The ABCs of Comfort Measures

As doulas, we are well-versed in the various comfort measures available to folks in labor and birth. Prenatally, our birth planning sessions, or prenatal visits, help families walk through all of the options available to them in birth: positions that feel best when you’re more upright and active, and how to optimize rest when you need it; any smells that make your shoulders soften down; what pain relief options you might want to access along the way. We cover so much information in these meetings and they stand as the pillar of our support.

From there, we are on-call for families until they need our in-person support with comfort on the big day! Through physical, emotional, and informational support, we help break the fear, tension, pain cycle to get a solid calm, confident, and coping cycle to take over. Whether you're preparing for your birth in Minneapolis, St. Paul, or the surrounding areas in Minnesota or somewhere else in the world, we’ve laid out the ABC’s of Comfort Measures to help you get started:

Ask Questions

Mindset is everything in birth. You’ll notice “confident” to be a key part in that preferred cycle, as you move in and out of the waves your contractions tend to mimic. Making informed decisions is a huge piece in your level of confidence and control you feel throughout your labor. As birth workers, we often turn to the acronym BRAIN to help make sure we’re asking all the right questions, even around the unexpected and unknown birth so often presents:

B - Benefits. Whatever your provider might be offering, what benefit will it bring to you? Simple as that.

R - Risks. When we ask only one-sided questions, we get one-sided answers. Even when leaning on the research and evidence to guide your choices as a parent, you have to ask what the risks might be, as well as the benefits.

A - Alternatives. What else does the same job? Maybe your labor has stalled - can you try to increase oxytocin (the juicy love hormone we create naturally in our bodies) before you lean on synthetic Pitocin? Maybe you’re Group B Strep positive (common!) - can you opt for a heparin lock in between the rounds of antibiotics, rather than being tied to an IV pole during early labor?

I - Intuition. This is a big one, and often overlooked either through fear-based decision-making or as being a little woo-woo. Listening to your body, or “following your gut” as a parent will be such an essential factor in making decisions that align with your values. Perhaps an induction is brought up - if deep down you know this baby is coming soon, why not ask if you can wait another 12-24 hours? What would be the benefits and risks of following your intuition?

N - Next. What will happen next if you say yes? If you say no? Not yet? What if you opt for one of those alternatives? Knowing what lies ahead can lead you to a more grounded and informed answer now.

Breathe

How you breathe is what is important here. No longer do we encourage that old-school Lamaze breathing. You know, short and quick “he he he ha ha ha”. Rather we want low and slow breathing and vocalizations. When your shoulders are up by your ears and you make an “eeee” sound, your throat and neck constrict. Remember the tension in the cycle we talked about up above? We want to avoid that. Because the more tension above, the more tension below, and a tight pelvic floor offers little room for movement. Rather, we encourage you to take big, deep, open-mouth breaths, maybe making an “ahhh” sound, softening above so below will follow suit.

And while we’re at it, we have another acronym for you: BURPEE

B - Breath. See above.

U - Urinate. You read that right. We want you peeing about once an hour because in order to do so you have to hydrate, hydrate, hydrate! Little sips of water in between contractions can go a long way. Also, peeing brings you into our favorite labor position: sitting on the toilet! In fact, we wrote an entire blog post about it! Sitting on the toilet brings you into that amazing squat position, that helps you release through the pelvic floor, soften all those muscles around your baby, and help them find a position in your uterus that offers a shorter and more comfortable labor experience!

R - Rest. A common saying, “in your average 12-hour labor, only 2 hours of that is in contraction.” THAT MEANS YOU HAVE 10 HOURS OF REST! It is just in small chunks between contractions, starting with 15-20 minutes at a time and slowly shortening to maybe a minute or two to breathe, soften, drink water, and recharge before the next. How can you optimize whatever time you have to fully soak in that rest?

P - Positions. Lots of ‘em! We often say, “to move the baby, you have to move the person birthing”. Getting onto all fours, followed by a lunge on each side helps your baby’s head navigate the pelvis. Lying down on your side with pillows or a peanut ball between your knees can offer that rest, while your pelvis stays open with space for the tailbone to move back.

E - Eat. Birth is typically a lengthy process. And we can only restore energy in a handful of ways: sleeping, drinking water, and eating. Keeping your blood sugar up with an applesauce packet or getting a boost of protein with a bite of an Rx Bar can make such a big difference in the long run. After all, your uterus is the strongest muscle in the body! It needs fuel!

E - Encouragement. See below.

Connect

Remember that oxytocin hormone we mentioned earlier? It is an essential ingredient in starting and maintaining the labor process. And our bodies make this hormone from feeling loved, supported, and safe. We encourage our clients to be intentional about who they invite into their birth space and how they can encourage them along the way. This is different for everyone. Some like a more coach mentality of support, with more direct and assertive suggestions and guidance. Some like a more gentle approach, with soothing voices and a lot of silence as support people hold space and help them feel seen and heard throughout the process. Whatever the case may be for you, the connection you feel alongside the knowing you are not in this alone is so, so important, regardless if you’re going through labor or headed into the OR for a cesarean.

Interested in inviting a doula as a part of your birth support team? Someone to help you ask all the right questions in the moment; someone to remind you of the options, positions, and breath to get through the intensity; someone to offer all this so you can truly connect with your partner?

We are here for you. Let’s set up a complimentary consultation to see how we might be able to support you during your birth.