"Pregnant women who stay in shape tend to have shorter labors," says Tekoa King, a certified nurse-midwife and an associate professor of obstetrics and gynecology at the University of California at San Francisco. "Fitness improves endurance, and if you're better able to tolerate labor, you're less likely to end up needing medical intervention." Walk, swim, or take a prenatal-exercise class during pregnancy (after getting an okay from your doctor or midwife).
Familiarizing yourself with the stages of childbirth and practicing comfort measures before the big event will help you feel less anxious, which can make for an easier labor, says Robert Stern, M.D., cochair of obstetrics and gynecology at Vassar Brothers Hospital, in Poughkeepsie, New York. Shop around for the right childbirth classes, suggests Teri Shilling, president of Lamaze International. Look for a small class (with fewer than ten couples), a certified instructor, and goals that mesh with yours.
Your partner will likely be by your side throughout labor, but you may want to line up additional help. According to an analysis of clinical trials published in the American Journal of Obstetrics and Gynecology, women who had continuous care provided by a doula (a person trained to support a laboring mother and her partner) were 50 percent less likely to need a C-section and 30 percent less likely to need pain medication, and they experienced a labor 25 percent shorter than those without this care. Discuss labor support with your doctor or care provider: Both you and she should be comfortable with the doula you hire.
For first-time mothers, active labor lasts an average of 12 to 14 hours. So when contractions begin -- you'll feel them first in your lower back or as lower-abdominal cramps -- try to stay calm, King says. "If you start worrying from the onset, counting contractions, and breathing through every ache, you'll wear yourself out," she says. Lose yourself in other activities: Take a walk, a shower, or bake cookies. Anything that relaxes you will help speed things along.
A light snack in the early stages of labor while you're home will help maintain your energy level. But avoid fatty or hard-to-digest foods, because a too-full stomach could make you feel nauseated and cause vomiting during the later active stages of labor. Muscle contractions and rapid breathing during labor can also cause you to lose fluids quickly. A recent study from the University of California at Irvine revealed that doubling the rate at which intravenous fluids are given can shorten labor by more than an hour. In addition, these labors were half as likely to last longer than 12 hours, says study author Thomas Garite, M.D., a professor and chair of the university's department of obstetrics and gynecology. Drink clear liquids while you're laboring at home, and, once you've arrived at the hospital, let your caregivers know whenever you feel dehydrated.
"Pain can cause you to tense muscles all over your body, which creates even more discomfort," says Marcie Richardson, M.D., an Ob-gyn with Harvard Vanguard Medical Associates, in Boston. "A warm shower can counter that response." For massagelike relief, aim a showerhead at the small of your back or wherever contractions are most intense. A shower is fine at any stage of labor.
Several hours into labor with my third child, I wanted relief. My doctors, saying it was too early for an epidural, suggested that I soak in the hospital room's whirlpool. It worked wonders: I was able to change positions easily by sliding around in the warm water, and aiming the tub's Jacuzzi jets at my lower back eased my intense contractions. When I got out, figuring it was time for the epidural, I was already fully dilated. Ten minutes later, our daughter was born.
In a study at the Touch Research Institute at the University of Miami School of Medicine, laboring women who received massages from their partner reported feeling less pain and anxiety during childbirth than those who were not massaged. "When you stimulate an area that's in pain, whether with pressure or heat, you soften the pain messages sent to the brain," King explains. Let your partner know what feels best. You may want a shoulder or neck rub in labor's first hours, for example, then firm pressure on your lower back during the intense transition stage. By the same token, there may be times when you don't want to be touched at all.
Staying upright throughout much of labor lets gravity work to your advantage: The baby's head pressing on your cervix will help it dilate. And trying a variety of positions -- standing, kneeling, or squatting -- can lessen discomfort and move labor along. "Movement helps widen your pelvis, allowing the baby's head to pass through," King says.
"If you're in active labor and dilated past three centimeters, an epidural will not significantly prolong childbirth or increase your chances of a C-section," says Philip Samuels, M.D., an associate professor of obstetrics and gynecology at Ohio State University College of Medicine, in Columbus. In fact, if you're tense, the anesthetic injected into the space outside your spinal cord can speed dilation by relaxing your muscles. Little of the medication reaches your baby, because the drugs break down before reaching the placenta. An epidural can limit mobility, however -- one reason some women opt instead for an analgesic, such as butorphanol, given via an IV. "Analgesics don't entirely take away the pain, but they do dull pain perception," Dr. Samuels explains.
Patterned breathing not only helps you focus during contractions, taking slow breaths between the intense cramps also helps you rest and relax, Shilling says. During labor, draw on any relaxation strategies that help you in everyday life -- deep breathing, visualizing a favorite place, or listening to music. Above all, remember that although there are few certainties about labor and birth, there is one you can count on: Every labor does eventually end. And that end signals the beginning of a new life -- your baby's as well as your own as a parent. That's why even the toughest labor is probably the most worthwhile work you'll ever do.
Copyright © 2001 Sarah McCraw Crow. Reprinted with permission from the April 2001 issue of Parents magazine. Updated March 2010
Be sure to check out these additional resources to help you better manage your labor and delivery: