Spilling the tea on - natural therapies for labour

Many women are looking for safe medication-free

options that

empower and enable them

throughout labour.

In this journal article, we will explore five of these techniques: heat therapy, water therapy, TENS (transcutaneous electrical nerve stimulation), birth combs, and sterile water injections.

1. Heat Therapy: 

You know that great feeling when you pop a heat pack on your achey back at the end of a big day? That is heat therapy. It is not only lovely to use on post-exercise muscles, it is a brilliant, simple yet effective way to help with labour.

Why does heat help with pain and discomfort? Heat and cold travel along the same nerve pathways as pain, so applying heat interrupts those signals as they travel to the brain. 

Applying heat to the lower back or abdomen increases blood flow, relaxes muscles, and reduces tension, making contractions more manageable. There are some thoughts that the warmth may increase oxytocin production, thus having potential to shorten labour.

Heat can be applied using a heat pack, heat patch, shower or bath, and we recommend that every pregnant woman purchase a heat pack (or two) to use during labour. And whilst they are an essential item for your labour toolkit, heat packs are also very useful to help manage muscle aches and ligament stretching throughout pregnancy and even postnatally, so grab one sooner rather than later. 

2. Water Therapy: 

There is something so therapeutic about a relaxing warm bath or hot shower - and it is no different in labour. Water therapy, or hydrotherapy, is one of the most popular natural pain relief methods used during labour.

Water immersion in labour provides many benefits - all over warmth (see heat therapy above), relaxation, pain relief, and support from buoyancy (which aids movement). The bath can also provide the sense of a seperate physical space. The Australian College of Midwives recommends water immersion in labour and have a really good postion statement on their site. Water immersion can be of great benefit in labour even for those women where birthing in water is not recommended.

However not everyone has access to a bath or birth pool, and some women don’t enjoy the confinement or heat of a bath - and for these women a shower can be really effective. The shower provides a more targeted form of water and heat therapy, and encourages an upright position. The participant in birth can help by directing the water where it is most needed.

Water immersion is also great outside of labour and many women enjoy swimming during pregnancy due to the weightless sensation, increased freedom of movement and cooling sensation.

3. TENS Therapy: 

TENS (Transcutaneous Electrical Nerve Stimulation) therapy is another option that utilises the pain gate theory. A TENS machine is a small, battery-operated device that delivers mild electrical impulses via patches applied to the skin - generally to the mid and lower back. These impulses interfere with pain signals sent to the brain, reducing discomfort and sometimes promoting the release of endorphins, the body’s natural painkillers.

TENS units are easy to use and and are fabulous in early and active labour for pain relief - they just need to be removed if using the bath or shower.

Some TENS machines are designed specifically for labour and have a ‘boost’ button to use with contractions. Several websites offer these TENS machines for hire.

4. Birth Combs:

A birth comb is an inexpensive, accessible, handheld tool that works very well in labour. There are varying thoughts on why they work. 

One hypothesis is gate-control theory - whereby gripping the comb tightly in the palm, the pressure stimulates nerves in the hand, which interrupt pain signals sent to the brain. 

Also there are acupressure points in the palm that help with contractions when pressure is applied - and the comb can apply pressure across all these points. 

It is also thought that squeezing the comb provides a distraction, something to focus on besides the contraction, and may contribute to endorphin release. Perhaps it is a combination of them all.

Personally I have heard great feedback from women who have been amazed at how effective the comb was in labour. It is a fantastic adjunct to breathing techniques, movement, massage, water and heat therapy. 

We offer a birth comb that has received great reviews. Click here to learn more.

5. Sterile Water Injections: 

Women tend to have mixed ideas around sterile water injections due to the associated sting, however they can be a highly effective method for relieving moderate to severe back pain during labour.

This technique involves two midwives injecting small amounts of sterile water just under the skin (intradermal) to create four blebs, creating an intense stinging sensation for around 30 seconds. The intense sting interrupts the pain messages travelling from the back to the brain (the gate control theory).

This sting is off-putting to some women, but personally I have found that if the back pain is severe, then women would rather experience a 30 second sting to up 2 hours of ongoing pain.

Some women do find that improving the back pain then makes them more aware of the contraction sensation in the front, but most find this easier to manage than ongoing back discomfort. 

Summary

This is only a brief overview of some of the more common natural tools for labour. I encourage you to do your own research and have a discussion with your pregnancy care provider.

If you have tried any of these techniques in the past, please share  your experiences in the comments below or on our socials.

References:

ELGİN, T., ÇOBAN, M., ARSLAN, Ş., & GÜNEY, E. (2021). Pharmacological and Non-Pharmacological Methods of Overcoming Labor Pain. Academic Researches in Health Sciences, 107-123

Fogarty, V (2008). Intradermal sterile water injections for the relief of low back pain in labour—A systematic review of the literature, Women and Birth, Volume 21, Issue 4, 157-163.

Goswami, S., Jelly, P., Sharma, S. K., Negi, R., & Sharma, R. (2022). The effect of heat therapy on pain intensity, duration of labor during first stage among primiparous women and Apgar scores: A systematic review and meta-analysis. European Journal of Midwifery, 6.

Lee, N., Leiser, B., Halter-Wehrli, Y., Mårtensson, L. B., Gao, Y., & Kildea, S. (2022). A comparison of two versus four sterile water injections for the relief of back pain in labour: A multicentre randomised equivalence trial. Women and Birth, 35(6), e556-e562.

Lee, S. L., Liu, C. Y., Lu, Y. Y., & Gau, M. L. (2013). Efficacy of warm showers on labor pain and birth experiences during the first labor stage. Journal of Obstetric, Gynecologic & Neonatal Nursing, 42(1), 19-28.

Mellado-García, E., Díaz-Rodríguez, L., Cortés-Martín, J., Sánchez-García, J. C., Piqueras-Sola, B., Macías, J. C. H., ... & Rodríguez-Blanque, R. (2024). Comparative Analysis of Therapeutic Showers and Bathtubs for Pain Management and Labor Outcomes—A Retrospective Cohort Study. Journal of Clinical Medicine, 13(12), 3517.