Whether you're planning on getting an epidural or not, planning on an induction or not, have a scheduled cesarean or not, chances are likely that you will have to experience some of the contractions and process of labor. As a childbirth teacher, I tell families that no matter what you think your plans are and what you want for your comfort/coping/pain management in labor, it's a smart idea to learn and practice natural comfort measures (ie, ways of relieving pain in labor without the use of IV medicine or epidural). Even if you're planning on getting an epidural, there's a good labor lead up time before that point, and it's not uncommon for epidurals to stop working or not work effectively. Point: have a back-up plan. And that back-up plan should include some natural methods for relieving pain.
A good childbirth class (which should be on your must-do before birth list!) will review and help you practice several coping techniques. If you're pregnant and nearing your third trimester, I encourage you to seek a class asap! That said, if you remember nothing else from your childbirth classes or favorite birth prep book (I really like The Birth Partner, Giving Birth with Confidence, and Pregnancy & Childbirth)
Movement is a person's natural response to pain in labor because movement actually serves a beneficial purpose that helps labor move forward. Moving in labor helps produce more oxytocin -- the "feel good" pain-relieving hormone that also keeps contractions going. Moving also helps widen the pelvic outlet, which better encourages baby to get into an optimal position for birth, and movement helps use gravity to your advantage, which helps baby move down and out!
Most people who have given birth will tell you that the most uncomfortable way to experience a contraction was when lying on their back. Considering that information, the natural choice would be to experience contractions in any other position than lying on your back! Movement includes both actually moving during a contraction (like swaying side-to-side while leaning over a counter or bed, for example) and changing positions frequently throughout labor. Walking, leaning over, swaying, "circling" on an exercise ball, rocking, standing upright, squatting, getting on all fours, and side lying, are all examples of movement in labor.
Sometimes, your place of birth, interventions in birth, and your care provider can interfere with your ability to move in labor. Be sure to talk early and often about your desires for remaining mobile in labor and find out how your birth place and providers will support you. Interventions, like continuous fetal monitoring, routine IV fluids, and epidural can all hinder your ability to move. Find out which interventions are routine (done without medical necessity) and which may be medically necessary for your birth. It takes more work and forethought, but it is still possible -- and important! -- to move around (in a limited way) with those interventions. Involve your nurse(s), your doula, and your partner to help you move around during labor. You can learn a variety of ways to move in labor, including ways to move if you have an epidural, with a good childbirth class.
Find or Bring a Dedicated Helper
Having continuous support throughout your labor from a trusted, dedicated friend or family member, your partner, or a doula has been shown through research to improve outcomes in labor and birth. Continuous support can help reduce your pain, increase your confidence and ability to cope, and improve your overall birth experience. Be sure to appoint someone who will take this role seriously -- in other words, they will not only remain by your side throughout labor, but also be able to provide supportive, empathetic, and helpful guidance and comfort. If that description doesn't sound like it fits the description/abilities of your partner, that's ok. Bring someone else along with you, like a friend or family member, or hire a doula whose job and role it is to provide continuous emotional, physical, and informational support. Partners can also get a lot out of attending a good childbirth class with you to better understand what it means to provide good, continuous support in labor and birth.
Water can be a transformational pain-relieving aid. Getting in a tub filled with water or standing in a shower during labor can provide tremendous pain relief and comfort. If you are at home in early or early active labor, consider getting into your own tub or shower for some relaxation and pain relief. If you're having a home birth, find out about renting a birth tub for your birth and get it in place prior to your birth. Many birth centers and some hospitals also offer birth tubs for labor and birth. If not, most hospital rooms have either a shower or bath tub. If bath tubs are limited in your hospital and you really want to get into the water during labor, find out during your hospital tour what you can do to increase your chances of getting a room with a tub. If a tub isn't available, you can use the shower and let the warm or hot water run down your back as you labor. Many hospital showers come equipped with a detachable, handheld shower sprayer, which is perfect for your partner to use on targeted areas, like your lower back, to reduce pain. If you require fetal monitoring during labor, find out if your hospital has wireless waterproof telemetry units, which can be used in the shower or tub.
The American College of Obstetricians and Gynecologists. (2017). Committee Opinion: Approaches to Limit Intervention During Labor and Birth.