One of the most common questions I hear as a midwife is, “What can I actually do to make contractions easier?”

I cannot promise you a pain free labour, and I think sometimes birth preparation does women a disservice when it suggests that the right breathing technique, mindset or environment can somehow remove the intensity of birth. Labour can be incredibly intense. But there is a big difference between trying to eliminate that intensity and understanding how to work with your body so that contractions feel more manageable.

Something I really want women to understand before labour is that how you experience a contraction is not determined by the contraction alone. Your position, environment, hormones, nervous system, sense of safety, exhaustion levels, expectations, support and understanding of what is happening can all influence your experience of pain.

That gives us quite a few things we can work with.

Understand what a contraction is actually doing

During a contraction, the muscle of your uterus tightens and shortens. As labour progresses, these contractions help your cervix change and open, while also helping your baby move down through your pelvis.

Importantly, contractions are not continuous. They build, reach a peak and then ease away. Between contractions your uterus relaxes and you have an opportunity to recover.

This can be a really helpful way to think about labour. Rather than wondering how you are possibly going to cope with hours of contractions, bring your attention back to the one you are experiencing. You only need to work through this contraction, then use the space afterwards to rest, breathe, drink, change position or simply switch off for a moment before the next one comes.

Try not to fight your body

When something hurts, our natural response is often to tense against it. Your shoulders rise, your jaw tightens, your hands clench and your breathing becomes faster and shallower.

The difficulty in labour is that you cannot physically move away from the sensation because it is being generated by your own uterus. Tensing your entire body does not stop the contraction. It can simply mean you are using additional energy at a time when your body already has a significant job to do.

This is where relaxation techniques can be genuinely useful. Not because relaxing makes labour painless, but because you do not need every muscle in your body to contract just because your uterus is contracting.

During a contraction, notice what your jaw, shoulders and hands are doing. Think about allowing your shoulders to become heavy, keeping your hands loose and releasing unnecessary tension through your face and jaw. These very simple cues can give you something tangible to focus on when the intensity builds.

Use your breathing as an anchor, not a performance

There is no magical breathing pattern that guarantees an easier birth. The real value of breathing techniques is that they give you something predictable to return to and can help prevent your breathing becoming rapid and panicked when contractions intensify.

Slow, comfortable breathing with an emphasis on a relaxed exhale works well for many women. Some like counting, others prefer making low sounds as they breathe out, while some simply focus on not holding their breath.

There is no prize for breathing perfectly. Your breathing should support you rather than become another thing you feel you have to get right.

Move and change position

The pelvis is not a rigid structure and your baby does not simply travel down through a fixed tube. Your baby needs to navigate through the different levels of the pelvis, rotating and adjusting along the way.

Changing your position can alter the space available within different areas of the pelvis, which is one reason movement can be such a useful tool during labour. It can also simply change where you feel pressure and make contractions more comfortable.

You might want to try leaning forwards, rocking or circling your hips, kneeling, using all fours, leaning over the bed or a birth ball, standing and swaying, or lying on your side when you need to rest. You do not need to find one perfect labour position and stay there. What feels good at one point may feel completely wrong an hour later.

Follow what your body is telling you and keep experimenting.

Do not underestimate warmth and water

Warmth can be incredibly soothing during labour. A warm shower directed towards your lower back or abdomen may help, and some women find immersion in a birth pool or bath particularly effective when it is available and appropriate for them.

Heat packs can also be useful when used safely and according to the guidance of your maternity team.

These tools might sound simple, but simple does not mean ineffective. Sometimes we become so focused on complicated birth preparation that we overlook some of the most instinctive ways humans manage discomfort.

Think about what makes your nervous system feel safe

Your birth environment matters more than simply making the room look nice.

Labour is a hormonal process, and our bodies respond to whether we feel safe, observed, frightened, interrupted or comfortable. This does not mean dim lighting, music and fairy lights guarantee a straightforward labour. They absolutely do not. But feeling safe and supported can help create an environment that is more conducive to the physiology of labour.

Think about what helps you switch off from the outside world. You might prefer lower lighting, fewer unnecessary interruptions, familiar voices, warmth, music, privacy or reassurance. Someone else might feel safest with lots of information and conversation.

There is no universal perfect birth environment. The useful question is, “What makes me feel safe and supported?”

Prepare your birth partner too

Birth partners can have a much more active role than simply standing beside the bed and offering encouragement. They can help protect your environment, remind you of the tools you practised, encourage you to change position, offer massage or counter pressure, make sure you are drinking, communicate your preferences and help you understand what is happening when decisions need to be made.

This is why I strongly believe birth preparation should include whoever is going to support you. In the middle of an intense contraction, you probably do not want someone asking you to explain which breathing technique you wanted them to remind you about.

Practise beforehand so they know how to support you without needing constant direction.

Remember that pain relief is part of the toolbox too

There is sometimes an unhelpful idea that coping well with labour means avoiding pain relief. It does not.

Depending on where and how you are giving birth, options may include water, gas and air, opioid medication and epidural analgesia. Each has its own benefits, limitations and considerations, which is why understanding them before labour can be so valuable.

There is no prize for experiencing more pain. If your coping strategy changes during labour, that does not mean your preparation has failed. Good birth preparation should help you understand your options well enough to make decisions as your circumstances and needs evolve.

The biggest thing I want you to take into labour

Pain is complex. It is not simply a measurement of how strongly your uterus is contracting. Fear, exhaustion, previous experiences, environment, support, expectations and feeling out of control can all influence how we experience it.

This is why preparing for contractions should involve much more than learning a breathing technique. Understand what your body is doing, learn how movement can help, explore comfort measures, prepare your birth partner, understand your pain relief options and think about what helps you feel safe.

And remember that coping does not have a particular look. You might breathe quietly through contractions, roar, swear, move constantly, ask for an epidural or completely change your mind about what you thought you wanted.

None of those things tell me whether you are “good” at giving birth.

The aim is not to perform labour perfectly or remain calm at all costs. It is to go into birth understanding what is happening in your body and having enough tools and support that, when something stops working for you, you know what you can try next.

Written by Midwife Pip

Pip an experienced practicing NHS Midwifery Sister, MSc, author of Midwife Pip’s Guide to a Positive Birth, KGH hypnobirthing diploma, founder of the Midwife Pip Podcast, pelvic health specialist, pre and postnatal trainer and, importantly, a mum. Pip is an enthusiast of all things womens health and wellness. Having worked with many families, for many years Pip see’s every day the void in high quality information available. Pip is on a mission to change this and to make sure that all women can access the information they deserve and need to be empowered and supported through their pregnancy, birth and postpartum journeys.

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