Be prepared. "Knowing what to expect ahead of time is vital," says John Sussman, M.D., chief of obstetrics and gynecology at New Milford Hospital, in Connecticut. "A couple should understand what's going to happen, be familiar with the environment, and be aware of all their options." The first step is to take a childbirth class, but you can do more. Read books about labor, talk to new moms, and learn about the pain medications you'll be offered. If you address your fears now, you won't be thrown for a loop later on if something doesn't go as planned.
Set the mood. A soothing environment can help you stay tension-free. Many hospitals now offer alternative delivery rooms that look more like your mom's house than a maternity ward. "Our birthing-center rooms have queen-size beds, regular curtains, even area rugs," says June Egee, R.N., coordinator of the birthing center at Women and Infants Hospital, in Providence. Even if you end up with a standard hospital room, make sure to give it a personal touch. Take along a picture from home, or pack a portable stereo. (Many women find that listening to soft music with a steady beat helps them count through their contractions.) And if the hospital approves, light a few scented candles.
Enlist a friend. "Having someone by your side who you're totally comfortable with can do wonders," Dr. Sussman says. Most often, this means a spouse or significant other. But a number of moms-to-be choose additional support: a doula or a birthing coach, a sister, or a friend. "Many women find it helpful to have a woman in the room who's already had children," says Stephen Chasen, M.D., director of high-risk obstetrics at New York Presbyterian Weill Cornell Medical Center, in New York City. "She can reassure you that what you're feeling is normal and offer insight into what to expect next."
Get a move on. "Staying upright and active not only helps keep your mind off the discomfort but can aid your baby's descent through the birth canal," Dr. Chasen says. With your doctor's approval, you could try yoga, short walks, slow-dancing with your partner, gentle stretching, or even some squats.
Try a little meditation. One of the latest techniques for staying calm during childbirth is hypnobirthing, in which mothers-to-be learn how to put themselves into a deeply relaxed state. A study by the University of Florida, in Gainsville, found that women trained in self-hypnosis were better able to manage their anxiety and discomfort and had fewer complications and shorter hospital stays than other women. Not sure you want to go quite that far? Try visualization. "I encourage my patients to picture a field of flowers or think about holding their baby in their arms," says Linda Given Welch, director of nurse-midwifery at Louis A. Weiss Memorial Hospital, in Chicago. Feel free to improvise. That's what Kathy Chia, of New York City, did. "My husband helped me visualize the contractions by describing the graph peaks on the monitor. I closed my eyes and imagined myself cycling up a huge mountain, reaching the top, and then coming back down."
Test the waters. "Warm water loosens tight, tired muscles and eases discomfort," Cook says. Most birthing centers-and more and more hospitals-offer Jacuzzis and specially designed laboring tubs. Jets of water bring added relief; simply aim them at the small of your back or wherever your contractions are strongest. Though a short shower or bath is generally fine at any stage of labor, it's best to check with your doctor or midwife.
Go with the flow. No single method works for everyone; you need to find out what makes you feel better (just make sure your caregiver approves). "One of my patients found that lying on the cold bathroom floor helped her stay calm," Welch says. So if the patterned breathing you've practiced doesn't seem to be working-but squeezing your pillow does-go for it. Ultimately, each woman's labor is bound to be as unique as the baby it produces.