Encouraging a straightforward birth: what to do in labour

There are steps you can take during labour to encourage a straightforward birth, which have a number of benefits for you and your baby. When you understand what helps and what hinders the process of normal labour, you can create the right environment around you. This article covers things you can do wherever you labour and the effect of induction of labour.

Encouraging a straightforward birth wherever you are

Wherever you are labouring it is a good idea to keep on the move. Changing position during labour is of great benefit, both in helping you deal with the contractions and in encouraging the baby through the birth canal in the best position. Try:

• swaying
• rocking or wriggling your hips
• walking
• going up and down stairs. 
• using a birth ball, which helps you remain upright and mobile.

Focus on managing the strong sensations of labour rather than trying to ‘remove the pain’. Some of the best ways of handling contractions are: 

• immersion in warm water
• changing position
• massage
• emotional support from someone who is calm and that you know and trust 
• encouraging the release of your hormones such as endorphins (see below). 

If you are planning a hospital birth, it’s a good idea to stay at home for as long as possible once you think your labour has started. Spend the early part of your labour in your own surroundings, keep moving and carry on with normal activities for as long as possible. You can try going for a walk, having a bath, cooking a meal, dozing in between contractions – anything that will help you go into labour feeling calm and self-assured.

Once in hospital, if possible, opt for the midwife to listen in to the baby’s heart at intervals rather than continuous electronic fetal monitoring. The midwife can use either a small ultrasound device called a ‘Doppler’ or the little trumpet-like tube called a Pinard’s stethoscope to listen to the baby’s heartbeat. Listening in at regular intervals using less intrusive methods is just as safe for you and your baby if you have a low-risk pregnancy. With continuous electronic fetal monitoring you are more likely to have an instrumental birth, a caesarean and have a greater need for pain relief.

Hormones

There are a number of hormones which have an effect on your body in labour. You can encourage the release of the following:

• Oxytocin is a hormone that your body will produce when you go into labour. It makes the uterus contract strongly and regularly. You will produce more if you don’t feel afraid, anxious, embarrassed or angry, and if you remain upright.
• Endorphins are nature’s own pain relievers that also give a sense of well-being. They are produced during labour and help you to cope with contractions. The best approach is to ‘let go’ and allow your body to work with you and for you. It is known that after a straightforward birth, endorphins are at their highest ever levels in mother and baby. 

Try to avoid stimulating the rational part of your brain. If the ‘rational’ part of your brain is stimulated it can override the ‘primitive’ part of your brain where oxytocin and endorphins are produced. The rational brain is stimulated by things like bright light, people asking you questions, or a feeling that you are being watched or judged. Your rational brain can be ‘turned down’ by labouring in a quiet, darkened room, feeling safe and having your privacy protected.

Induction of labour

Avoid having your labour induced if possible. All too often, the induction of labour sets off a ‘cascade of intervention’, and before you know it you may be drawn into having drips, electronic monitoring, epidurals and all the trappings of a medically complicated, high-tech birth. If you go two weeks past your dates, you can ask to have regular checks on the baby rather than have your labour induced. 

There are a number of ‘low-tech’ ways of encouraging the start of labour, including making love. The hormone oxytocin, which is released during nipple stimulation and orgasm, may nudge your uterus to start contracting if it is almost ready to begin anyway. The prostaglandins in semen also help to soften the cervix.

You could also ask your midwife to ‘sweep the membranes’ during an internal examination (although this can cause your waters to break). Other methods you may want to consider are acupuncture, hypnotherapy, reflexology and shiatsu. There is no clear evidence that these methods work, but they may be worth a try.

Further information

NCT's helpline offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 0300 330 0700. We also offer antenatal courses  which are a great way to find out more about birth, labour and life with a new baby.

The Royal College of Midwives Campaign for Normal Birth website includes stories, research and video clips of birth positions.

The MIDIRS Informed Choice resource offers information on a range of brth-related subjects based on unbiased/objective summaries of the best available research evidence.