In addition to learning to relax your body and quiet your mind prenatally so that those skills will be ready-at-hand when labour begins, there is another aspect of relaxation, or maybe comfort, that is more intellectual in nature. Becoming comfortable with the realities of labour, getting to know terminology and feeling good about your ability to get information and use it productively will make you feel more at ease as labour progresses. If you don’t have a certain degree of comfort with the practical side of things, you’ll be less likely to be able to let go and allow your relaxation techniques do their thing.
Understanding the realities of labour – what happens during each stage, what I and my partner will likely feel (physically, emotionally) during these stages, what the possible complications that could arise are, how complications might be dealt with, what the risks and benefits of common interventions are, etc. – can make most of the sensations of labour easier to cope with. The knowledge that pain is ‘pain with a purpose’, if for many women the key to managing labour and preventing pain from becoming suffering. If you find that you feel uncomfortable talking about these subjects prenatally, you can use that realization productively too. Ask yourself (and your partner) if your discomfort is connected to fears or anxieties about labour and birth. If so, talking through and dealing with those issues before you are in labour will help to make your labour go more smoothly. After all, birth is a psychosexual experience – emotional roadblocks can seriously affect physiological processes by interfering with the release of various hormones. While you may be able to deal with emotional issues as they come up during labour (particularly if you have very intuitive and supportive people around you), it is much easier to identify and work through them ahead of time. Counselling, acupuncture and peer support are just a few options that are open to you for this purpose.
Directly related to knowledge of the processes of labour is an understanding of medical terminologies. Knowing common ways of referring to labour progress (for example, what does it mean when your doctor or midwife says “80%” during a vaginal exam?), complications or interventions can make the hospital context much less stressful and will allow you to filter out information that you don’t need and take note of things that might be useful or that might impact the decisions you’ll have to make. Having a doula who will translate for you prenatally and who will check to make sure that you understand the things that are being said to and about you during labour can go a long way towards demystifying the experience. As with knowledge of normal labour processes, this kind of information can make the experience of labour much less overwhelming and easier to cope with. That can make a significant difference in terms of allowing you to focus on your coping strategies and allowing your partner to feel reassured and more equipped to provide you with support.
The final aspect of relaxation or comfort that I want to discuss here has to do with acquiring and using skills for self-advocacy. Learning how information might be withheld from you (not necessarily intentionally, but often as a result of harried, rushed or burnt-out personnel) or how information is sometimes provided in such a way as to be confusing or frightening (again, possibly as a result of institutional pressures or other factors as opposed to a malicious plot to make you feel afraid) can help you to filter out statements that are more about getting your consent than about giving you information. Preparing yourself for the possibility that you might hear negative or scary things from nurses, doctors or midwives (among others) can help you to dismiss the fear and get to the information that you need to make your choices. A doula can teach you what kinds of questions to ask and when to ask them and will remind you to use your voice and to ask those key questions during labour. Even without a doula, having practiced questions in advance, such as, “what are the risks involved with this procedure?” or “what are the alternatives available to us? Other treatments? Watchful waiting?” in advance can help to make you more comfortable with asking them when the time comes. Formulating a birth plan and sharing it with your doctor or midwife, as well as any other health care professionals that you encounter during your labour might help to eliminate the need to ask them at all, at least some of the time. It is important not just to know these things, but to try to feel comfortable with applying them. Many people feel intimated by medical professionals and give their consent for things without being fully informed because they are afraid to say no, or because they are worried about offending someone by asking questions. You have a right to know how your options will affect you and your baby in real terms, you don’t have to say yes just because someone in scrubs says you should.
The bottom line as I see it is this: you need to be able to relax and feel comfortable trusting your body during labour, but just as importantly, you need to be knowledgeable about birth and comfortable both with that knowledge and with your ability to acquire and apply new information. That way you can feel good about your choices and keep your stress hormone levels down, without compromising your ability to let go.