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Relaxation is the key to making your labor as comfortable as possible. During labor, your muscles will naturally tense in response to the stress of labor, even though they are not related to the work or function of labor.

Tense body muscles are actually counterproductive to labor, often leading to a more painful, prolonged labor experience. To help avoid this, learn and regularly practice techniques to elicit the relaxation response. Relaxation effectively counterbalances the negative impact of labor stress by

• reversing the physiologic changes of the stress/fight or flight response (e.g. marked increases in blood pressure, heart rate, and breathing rate),
• relieving/diminishing pain,
• conserving energy and decreasing fatigue,
• increasing oxygen supply to the baby and uterus,
• decreasing muscle tension,
• managing a stressful situation in a healthy, positive manner,
• promoting a feeling of calm, comfort, and control,
• boosting self-esteem through personal empowerment and involvement, and
• refreshing the spirit.

Many women also find the relaxation techniques useful for overcoming the insomnia that often occurs during the second half of pregnancy.

Relaxation is usually not an automatic response to stress but rather a learned skill; therefore, in preparation for labor and birth stress, try to practice the relaxation techniques of your choice on a daily basis. This repetitive practice will enable you to more effectively relax your body muscles in response to the contracting uterus of labor or any other birth stress.

The following exercises are examples of relaxation techniques designed to help you summon the relaxation response.

Do not be discouraged if you cannot achieve perfect relaxation. Diligent practice, however, will definitely increase your ability to elicit the relaxation response.

There are many positions that can be used for relaxation such as tailor sitting, side-lying, and reclining; however, avoid lying flat on your back since it puts pressure on major blood vessels, which decreases blood flow to your uterus and baby. Whichever position you choose, be sure that your limbs are flexed and supported with pillows. No body part should be resting directly on another.

Tense and Release with Mental Imagery
This is a basic relaxation exercise that will assist you in learning to feel the difference between muscular tension and relaxation.

• Assume a comfortable, supported position. Close your eyes.
• Clear your mind—erase all worries and anxieties. Ideas and emotions may come to you, but your mental state remains passive.
• Listen to yourself breathe; try to breathe very slowly and quietly.
• Turn inward and mentally travel through your body, tensing and relaxing each set of muscles as you proceed—forehead, jaw, neck, shoulders, arms, hands, fingers, abdomen, buttocks, legs, feet, and toes—until you reach a fully relaxed state. You should feel as relaxed and limp as a rag doll.
• Take a deep, full breath and then slowly let it out. As you do this, feel your relaxation flow through your body, from head to toes.
• Using your imagination, picture yourself at your favorite place—a warm, sandy beach; a mountain meadow of fragrant wildflowers; a cool, green forest; in front of a blazing fire on a winter night, or anyplace where you can imagine yourself relaxing.
• Use all of your senses to further enhance and enjoy this experience of complete relaxation.
• To end your relaxation, take a deep breath, slowly count to five, move and stretch gently, then open your eyes.

Touch Relaxation
Touch relaxation is the spontaneous relaxation and release of tense muscles solely in response to the non-verbal, caring communication of touch.

Through diligent practice, you will learn to use the coach’s touch as a cue for complete relaxation. Touch relaxation is a very helpful technique during labor.

• Assume a comfortable, supported position.
• Begin and end the exercises with one or two cleansing breaths to enhance relaxation. Use a focal point to help concentration.
• You will contract a set of muscles.
• The coach will then rest his hands on your contracted muscles, then slowly and gently move his hands along the entire length of these muscles.
• At his touch, you will relax your contracted muscles and release the tension towards his touch.
• Touch is the cue to RELAX.
• Gentle stroking or massage can be added to get rid of any residual tension.
• Reverse roles at the end of the exercises so that the coach can be on the receiving end as well.

Massage
Massage is another tool that can be of great help and comfort during labor by relieving pain, enhancing relaxation, and increasing circulation. Massage can be done in a variety of ways. Deep touching, such as squeezing or firm pressure, often relieves pain, while stroking and kneading enhance relaxation and increase circulation.

Some mothers may be irritated by touch during contractions, but massage may still be helpful between contractions.

Massage will be most successful if you are assertive and communicate what is helpful and feels good as well as where touch might feel better.

It is important for you and your coach to assume comfortable positions. You should be well supported with pillows, and the coach should be in a position to perform massage without causing back strain by too much reaching or bending.

Massage is easier to do over bare skin. To keep the massage smoother and prevent friction over skin, use a lubricant such as powder, cornstarch, oil, or lotion.

Massage is done most effectively if you do the following:

• Mold your hands with fingers together to fit the shape of the body part being massaged
• Use smooth, rhythmic movements as you massage
• Maintain constant physical contact with the body part until you have finished massaging it

Effleurage

Effleurage is a stroking massage on the skin of the abdominal wall that is usually performed concurrently with contractions. The stroking is generally done in a circular motion. As with other massage, it is best done over bare skin with a lubricant.

Effleurage may be done either by you (on yourself) and/or by your coach. When you do it on yourself, it provides you with a focus of attention and a constructive use of your energy.

It is most beneficial if the stroking is at a constant pace with no acceleration, even as contractions intensify. Firmer stroking may increase comfort as contractions intensify.

Effleurage is most often done over the abdomen and contracting uterus, but it may also be done over the upper thigh and groin region. Use effleurage wherever and whenever it feels good.

• Place one or both hands on the area to be stroked.
• With moderate pressure, stroke the area by making circles with each hand.

ADDITIONAL NOTE: Relaxation and massage are not only applicable and beneficial during pregnancy and labor, but also during the postpartum period and in everyday life.