! Partner support hits different:


A doula is not hired to replace a partner or spouse in the role of birth, we are a team! A partner can provide a unique level of comfort and support that we simply cannot always give depending on how long we’ve bonded with our client. When someone who we love or trust touches us, our body and brain sends a signal to our vagus nerve which slows down our central nervous system. When our CNS slowed, our body is out into a resting state which lowers the stress hormone cortisol and serotonin is released. Serotonin is a neurotransmitter that basically acts as the body’s natural antidepressant and pain reliever. Massage works similarly and decreases cortisol/stress hormones and increases serotonin and dopamine.


LOL - Laugh it out!

Laughter truly is the best medicine, it triggers the release of endorphins (the body’s natural pain relievers) and decreases the number of bad stress hormones which causes the body to relax and relieves stress and anxiety. Which all lend to having a positive and enjoyable birthing experience. Humor can reflect pain, comedians will probably tell you this, and the laugh we are looking for in order to seek relief is a good ol’ belly laugh or a hearty laugh that is genuine and felt in the eyes, face and smile. Put on your best comedy show or have a funny doula or partner get you going! Partner note: as a doula, I have to gauge when is the best time to stop the joking, usually as things progress to harder stages like pushing, that’s probably not the best time to joke but early on when birth giver is moving around and walking, dancing or chilling on the ball is a good time.



Herbal remedies for relief during birth:

As a doula I carry a small box of key essential oils and have my clients try them prior to birth to see what their preferred scent pattern will be, this can change but I like to get a general idea whether warm, clean, fresh, spicy. One oil that is great for encouraging labor and easing the process, as well as stimulating contractions which promotes oxytocin production is Clary Sage.


Clary Sage is relaxing, soothing and balancing try:

Safety Warning! Do NOT use this oil if in preterm labor or during the first trimester!

  • Massaging into acupressure points

  • Put a few drops in your bath or shower

  • Smell it directly from the bottle or dab a drop on your wrist, behind ear or neck

  • Use it in a diffuser - I always bring this to births! I ask for consent from the birth giver before turning it on and before choosing the oils. Hospitals should not have any issue with you using it, just ask them where is the best place to plug it in.


Cannacurious?

I wrote a blog about the use of cannabis while chest/breastfeeding. I'm a supporter of the responsible use of cannabis by consenting adults who are 21 and older, particularly for parents. CBD oil is a plant compound extracted from the hemp or cannabis plant, it does not contain THC (part that gets you high). CBD mostly acts as a muscle relaxant so many have found it helpful during the early stages of labor. While it is not widely recommended that birthing folks smoke cannabis, we must acknowledge that culturally speaking small amounts of CBD oil and hemp products have been used for centuries in Middle Eastern, Indigenous, Afro-Latin and Chinese cultures to help women throughout labor.


CBD supports your body, mind and soul by:

  • Allowing you to access your instinctive brain

  • Ease unwanted sensations

  • Ease anxiety and depression

  • Ease severe vomiting or nausea


Currently the FDA regulations do not advocate for use of CBD oil during pregnancy or labor out of concerns with possible overdosing which they believe can lead to potential fetal development problems or impairment but there is little to no conclusive evidence to this point.