How to relieve pain during contractions. Pain relief for childbirth: with and without medications. Proper breathing and... singing

Childbirth is a natural and painful process. Moreover, every woman feels pain differently. Some people find it tolerable, others find it unbearable. It happens that one woman gives birth to a baby without any intervention from medical staff, while another simply needs this help. In this case we talk about diverse. So what types of pain relief are there and how safe are they?

Psychological pain relief for childbirth

No matter how strange it may seem, a woman’s positive psychological attitude is an excellent way to significantly reduce pain during the birth of a baby. If the expectant mother is psychologically ready for the process itself, if she does not “wind up” herself, does not “squeeze” and wait for pain, then everything will go much easier. It has already been proven that with the onset of contractions, many women begin to feel pain only because they are waiting for it. Instead of getting ready for serious work and helping the baby to be born as soon as possible, they begin to be intensely afraid of pain. Self-hypnosis, you see, is a serious thing. However, we will not deny that many women, due to some individual characteristics, actually experience severe pain.

What can be advised in these cases? Relax. Believe me, wise nature also took care of pain relief during childbirth, but women sometimes harm themselves. A pregnant woman must realize and firmly get it into her head: the more she tightens, the more painful it will be for her. And vice versa: pain will be minimal if the woman can relax. If you become familiar with breathing techniques that promote relaxation before giving birth, master them, and apply the acquired knowledge at the onset of labor, then you can pass this exam with an A plus. After all, in a calm state, a woman in labor produces a sufficient amount of endorphin hormones, which can reduce unpleasant physical sensations, help relax, reduce pain and have a beneficial effect on the course of labor. It is also important to listen to the advice of an obstetrician-gynecologist who “commands the parade”, then you can significantly alleviate the condition.

Many women find massage to cope with the pain of childbirth. It is especially good to stimulate points located in the buttocks and. Moreover, a warm bath can help you relax. This is relevant if the woman is still at home or if the conditions in the maternity hospital allow it. This procedure helps to relax during contractions, relieve tension in the muscles,.

Pain relief during labor with acupuncture

Reflexology is one of the safest methods of pain relief during childbirth. This method is suitable for all women in labor without exception, since it is non-drug and does not affect the whole body, but its specific points. Using this method, you can reduce pain, interrupt the transmission of nerve impulses to the brain, and promote the release of pain-relieving hormones.

To tell the truth, with this method there is not a complete, but a relative effect on pain centers, so special means are often used along with acupuncture.

Drug pain relief for childbirth

Often, medications are used to relieve pain during childbirth. In particular, we are talking about drugs from group A, which includes analgesics. True, they are used in cases of extreme necessity: only when the expectant mother cannot do without their use. In general, pain relief with drugs is used if a woman experiences nausea, vomiting, or if she is too focused on pain and cannot concentrate on the birth process. Analgesics are administered intravenously, intramuscularly, using compresses (applied to certain places), as inhalers.

Sometimes the doctor decides to use Promedol. This is a narcotic substance that is administered intravenously or intramuscularly. Of course, it does not completely relieve pain, but it significantly reduces it. It has already been proven that a single dose of Promedol does not negatively affect the child’s health. However, its use a second time is unacceptable.

In addition to medications included in the group of antispasmodics and narcotics, others are used, for example, anesthetics, antipsychotics, and tranquilizers.

Epidural anesthesia

During this procedure, a painkiller is injected into the space between the lumbar vertebrae in front of the dura mater surrounding the spinal cord. In this case, known anesthetics are used (for example, Lidocaine or Bupivacaine). As a result of this procedure, the roots of large nerves are blocked, and the woman does not feel pain at all. This method of pain relief allows you to “top up” the anesthetic substance from time to time, if necessary. This is done through a thin catheter. But at the same time, the woman should know that after this manipulation she will not be able to move independently for some time.

Unfortunately, this method of pain relief is not suitable for everyone. If a woman has poor blood clotting or an elevated temperature, or if she has neurological diseases, then it will not suit her. It is also not suitable for women who are obese or allergic to local anesthetics.

One of the side effects that often occur as a result of epidural anesthesia is headache. Sometimes it can last up to three weeks. This happens if the needle is inserted a little deeper than it should be. Today doctors know how to deal with such consequences and effectively eliminate this pain.

We looked at the most popular methods of easing or eliminating pain that occurs during the most important event in the life of a pregnant woman - the birth of her child. But you should know that the decision on pain relief during childbirth is made by doctors depending on how severe the pain is, and is applied only on the condition that all manipulations will be safe for the baby.

Especially for- Ksenia Dakhno

Partner childbirth is always a big responsibility: whether the expectant mother is accompanied by a friend, husband or one of her relatives, he should become a support and, if possible, alleviate the suffering of the woman in labor. Teachers in prenatal training courses often mention ways to alleviate a woman’s suffering due to contractions, but we decided to systematize this information.

1. Facial massage helps relieve stress and relax;

2. Remind the expectant mother to go to the toilet every hour: a full bladder is not only very unpleasant, but also increases the feeling of contractions;

3. Place a cold compress on the mother’s neck and face or lightly moisten it with cool water;

4. If doctors do not prohibit it, you can offer the woman water and light snacks - they will help replenish the energy that the expectant mother loses during labor;

5. Help the woman in labor change her position to speed up the process of cervical dilatation. Some positions will be painful, others will provide a short respite from the pain, your task is to find the best option for it;

6. During contractions, the expectant mother suffers from back pain: massage her lower back, lightly press on the sacrum. The position “on all fours” also helps to cope with pain;

7. Be close: Even if a woman does not want to be massaged during contractions, feeling the presence and support of a loved one is very important. Encourage her with words, hold her hand;

Light shower. Many doctors agree that water perfectly relaxes muscles and relieves pain, so if there are no contraindications, you can help a woman take a warm shower;

9. Try to distract the woman from the pain: if her condition allows, talk to her, listen to her favorite music, read something interesting. Be a mediator between the woman in labor and the medical staff;

10. Remind her that soon the painful sensations will pass, and the expectant mother will be able to hold her baby in her arms - this always works.

Video: Childbirth without pain

The appearance of contractions

Many women who will become mothers for the first time are worried that they will miss the onset contractions. In the last weeks of pregnancy, false contractions are observed, which are mistaken for harbingers of labor, but real contractions cannot be confused with anything. Harbingers of contractions can be: the passage of amniotic fluid, the appearance of a mucus plug that clogs the cervix, dull pain in the hips or back. The first contractions are similar to the pain and cramps during menstruation, but soon these sensations intensify. When contractions become regular, it's time to rush to the hospital. When the situation stabilizes, the duration of contractions ranges from 40 seconds.

This is the beginning of the first stage of labor, when the cervix begins to dilate. If this is your first birth, your uterine muscles may contract for 10-12 hours, so don't be alarmed or worried. You will have a formal interview and first examination at the maternity hospital; you may be asked to take a test for the presence of protein and sugar. If your water hasn't broken yet, you can take a shower.

Video: How to survive a fight

Comfortable positions during contractions

You can relieve pain or at least get a little distraction by changing body positions - your birth partner can help you with this.

• Vertical position. Effective in the initial stages of contractions: you can lean against a wall or bed. You can sit on a chair (facing the back), leaning on a pillow. To make sitting softer, another pillow can be placed on the surface of the chair. Lower your head into your hands, breathe calmly and measuredly, spread your knees to the sides;
• Kneeling or supported position. During contractions, you can put your hands on your husband's shoulders and lean on him while standing. Ask for a relaxing massage. You can also kneel down, spread your legs, and place your hands on the pillow. Try to keep your back straight;
• "On knees". It is most convenient to take this position on a mattress: make forward movements with your pelvis, try to relax between contractions, resting your head on your hands. If you put your weight on your arms, you will reduce the back pain caused by the baby's head during cephalic presentation (it rests directly on the mother's spine). In the intervals between spasms, you can walk, your partner can massage - pressing in a circular motion on the base of the spine is especially effective;
• Movement helps to cope with the pain from contractions - you should walk at intervals, keeping your back straight, then the baby's head will rest against the cervix and the dilatation process will go faster. Try to relax during breaks, focus on breathing. Visit the restroom more often - a full bladder is not the best feeling, and it can interfere with the progress of the fetus.

Second stage of labor or pushing

For a woman, the most difficult time is the end of the first phase, contractions become long and painful, and also very frequent. At this moment, the woman needs help and support, since you may encounter tears, depression, the expectant mother may begin to feel chills or begin to fall asleep. Breathe with her, support her, wipe away the sweat. If you see that the woman in labor is cold, take care of a warm robe and socks. If you start pushing, call your midwife.

The second period is the expulsion of the fetus, so in addition to contractions, the woman in labor needs to make her own efforts, listen to the guidance of the midwife. The duration of this period is up to several hours.

Video: Breathing during contractions and pushing

Positions for the second phase of labor:

• "On knees". Gravity opens your pelvis faster, but you may feel tired quickly. It is best if your husband sits on the edge of the chair and spreads his knees, and you can sit comfortably between them and rest your hands on his thighs;
• On the knees. The position is less tiring and reduces pain. It is best to have your spouse support you to make your body more stable. If you feel tired, lean on your hands, but keep your back straight;
• Sitting on the bed. If it’s not very comfortable, surround yourself with pillows. As you begin to push, you can lower your head down and clasp your legs with your hands; do not forget to rest in the interval.

Childbirth

During this period, all the expectant mother needs is to listen to the doctors’ instructions. As soon as the baby's head appears, you will no longer need to push, relax, catch your breath. After a few contractions, the baby’s body will appear: after the little miracle is placed on the woman’s stomach, the torment is quickly forgotten. Then the baby is taken for examination: the neonatologist makes a control weighing, takes measurements, and cuts the umbilical cord.

After giving birth, women often receive an injection that increases the contractions of the uterus to help the placenta come out faster, otherwise, if you wait until it comes out naturally, you can lose a lot of blood. This issue is discussed in advance with the doctor, as is pain relief.

Childbirth is a tiring and difficult process, but all unpleasant sensations are forgotten when you hold your baby for the first time.

A good atmosphere and positive emotions have a positive effect on the condition of the pregnant woman and on childbirth.

Experts do not advise lying down during contractions; leisurely walking helps not only relieve pain, but also speed up labor. The vertical position of a woman before the most crucial moment has a favorable effect on the child himself, for whom birth is a rather difficult ordeal. When bending, rocking, walking, the child takes a comfortable position and stimulates.

To relieve pain, doctors advise jumping on a fitball or hanging on a wall bars.

Some women find a cool shower to relieve pain. It allows you to take your mind off the upcoming birth. But prolonged contact with water, for example, immersion in a pool or bath, leads to weakening of contractions, as a result of which the cervix stops opening and labor is delayed.

For the correct course of the prenatal period, you need to concentrate on breathing. Deep inhalations and exhalations help maintain the strength that will be required during pushing, and also allow you to enrich the child’s body with oxygen. The hysterical state and screams exhaust the woman, as a result of which she is unable to quickly give birth to a baby.

Massage during contractions

If common methods of relieving contractions do not help, specialists solve the problem using medications. Anesthesia is necessary to ensure a painless birth. But such interference in the natural process negatively affects the child and the expectant mother.

Unfortunately, none of the currently known methods of drug pain relief for childbirth is perfect. All of them, in one way or another, affect the fetus and the duration of labor and their use is not always possible. However, there are methods of pain relief that have no contraindications for mother and baby.

Methods of non-drug pain relief are absolutely harmless, very simple and effective, and can be used at any stage of childbirth. Self-numbing methods include birth massage, special breathing techniques, relaxing poses and movement techniques, the use of a fitball (gymnastic ball) and aquatherapy during childbirth. In order to master these techniques, only one thing is required - desire!

Active position

The first and most important factor in reducing pain from contractions is active behavior during childbirth. This term refers to the free behavior of a woman in labor, constantly changing positions and moving around the ward, searching for the most comfortable body position. The movements themselves significantly reduce the overall sensation of pain. And not only because any action is distracting.

Firstly, the level of pain depends on blood circulation. During contractions, the muscle fibers of the uterus contract, wasting energy. The main “energy fuel” for the functioning of all cells in our body is oxygen; myometrial cells (uterine muscles) are no exception. As is known, oxygen is contained in arterial blood; therefore, cell respiration depends on the level and speed of arterial blood flow. When the body is stationary, the overall blood flow decreases, the supply of oxygen to the uterine muscle slows down and pain increases. If a woman in labor walks around the room or moves in a comfortable position, as a result of the movement, the level of blood flow increases and the uterine cells are better supplied with oxygen. Therefore, with active behavior during childbirth, the pain from contractions is much weaker than with a stationary position. Even if, for medical reasons, a woman in labor cannot get up, she can behave actively during a contraction - sway, spring on the bed, spread her knees and bring them together. These minor movements significantly reduce the pain from contractions.

Secondly, the feeling of pain depends on the general tension. More precisely, there is a direct proportional relationship between these concepts - pain and tension. That is, the more we strain, the more painful it is for us, and vice versa. During a contraction, when the uterus tenses and painful sensations appear, some women instinctively “freeze,” stopping moving completely. This behavior of a woman in labor is caused by fear of pain. The woman in labor seems to be hiding from the pain and from herself during the contraction. During childbirth, this behavior does not bring relief: “freezing”, the expectant mother unconsciously tenses, which leads to a sharp increase in pain. The main assistant in the fight against excessive tension during contractions is physical activity. After all, when we are in motion, our muscles alternately tense and relax; therefore, hypertonicity (excessive muscle tension) is excluded. And if movement helps you relax, it means it reduces your overall pain level.

Movements during childbirth can be very diverse. If childbirth proceeds without complications, the choice of the type of movements during contractions remains with the woman in labor. In this case, there is one, but very important limitation. At no stage of labor should you make sudden, jerky movements. Here are examples of the most common types of active behavior during a contraction:

• walking along the ward or corridor;
• bending to the sides and forward;
• stretching and turning the whole body;
• rocking and rotating movements of the pelvis;
• shifting from foot to foot;
• transferring body weight from toes to heels and back;
• half squats;
• flexion and arching of the spine;
• in a lying position: swinging the pelvis, turning from side to side, springing movements of the hips, abducting and spreading the legs.

During contractions, you should behave freely, choosing the most comfortable body position. There are many well-known positions that reduce discomfort during contractions and help you relax. The main principle by which a woman in labor chooses a position during labor is the level of comfort, stability and relaxation. Most birthing poses use four points of support and a predominantly vertical body position; There are also “lying” poses. However, in order for the poses to help, you should change your body position as often as possible and remember to move a little within any pose. To reduce pain during labor, try taking the following positions during contractions:

• Stand by the bed (sink, window sill, bedside table), with your feet slightly apart. Rest your hands on the bed, relax your back and stomach, as if transferring the weight of your body to your arms and legs. Rock from side to side, back and forth, shift from foot to foot, rock your pelvis.
• Stand in the position of a sumo wrestler: legs wide apart and knees bent, body slightly tilted forward, hands resting on the middle of the thighs. Shift from foot to foot or sway from side to side.
• Squat down, spreading your legs wide and resting on your full foot. There should be a fixed support behind your back (headboard, bedside table, wall). Place your feet shoulder-width apart and place your hands on your hips. Swing left and right, back and forth. Get on all fours on the bed with your legs slightly apart. Alternately arch and arch your back in your spine.
• Stand on the bed in a knee-elbow position, legs slightly apart, and sway from side to side. You can put a pillow under your elbows. Kneel on the bed, lean your hands on the headboard, shift from one knee to the other. Squat down facing the bed. Hands and head can be placed on the bed.
• Sit on the vessel, placing it on a chair or a special bench (you cannot sit on the chair itself - this creates unnecessary pressure on the perineum and can harm the baby). Bend your legs at the knees and spread them wide apart (there is always a bedpan and a bench in the room).
• Stand at the headboard or bedside table. Place your arms bent at the elbows on it. Squat down, as if hanging from your arms,
• If you are tired and want to lie down, lie on your side with your knees and hips bent.

There are so-called “partner positions” for which the woman in labor will need an assistant. Here are some of the simplest and most convenient positions for pain relief from contractions:

• Stand facing your partner and clasp your hands around his neck, press your upper body against your partner, turn your head to the side. Bend your legs at the knees, spread them as wide as possible and sway from side to side without lifting your feet from the floor.
• Stand like a train in front of your partner. Ask him to put his arms bent at the elbows forward (boxer pose). Spread your legs widely bent at the knees, lean back on your partner and hang on his hands, like on gymnastic rings, without lifting your legs from the floor and swaying (in this position, the woman in labor is fixed with her armpits on her partner’s forearms).
• Have your partner sit on the edge of a chair or bed with their legs spread wide apart. Squat down with your back to your partner, legs spread wide and resting on your full feet. Lean back against your partner and sway from side to side.
• Lie on your side and ask your partner to sit next to the bed. Bend the leg on top at the knee and rest it on your partner’s shoulder. Try bending and straightening this leg (ask your partner to provide slight resistance to this action).

Recently, many maternity hospitals have allowed women in labor to use a fitball to relieve pain during labor. A fitball is a rubber exercise ball commonly used for aerobics and Pilates. With the help of a fitball, you can take a wide variety of poses, easily changing one to another, guaranteed relaxation and continuous movement, while saving energy. For use during contractions, the fitball is not fully inflated so that it remains soft and springy. You can take all the poses listed above on the ball; In addition, there are special poses with a fitball:

• swing, rotate the pelvis, spring, roll from side to side, sitting on the ball;
• stand on all fours, leaning your chest, arms and chin on the ball and swinging on it;
• lie on your side, placing the ball under your side and arm and springing on it;
• lean on the ball with your back in a half-lying, half-sitting position with your legs spread wide;
• swing, pushing off your back from the ball; sit or kneel, leaning on the ball with outstretched arms and springing;
• lie on your side, placing the ball between your calves and springing them.

As you can see, active behavior during childbirth does not require special physical training. In order to use “active”, you only need the knowledge and desire of the woman in labor to be a participant in the birth, and not a passive patient.

Pain relieving breath

The most effective way to relieve labor pain is with special breathing techniques. The analgesic effect of breathing is based on hyperoxygenation - oversaturation of the blood with oxygen. The respiratory center of the brain, registering excess oxygen in the blood of a woman in labor, sends an impulse to the pituitary gland, the main hormonal gland of the body, responsible for the release of endorphins. These substances, called “pleasure hormones,” regulate a person’s pain sensitivity threshold. The more endorphins are released, the higher the pain threshold; That’s why proper breathing during contractions and pushing relieves pain no worse than analgesics.

Breathing techniques can be used at any stage of labor without restrictions. They are applicable in any position of the body, helping equally effectively both during the normal course of labor and during the development of various deviations of labor.

At the beginning of labor, when contractions are practically painless, it is recommended to use “belly breathing.” At the beginning of the contraction, the woman in labor takes a relaxed, slow breath in through her nose, and then exhales the air through her mouth for a long time (as if blowing on water). This type of breathing helps to relax, relieves nervous excitement and ensures high blood oxygen saturation, stimulating and pain-relieving contractions.

By the middle of the first stage of labor, when contractions increase and become painful, “candle breathing” helps a lot. This is frequent shallow breathing, in which a short inhalation is made through the nose and exhalation through the mouth (as if we are blowing out a candle). As the contractions intensify, breathing becomes more intense, but still remains very rapid. You should only breathe in this way during a contraction; after the pain ends, the woman in labor takes a deep breath and exhales, evening out her breathing, and rests until the next contraction.

At the moment of full dilatation of the cervix, when contractions become especially long and frequent, it is most effective to breathe “locomotive.” This breathing is an alternation of the previous techniques. At the beginning of the contraction, the expectant mother uses belly breathing, saving strength. As the pain intensifies, breathing quickens and at the peak of the contraction becomes as intense as possible. Then, as the contraction “subsides,” the woman in labor calms and evens out her breathing.

In the second stage of labor, when the fetus begins to move along the birth canal, each contraction is accompanied by a false urge to defecate (the desire to empty the intestines). This sensation is caused by the pressure of the fetal head on the rectum, located next to the vagina. At this stage, the woman in labor needs to avoid premature births and relax as much as possible, helping the baby descend through the birth canal. To achieve this goal, you need to breathe “dog” during a contraction. This is frequent shallow breathing through the mouth, really reminiscent of dog breathing. When breathing "dog" the diaphragm - the main abdominal muscle - is in continuous movement, which makes pushing impossible. Breathing has the maximum pain-relieving and relaxing effect.

Magic touches

Another effective way of non-drug pain relief during labor is massage. By stimulating certain points and areas on the body during contractions, the expectant mother can independently regulate the pain impulse, reducing the level of pain and relaxing.

The most “popular” massage area for women in labor is the lower back, or more precisely, the sacral region. The sacrum is the fixed connection of the vertebrae at the bottom of the spine. In this area of ​​the spinal cord is located the sacral nerve plexus: a nerve node that innervates the uterus and other pelvic organs. By stimulating the sacral area (lower back in the middle) during contractions, the woman in labor blocks the transmission of nerve impulses, thus reducing pain. Massage can be performed with one or two hands, massaging the area with the pads and knuckles of the fingers, the base of the fist, the base of the palm, the inside of the palm or a hand massager. Movements during a massage can be stroking, pressing, patting, pinching and even lightly tapping the area to be treated. To prevent irritation from occurring on the skin of the sacral area, you can periodically lubricate it with cream or oil. If you haven’t stocked up on massage oil, don’t worry: ask your midwife for liquid Vaseline oil, which is always available in the maternity hospital.

During contractions, you can stimulate the protrusions of the pelvic bones on the sides of the abdomen. These bones should be treated in the same way as the sacral area. You can try different methods: squeezing, pressing and releasing, stroking, pinching. Choose the type of massage stimulation that most effectively reduces pain for you. This method is a kind of distracting maneuver that transfers the source of pain.

Periodically during the contraction, gently stroke the lower abdomen and the area of ​​the fundus of the uterus (the uppermost part) in a semicircle. The same stroking movements can be made by moving your hands from the lateral protrusions of the pelvic bones along the inguinal fold towards the perineum and back. These movements calm the woman in labor, help relax and improve blood circulation in the uterine area,

The next massage option is most convenient to use while lying on your side or sitting on a ball. Press the insides of your palms against your inner thighs. During a contraction, move your hands with pressure, without lifting your palms, from the groin to the knees and back. The recurrent nerve, which innervates the pelvic organs, passes through this area. Massaging the inner thigh helps reduce pain and maximize relaxation.

In partner childbirth, the assistant can constantly perform a light relaxing massage of the whole body, avoiding only the chest, perineum and abdomen of the woman in labor. The touch of a loved one's hands calms the expectant mother and helps her relax better.

Water as a helper

The main advantage of aquatherapy is the relaxing and pain-relieving properties of water. In warm water, contractions feel softer, blood circulation improves, the woman in labor has the opportunity to relax and take a comfortable body position, and gets less tired. Water eliminates the occurrence of such side factors of discomfort during childbirth as dry skin, increased sweating, chills or a feeling of heat,

Recently, many maternity hospitals have begun to use non-drug pain relief from contractions using water. For childbirth with aquatherapy, special showers and a hydromassage tank are used, located in the maternity ward. The rooms for water procedures in the maternity block are disinfected in a special way. Of course, staying in water during childbirth without risk to the health of the mother and fetus is possible only under the supervision of a qualified medical specialist. When using a special bathtub, the expectant mother should fit entirely in it, being able to turn and change her body position. The water temperature should not exceed normal body temperature (36.0°C-37.0°C) and should not fall below 30.0°C. A birth partner or a maternity hospital specialist should always be near the woman in labor (in the shower or near the massage bath).

Unfortunately, this wonderful method of pain relief cannot always be used. Staying in a water tank during childbirth can be considered absolutely safe only as long as the baby and the uterine cavity are protected by the wall. After the rupture of the membranes, the last barrier between the sterile uterus and the non-sterile vagina disappears. After all, water through the vagina can penetrate into the uterine cavity and cause infection. There are fewer restrictions on the use of a shower during childbirth: this method will have to be abandoned only if the doctor recommends bed rest to the mother in labor.

If childbirth proceeds without complications, you can visit the shower quite often throughout the first stage of labor. For this, two conditions are necessary: ​​the presence in the maternity unit of a shower equipped for women in labor, and the ability to observe the expectant mother during water procedures. Shower stalls for women in labor are made open (without doors - to allow medical observation), trays with a “non-slip” coating are used, and comfortable handrails are installed on the walls. During the entire stay in the shower, a midwife or doctor must remain with the expectant mother. Of course, this is only possible in the case of individual management of childbirth; however, during a partner birth, the spouse of the woman in labor can become an “observer” and assistant.

The optimal analgesic and relaxing effect can be achieved by using a stream of water like an aqua massager. To do this, you need to take the shower head in your hand and, changing the water pressure from weak to medium and even strong, water your stomach in a circular motion throughout the contraction. If you have an assistant, you can ask him to massage the lower back and sacral area with a stream of water. Between contractions, it is worth reducing the water pressure and directing the stream to the face, shoulders, chest and legs, achieving complete relaxation. The ideal water temperature for pain relief during childbirth is 36-40°C; lower temperatures have a stimulating effect on the nervous system, and too hot water can cause bleeding.

The birth of a child is the most wonderful event in a woman’s life. Of course, the process preceding this event requires a lot of strength and patience from the expectant mother. But you shouldn’t expect pain and unbearable pain from childbirth; childbirth is rewarding work. And if a woman has prepared for childbirth, knows how to help herself and goes into labor with a smile, this exciting event becomes a real holiday. And pain has no place at the holiday!

Elizaveta Novoselova, obstetrician-gynecologist, Moscow

Drugs for pain relief during labor really bring relief to the mother in labor. However, it should be remembered that they are prescribed strictly according to indications, since they have a complex effect on the entire body, not only the mother, but also the child, have side effects, and in some cases can cause complications. That's why expectant mothers shouldn't hope for a miracle shot or a magic pill. Fortunately, today there are many opportunities to obtain information on how to make the birth of a baby as comfortable as possible for both him and the mother: educational manuals and courses for pregnant women talk about effective self-help techniques during childbirth, one of the most effective methods among which is is a massage during childbirth. Thanks to it, you can significantly reduce pain. And all this – without the use of medications or doctor intervention!

Why is there pain during childbirth?

• pain is provoked by intense contractions of the muscles of the uterus,
• stretching of the birth canal and perineum,
• muscle spasms,
• compression of large vessels in the pelvic area,
• individual characteristics, such as the structure of the pelvic organs or a woman’s low pain threshold, when it is very painful even with minor impact.
• psychological reasons: fear of childbirth, anticipation of something unpleasant and unknown, general tension.

It is important for every woman preparing to become a mother to remember: there is no constant pain during childbirth. Both in contractions and in attempts, unpleasant sensations increase gradually, and just as gradually subside, giving way to periods of rest. And a correctly performed massage during childbirth at the right time will completely reduce pain to a minimum.

How does massage work during childbirth?

Massage during childbirth has a beneficial effect on the entire nervous system, and through it on the entire woman’s body: it allows you to relax, relieve nervous tension and muscle fatigue, distract from painful sensations and even relieve pain from contractions. The mechanism for such a beneficial effect of massage during childbirth is quite complex.

Its first stage is the stimulation of skin receptors in the massaged area. The impulse is then transmitted throughout the central nervous system, in which a favorable response is formed. Massage during childbirth activates the production of natural stimulants - hormones and enzymes, which play the role of natural adaptogens that help the body quickly adapt to a stressful situation.

In addition, massage helps to increase blood circulation and better oxygen saturation of the tissues and organs of both the woman herself (which also has an analgesic effect during childbirth) and the fetus, which prevents the development of oxygen starvation.

7 types of massage during childbirth

Both the woman in labor and her assistant (husband, mother or midwife) who is present during childbirth can give pain-relieving massage during childbirth.

Follow simple rules:

• You can carry out a massage during childbirth with dry hands (the main thing is that they are warm, since the feeling of cold can provoke a reflex muscle spasm) or with the help of special creams and gels that improve gliding over the skin and may contain components that relieve pain from contractions. Don't be upset if you forgot your massage cream while getting ready for the maternity hospital. You can always ask your midwife for some Vaseline oil.
• It is possible to use aromatic essential oils - they promote deeper relaxation. But at the same time, you should find out in advance whether the expectant mother has allergic reactions to them and whether they cause an increase in blood pressure.

Which birthing massage is right for you?

1. Acupressure during childbirth

Until the contractions are in full force, you can limit yourself to acupressure during childbirth. It is useful for the expectant mother to remember where two important points are located that will need to be influenced during childbirth. The first is located on the back of the hand in the depression between the thumb and forefinger (it is clearly visible if you spread your fingers wide). The second is located on the inside of the lower leg, four fingers above the ankle (this is the area of ​​the ankle where the bones protrude from the outside and inside). Press on these points continuously, with your finger positioned perpendicular to the surface of the body. Movements should be short, pulsating, and last no longer than a minute. Then you should take a break for a couple of minutes and continue the effect at the given rhythm. It is clear that such a massage during childbirth can be done by both the woman in labor and her assistant. Correct impact on active points helps to intensify and relieve pain, the cervix opens faster, and all this happens without increasing pain.

2. Stroking the abdomen during contractions

At the beginning of each contraction, you can gently stroke the lower abdomen. To do this, place your palms on its lower part and lightly massage your stomach with your fingertips from the center to the sides and back. When the contraction intensifies, the intensity of pressure can be increased, but only slightly. If an assistant gives a birthing massage to a woman in labor, it will be more convenient for him to sit behind her.

3. Massage of the sacrum during childbirth

Women who are familiar with menstrual pain often note that the sensations in the first stage of labor are similar to those that occur during “critical days”: the lower abdomen ache and the lower back ache. In this case, massage in the sacral area (this is the area that is located just below the lower back) helps a lot. What is remarkable about this zone? The secret of the labor pain-relieving effect when exposed to it is simple. The fact is that the sacral nerve plexus is located here, connected to the pelvic organs and responsible for their innervation. When this area is stimulated, the transmission of nerve impulses to the uterus and other organs is blocked, thus reducing pain.

Massage of the sacral region can be done either with one hand or with both hands at once, with the pads or knuckles of the fingers, the base or edge of the palm, a fist or a hand massager. The main thing is that the impact is sufficiently intense: pressure, active rubbing, patting and tapping are acceptable. If desired, you can cover not only the sacrum, but also a wider area around it.

A powerful, pain-relieving effect can be achieved by pressing on the dimples above the buttocks - the exit points of the sacral nerve - the impact on which brings noticeable relief.

4. Massage the iliac bones during contractions

This method is based on the principle of transferring the source of pain. Just as we rub our temples to relieve a headache, during contractions you can rub and massage the ilia of the pelvis, which are located below the waist on both sides of the abdomen. Both of them need to be stimulated at the same time, using active rubbing. This type of massage during childbirth can be combined with the stroking of the lower abdomen already described above (in this case, hand movements should go from the ilium to the center and back), as well as with hand movements along the inguinal fold from the ilium to the perineum - this improves blood circulation in the uterus .

5. Massage of the buttocks during childbirth

Important reflex zones are also located in the buttocks, where the sciatic nerve exits. To detect them, you need to mark an imaginary center on each buttock (as a rule, there is a small hole there, which may cause slight pain when pressed). Rolling the center of the buttocks with your fists or pressing on these points with your thumbs helps relax the pelvic floor muscles - this is a great way to distract a woman from labor pains.

6. Massage the thighs during contractions

Rubbing your inner thighs with your palm is an excellent technique to relieve pain from contractions. To do this, you need to lie on your side and, pressing your palm firmly against the skin of the inner thigh, stroke it from the groin to the knee and back. As the intensity of the contraction increases, the pressure on the thigh should also increase.

7. Massage between contractions

During the period between contractions, it is not recommended to touch the skin of the abdomen, as this may result in too intense an emergency contraction. However, massage can be very useful here too! An assistant can stretch the woman’s cervical-collar area, upper back, and give a general light relaxing massage of the whole body so that the woman in labor can calm down and regain strength before the next contraction. It is important to remember that lying on your back is undesirable, since the inferior vena cava may be compressed and blood circulation in the pelvic organs may be impaired.

Pain relief from contractions with massage: alone or with an assistant?

The choice of postures for massage during childbirth depends on the individual characteristics of each expectant mother: the body itself tells you how it is more convenient for it to position itself during the massage: on its side, on all fours, lying or sitting on a fitball, in a knee-elbow position - it all depends only on you.

If you have an assistant, then the choice of possible poses will be wider. For example, poses in which a woman in labor, kneeling or on straightened legs, seems to hang on her assistant, holding his neck with her hands - at the same time, the lower back relaxes well, and the partner can additionally massage her sacrum. The convenience of giving birth with an assistant is that in this case it is possible to combine different types of massage during childbirth, for example, the woman strokes the stomach and rubs the ilia, while the partner acts on the sacrum.

However, the absence of an assistant does not mean that pain-relieving massage should be abandoned. After all, only the woman herself can know what kind of impact and on what zone she needs at the moment. So listen to your body and, focusing on your sensations, you will certainly be able to choose the types of massage that are most effective for you, and help yourself endure labor pains more easily.

When should you not get a massage?

Despite the fact that pain-relieving massage during childbirth is indicated for almost all women, it is worth separately mentioning possible obstacles to its implementation. Directly during childbirth, a woman may find any touch extremely unpleasant. In this case, you will have to refuse the massage.

Deviations from the normal course of labor (for example, weak labor, stopping the advancement of the fetus along the birth canal, acute fetal hypoxia, bleeding, etc.) become a serious contraindication. You will have to give up massage during childbirth during the installation of CTG sensors, as well as in the second stage of labor, when pushing begins.