Adrenalin, the fear hormone, and interventions drive the birthing experience for many women, according to Australian midwives, but with the right support, it doesn’t have to be this way.

Belinda Joyce, midwife and author of Survive and Enjoy Your Baby, said there are many strategies to reduce the pain of childbirth, but simply educating woman about labour can be powerful.

“Just knowing how labour works and understanding what’s normal can have a positive impact.”

A woman’s endorphins, which act as natural opioids, can be triggered with massage, meditation, guided imagery, deep breathing, music, dim lights, and more, throughout labour, explained Ms Joyce.

“Being active and changing positions for comfort, and to open the internal diameter of the pelvis, are also important.

“Women … who can get themselves into the 'zone' and birth drug-free feel such accomplishment. I truly believe it helps to set them up for those early weeks of mothering.”

Some women need pain relief but delaying the use of medication helps establish labour and allows the baby to get into an ideal birthing position, said Ms Joyce.

The power of endorphins

Fear and the associated adrenaline release can slow or even stop labour. The antidote? Endorphins.

Endorphin hormones are released by the brain during labour to relieve pain. They have a similar effect to opioid drugs and are the same hormones that give people the ‘runners high’ after exercising, explained Ms Joyce.

“During labour, endorphins will rise as the pain increases, and we can optimise this natural endorphin release by keeping the labouring mother comfortable, calm and feeling safe.

“Endorphins are at their highest levels in women who feel relaxed, safe and calm.

“So, those women will feel less pain and report feeling ‘high’ during labour and even in the early days after birth.”

“We see the adrenaline release most obviously when women arrive at the hospital, and their labour ‘stops’ and then restarts once they settle in and feel comfortable.” 

Non-medical interventions during labour

Massage

Massage stimulates the release of endorphins. The lower back is most often massaged, but any form of massage will be helpful.

A scalp massage can also be useful in relaxing the mother.

Massage oil enhances the sensations, as your hands will glide more freely. You can also use labour blends of essential oils.

Midwives are generally well skilled at massage and can help guide the support person.

Guided imagery

This technique involves all five senses. You can use a recorded script or download an app.

Research shows that guided imagery can reduce fear and anxiety. This is great to practice in pregnancy to use it effectively in labour. Some women even memorise their script so they can use it in labour without the recording.

Meditation

Meditation is grounding and relaxing and is best practised during pregnancy. A guided meditation differs from guided imagery in that whole-body senses are not involved, just the mental state. Many recordings are available online or can be downloaded via an app.

Deep breathing

Contrary to what we see in movies, we don’t generally teach Lamaze style breathing in Australia. However, breathing deeply and breathing away the discomfort, rather than quick panicked breaths that don’t help with relaxation, are helpful. 

Most women know how to breathe, and depending on their stage of labour, midwives can demonstrate different patterns to try.

Music

Music sets the mood and can be very relaxing. Classical music works best.

Dim lights

Keeping the room dark, quiet and calm helps the labouring mother feel safe and in control.
The music and dim lights in combination help people, including midwives and doctors, to slow down. So, when they walk into the delivery room, they can feel the mood has been set and they will be quiet and calm as well.

Other ideas

· Heat packs
· Position changes, swaying and rocking
· Emotional support from a known support person, eye contact, listening etc
· Baths, showers, spas. Baths really reduce the pain felt during labour.

Hypnobirthing to promote a calmer birth

Eugenie Pepper, a certified hypnobirthing practitioner, said hypnobirthing can harness hormonal physiology to promote a less painful birth.

“During labour, the body produces a chemical called oxytocin, which helps progress labour.

“Stress hormones affect the production of oxytocin.

“Hypnobirthing takes breathing exercises and adds relaxation, visualisation and mindfulness and meditation techniques to help women relax and concentrate on the body and the birth.

“Hypnobirthing can help manage stress hormones and reduce anxiety, which leads to a calmer birth.”

When it comes to pain management during labour, there are many ways to encourage a gentle, less painful birth. Midwives can be guided by the client’s needs and preferences, as each woman and birth are unique.