The Ultimate List of Tools

and Techniques to Cope

with Pain in Labor 

(and how I avoided an epidural)

Jessica Pumple
Registered Dietitian, Prenatal Fitness Professional,
Certified Diabetes and Bariatric Educator
 Table of Contents
Tools and Products To Cope With Labor Pain Page 3

1. Massage and/or Aromatherapy Oils

2. Hot Therapy Pack
3. Birthing Stool or Squatty Potty
4. Birthing Ball (Yoga Ball)
5. Hair Comb
6. TENS Machine
7. Rebozo
8. Birth Pool or Water Therapy

Pregnancy Preparation Page 7

1. Pregnancy Yoga, Exercises and Pelvic Floor Preparation

2. Perineal massage
3. Positive birth stories
4. Learn to relax and create relaxation ritual
5. Plan Labor routine and practice labor positions

Techniques During Labor Page 12

1. Birthing Sounds
2. Visualization
3. Music Therapy
4. Meditation
5. Rhythmic Breathing
6. Hypnobirthing
7. Birth Affirmations
8. Counter Pressure and Hip Squeeze
9. Movement to decrease pain
10. Acupressure
11. Labor Massage

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 Tools and Products to
Cope with Labor Pain 
1. Massage and/or Aromatherapy Oils
You can use whichever ones you enjoy or find relaxing. My favorites are lemon to help ease
nausea; then lavender and clary sage oil (not to be confused with sage) for relaxation. Some
women also state clary sage oil helped them induce labor and strengthen contractions.
However, there are no randomized controlled scientific studies that show these results. 

If you use these oils for massage, be sure to mix them with a carrier oil such as coconut oil.
Applying directly may cause skin irritation or systemic toxicity. If you’re unsure, you can
safely use an electric aromatherapy diffuser.

2. Hot Therapy Pack

Once the pack is heated, you can apply it to your lower back, tummy or hips during
contractions. A warm pack or warm compress on the perineum can also help it to stretch
which may help to reduce tearing.

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 Tools and Products to
Cope with Labor Pain 

3. Birthing Stool or Squatty Potty

Many women find it helpful to sit on the toilet to labor as it opens up the hips in an ideal
way for baby to move down as well as allowing gravity to help. However, toilets can be
viewed as unhygienic and it's also difficult to catch a baby on the toilet.

A birthing stool is similar in shape to a toilet, but often lower to the ground to promote a
squatting position. It's open on one side so you or your support person can catch your baby.

If you want to save money, you could also sit on a squatty potty stool to birth. 

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 Tools and Products to
Cope with Labor Pain 

4. Birthing Ball (Yoga Ball)

This is probably my favorite labor tool! I used it in all three of my births. I found it to be
less painful to sit on the ball in labor than on a chair or the bed. When you sit on the ball, it
helps take pressure off your spine, applies counter pressure to your perineum, opens up
your hips and keeps you upright to use gravity to your advantage. I also found bouncing in
a rhythmic pattern and doing large hip circles soothing and that it relieved pain from
posterior labor (back labor). 

Another great position is to kneel leaning over the ball. This is particularly helpful for a
posterior labor as it relieves the intense back pain and encourages baby to turn the right
way.

Check the brand-sizing guide to purchase the correct size. The 65 cm is the most common
size. If you’re shorter, then you may need the 55 cm size.

5. A Hair Comb
To distract your self from the discomfort, you can squeeze a hair comb in your hand.
Hold it so the spikes dig into the crease where your fingers meet your palm. Try using
one in each hand.

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 Tools and Products to
Cope with Labor Pain 

6. TENS Machine
TENS stands for Transcutaneous Electrical Nerve Stimulation. It’s a small appliance which
delivers a gentle electric pulse through wires you attach to your skin with sticky pads.
Many report that it feels tingly or similar to a buzzing sensation. Controls allow you to
adjust how strong the pulses are.

A TENS machine works by disrupting the pain signals so they don’t have a ‘full’ effect. 

For best results start using in early labor. Put the pads on your middle or lower back. Don’t
put the pads on your stomach. Start at a low setting and turn up the intensity as your
contractions become stronger. 

Note: Do not use if you have epilepsy or a heart condition. Do not use in water. You will
also need to take it off if your baby's heart needs to be monitored.

7. Rebozo
A rebozo is a traditional Mexican shawl used for birth. Midwives and doulas use it to
encourage movement, to help flip a baby, to ease back labor and lessen the pain with
movement and pressure. Watch this video on different ways to use the rebozo.

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 Tools and Products to
Cope with Labor Pain 

8. Birth Pool and Water Therapy

Many women find using a birthing pool helps them cope better and lessen the pain in
labor. A birth pool is simply a large tub or small inflatable pool where you can labor and
give birth.

Sitting in warm water provides relaxation and may reduce the need for pain relief. Some
hospitals and birth centers have them or you can rent one for a home birth. If you are
having a home birth you could use your own tub. If a tub is not available many women
find a shower is relaxing and helps them to cope better in labor. 

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 Pregnancy Preparation
For my first pregnancy (2012) I was hearing all sorts of terrible birth stories until I started
prenatal yoga and got education with a doula. Then I started hearing positive birth stories
from the women who had been preparing their bodies! Many natural, or unmedicated
births and many at home. This gave me the confidence that I could do it too. After I had
my positive natural birth experience I wanted to share what I had learned to help other
moms have the same positive experience! 

1. Prenatal Yoga, Exercises and Pelvic

Floor Preparation.
Ask your doctor what activity is safe for you in your pregnancy. In most healthy
pregnancies prenatal yoga and fitness, cardio, swimming, light to medium weights and
strength training are safe and increase the health of you and your baby.

Here are the links to my pregnancy playlists for birth preparation.

Pregnancy and Postpartum TV

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 Pregnancy Preparation

2. Perineal Massage

I was skeptical because I saw mixed research regarding perineal massage. This Ph.D. Nurse
wrote a great article looking at the evidence.

Read the full article here

In summary, she says, yes, perineal massage in the last 4-5 weeks of pregnancy may
decrease the risk of episiotomy. This, in turn, decreases the risk of trauma requiring stitches
for first time moms only. Personally, I wanted to avoid an episiotomy and tearing and
given that there is no downside to trying perineal massage, I decided it couldn’t hurt.

How to do perineal massage

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 Pregnancy Preparation

3. Listen To Positive Birth Stories

Women are often quick to tell you their birth horror stories, but there are also so many
women who have had amazing births. When I surrounded myself with women who were
preparing for labor I was greatly encouraged by hearing many positive birth stories.
Connect with women in prenatal yoga and fitness classes or through local groups organized
by midwives or doulas. After all, many women consider this the best day of their life -  the
day they meet their baby. 

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 Techniques During Labor

4. Relaxation, Ritual and Rhythm

In the book, Childbirth Without Fear, English obstetrician, Dr. Grantley Dick-Reid
hypothesized that when a woman is afraid during labor, blood and oxygen are diverted away
from the uterus and therefore the fear and tension actually directly contribute to
pain. Alternatively, when a mother remains calm, the uterine muscles relax. This produces
oxytocin and endorphins, which are nature’s pain relief.

Birth gurus, Penny Simkins and Ina May Gaskin both state that when the body is tense and
anxious labor is much more painful. The goal is then to be as relaxed as possible. Creating ritual
and rhythm will help you cope throughout your labor. It is good to practice ahead of time so
your rituals and rhythms are second nature and you don't have to think about them too much.  

Relaxation: Reducing the stress of labor.

Ritual: Doing the same routine with each contraction and even between contractions

Rhythm: Doing something in a familiar and repetitive pattern

4. Practice Labor Routine / Labor

Positions

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 Techniques During Labor

1. Make Birthing Sounds

You can use the sounds you make in labor to create relaxation, distraction, ritual, and
rhythm. You can also use your sounds to tell how your labor is going or even what stage of
labor you are at.

Low tones and moaning (possibly similar to the sounds a woman may make during great
sex) usually mean that a woman is coping and feels in control. High pitch sounds and
screaming often mean a woman is not coping and feels out of control. You can use low
toned sounds to help stay in control and cope with labor. 

A woman may start to grunt or make very animalistic sounds as she is ready to push. In my
third labor, this was my first clue to the fact that I was ready to push. From "laborland" I
heard myself grunting and knew it was time.

I personally found practicing noises helpful. Moaning noises in low tones were the most
calming for me. During labor, they helped me focus on my breath and the rhythm in an
almost meditative state. This allowed me to relax and visualize opening up my cervix. I
tried moaning in different vowel sounds. For me, the most natural sounds were Ahhhh and
Eeeee, but any of the vowel sounds may work. The particular vowel sound doesn't matter.
The key is the LOW TONE of the sound as well as the rhythm rather than the particular
vowel sound.

Read this article on birthing sounds

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 Techniques During Labor

2. Visualization
There are three different visualization techniques that women in labor can use to help
provide relaxation and distraction.

1. Reliving a positive experience

This is simply thinking about or discussing a positive experience in your life, such as your
wedding, a holiday or a date. You and your partner can talk through all the different details
of the event including as many senses as possible: sights, sound, tastes and even smells. This
will create very detailed imagery of the event.

2. Creating an ideal environment

This is simply visualizing the ideal labor and birth that you want to have. It may help to
have a birth plan and then during labor talk through the ideal situation that you would like
to unfold. Of course, things happen that are out of our control and you want to be flexible,
but the positivity may help relax you. 

3. Visualizing the work of labor

This was a personal favorite for me. I found it very helpful to imagine exactly what was
happening inside my body. Understanding that "the pain" was simply my cervix opening
up to let my baby out instead of a harmful pain was very comforting. It allowed me to relax
and cope with labor. I used medical drawings to know what my uterus and organs would
look like during birthing and was able to visualize this as it was happening in my body.
Some women visualize their baby coming through a "turtleneck" shape or some use a more
abstract visualization such as a flower bud opening up.

3. Music Therapy
Choose some relaxing music during your pregnancy and listen to it daily with focused
listening. Then, listen to the same music in labor to help distract from the pain. 

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 Techniques During Labor

4. Meditation
A common type of meditation in labor is a deep breathing meditation. This focuses the
mind on the feeling and sound of rhythmic breath allowing relaxation, lowering levels of
stress and anxiety. When the body is relaxed, the experience of pain and anxiety is lessened.
Meditation also produces endorphins which benefits labor as natural pain relievers. 

5. Rhythmic Breathing
I used meditative slow rhythmic breathing for the first stage of labor. Then when I got to
the second stage (pushing) I changed my breath to “breath my baby out”. I switched to
“hee hee whoo” panting type breaths. My goal was to go slowly rather than too quickly,
which can cause tearing. I only actively tried to push when my body naturally felt the urge
to push. Often women are told to push when they get to 10 cm. This happened to me in
my first birth. I was 10 cm but didn’t feel the urge. I ended up exhausted with broken blood
vessels all over my face from trying to push before my body was ready. Some obstetricians
and midwives will encourage their patients to "labor-down" or relax when they get to 10
cm until they feel a strong urge to push.

6. Hypnobirthing
There is a common misconception that hypnobirthing is "putting someone in a trance" and
many women may consider it a little too "woo woo" for them. However, the technique
which is also known as the Mongan Method is simply a combination of visualization,
breathing, and deep relaxation. One of the most important aspects is an understanding of
the physiology of birth to reduce fear and anxiety.

Celebrities such as Kate Midleton and Angelina Jolie claim that they used hypnobirthing to
help them cope with natural births. 

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 Techniques During Labor

7. Birth Affirmations
Positive thinking goes a long way. Women have been birthing since the beginning of time
and you can do this too! For a list of birth affirmation and printable cards see my Pinterest
board on birth affirmations (click the image). 

"A contraction
is simply a wave
that comes and
goes. Every
wave brings me
closer to my
baby"

8. Counter Pressure and Hip Squeeze

Many women say they could not get through labor without the help of their partner or a
doula. These techniques are two ways your assistant can help you to relieve pain and cope
with contractions.

To provide counter pressure get your partner or doula to press on your sacrum or lower
back. Massage in this area may also feel good. Alternatively, your partner could use the
rebozo apply pressure here.

To do the hip squeeze, get your partner or doula to place their hands on your hips from
behind and squeeze in.  

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 Techniques During Labor

9. Using Movement
I found it extremely helpful to create a ritual of movements. Often moving around can
shorten your labor and shift your baby into a favorable position which will cause you less
pain.

Some possible actions include:

Hip circles
Swaying
Bouncing on the Birthing Ball
Walking
Slow Dancing with your partner or support person
Lunges

My favorite routine or ritual followed the list below: 

Bouncing, swaying and hip circles on the birthing ball

Walking the hospital hallway
Slow dancing with my husband
Sitting on the toilet
Lunges 

I repeated until I needed a rest, then resumed my "circuit" until it was time to push. 

10. Accupressure
Acupressure is like acupuncture but without the needles. This technique works by applying
steady pressure to certain spots of your body to relieve pain and nausea. Your coach can use
their hands, a tennis ball, a paint roller, or special tools made for triggering pressure points.

Watch a video on 5 acupressure points to

relieve pain in labor 

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 Techniques During Labor

11. Massage
While some women may not want to be massaged or even touched during labor, others
find massage relaxing and helpful in managing pain.

When you’re experiencing contractions, have your partner try massaging different parts of
your body to see what helps you. A back, neck, or foot massage might be just the thing to
help you through different moments of your labor.

A few techniques are nerve stokes down the mothers back, hip squeeze (see above), pressing
on the sacrum or massaging the upper back while "slow dancing together".

Always let the mother guide what feels good, be careful not to squish the belly and avoid
any deep pressure.  

Watch the massage video here

Thank you!
Congratulations on your pregnancy! I truly hope you found this eBook helpful
to prepare for your birth!

Click on the icons to connect with me on social media: 

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 About: 

Pregnancy and Postpartum TV is a Resource Health Centre

for pregnant and postpartum moms under P&P Health. You
can find free pre & postnatal yoga and fitness videos on our
YouTube Channel. You can also access nutrition and weight
management education as well as other free resources and
guides. 

Jessica, founder of Pregnancy and Postpartum TV, is a

registered dietitian, certified diabetes & bariatric educator, pre
& postnatal fitness & yoga instructor and, most importantly, a
mom of three. 
She has worked with pregnant and postpartum women since
2004. She helps moms have healthy babies, pregnancies, easier
and faster labors and specializes in postpartum weight
management.

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