8 Non-Pharmacological Pain Relief Techniques Your Doula Wants You to Know

One of the biggest myths about labor is that you have to stay in a bed. In fact, movement is your greatest ally. When you move your hips, you are actively helping your baby navigate the bony pelvis. Think of it as a lock and key—as you sway, tilt, and rock, you are helping the ‘key’ (your baby) find the perfect fit through the ‘lock’ (your pelvic outlet).

How to Perform the Labor Dance

1. Wrap your arms around your partner’s neck or shoulders, allowing your upper body to go completely limp and heavy.
2. Widen your stance and slightly bend your knees to take the pressure off your lower back.
3. Sway your hips slowly from side to side, mimicking a slow dance.
4. Let your partner rub your lower back or provide a steady ‘double hip squeeze’ while you move.
5. Incorporate ‘The Curb Walk’ if labor stalls, stepping one foot up onto a curb or a low step and back down to create asymmetrical pelvic opening.

“Movement is the medicine for labor. If you feel stuck, change your view, change your position, and let gravity do the heavy lifting.”

There is a reason why many doulas and midwives call the shower or birth tub the ‘midwife’s epidural.’ Water has a profound effect on the nervous system. The buoyancy of water relieves the weight of the pregnant belly, while the warmth helps muscles relax, breaking the Fear-Tension-Pain cycle.

Using Water Effectively

• The Shower: Aim the warm spray directly onto your lower back or the top of your belly where you feel the most intensity. The rhythmic ‘pitter-patter’ of the water acts as a form of sensory distraction.
• The Birth Tub: Waiting until you are in active labor (usually around 6 centimeters) to enter the tub can provide a dramatic ‘reset’ for your pain management.
• Temperature Control: Ensure the water is warm but not hot (staying under 100 degrees Fahrenheit) to keep both you and baby safe.

If you find yourself needing to labor in bed—perhaps due to an epidural or simply exhaustion—the peanut ball is your best friend. This peanut-shaped exercise ball is placed between your legs to keep the pelvis open even when you are lying down. For those who are mobile, the standard birth ball (exercise ball) allows for active resting.

Positions to Try

• The Forward Lean: Kneel on a soft mat and lean your chest over the birth ball. This encourages the baby into an Optimal Fetal Position (OA).
• The Pelvic Tilt: Sit on the ball and make small circles or figure-eights with your hips to loosen the lower back.
• The Side-Lying Peanut: While in bed, lie on your side with the peanut ball between your knees and ankles to open the pelvic outlet by up to 30%.

When we feel pain, our natural instinct is to hold our breath and tighten our shoulders. In labor, this deprives your uterus of oxygen and slows things down. Doulas teach ‘Low Tones’ to keep the ‘bottom’ open. There is a physiological connection between the jaw and the pelvic floor—if your jaw is tight, your cervix is likely tight too.

The ‘Horse Lips’ Technique

1. Inhale deeply through your nose, expanding your ribcage.
2. Exhale through loose, floppy lips, making a ‘brrrr’ or ‘pffff’ sound, like a horse.
3. Keep your jaw unhinged and your throat open.
4. Direct your sound downward. Instead of high-pitched screams, use low, guttural moans like ‘Oooooo’ or ‘Aaaaaa.’

“Keep your face soft, and your bottom will follow. Let the breath carry the contraction away like a wave.”

For many women, labor is felt intensely in the lower back (often called ‘back labor’). This is where your partner or doula becomes a physical anchor. Counter pressure involves applying firm, steady force to the sacrum to counteract the internal pressure of the baby’s head.

Step-by-Step Double Hip Squeeze

1. The laboring person leans forward onto a bed, counter, or birth ball.
2. The partner stands behind and places their hands on the fleshy part of the hips (the iliac crests).
3. Apply firm pressure inwards toward the spine and slightly upwards.
4. Hold the pressure for the entire duration of the contraction.
5. Communicate! Ask “Harder?” or “Lower?” to find the sweet spot.

Your environment dictates your safety levels. If the lights are too bright or the room smells like ‘hospital,’ your adrenaline might rise, which can stall labor. Aromatherapy is a powerful way to signal to your brain that you are safe and relaxed.

• Lavender: The gold standard for relaxation and anxiety reduction.
• Peppermint: Excellent for curbing the nausea that often strikes during transition. (Pro-tip: Just sniff the bottle or a cotton ball; don’t diffuse it if you’re sensitive).
• Clary Sage: Known to help strengthen contractions (use only once labor has naturally started).
• Dim Lighting: Use battery-operated tea lights to create a ‘birth cocoon.’

A TENS (Transcutaneous Electrical Nerve Stimulation) machine is a small device that sends tiny electrical pulses through pads placed on your back. It works on the ‘Gate Control Theory’ of pain—the idea that the brain can only process so many signals at once. The tingling sensation of the TENS ‘shuts the gate’ on the slower-moving pain signals from the uterus.

TENS Best Practices

• Start Early: Put the TENS on in early labor to build up your body’s natural endorphins.
• Control the Boost: Most units have a ‘boost’ button for the peak of a contraction.
• Safety Note: Do not use a TENS machine in the water (shower or tub).

The mind is the most powerful tool in the birth room. When the intensity peaks, visualization helps you reframe the sensation from ‘pain’ to ‘purposeful work.’ Instead of fighting the contraction, imagine it as a wave bringing you closer to the shore where your baby is waiting.

Affirmations to Repeat

“Each contraction is not stronger than me, because it IS me.”

“My body is opening like a blooming flower.”

“I can do anything for 60 seconds.”