Natural Ways to Cope With Labor Pain (That Actually Work)

First, the ground rules

Before we go any further: I am a doula and a trainer, not a doctor. I coach toward natural birth, and both of my own births were unmedicated — my son Judah was born unmedicated in a hospital on Valentine's Day, 8lbs 11oz of very opinionated baby.

That does not make me better than anyone. It does not make unmedicated birth better than an epidural. Pain relief choices are personal, and medical options are sometimes exactly right. If you read this whole article and then get the epidural, I will be genuinely happy for you. Comfort measures and pain medication are not enemies — plenty of women use both in the same labor.

Also: the skeptic in you is welcome here. Question your doctor, read the studies, and make decisions WITH your partner and provider. That is not rejecting medical care — that is being a wise, informed human. Now let's talk about what works.

1. Have someone who never leaves your side

Of everything in this article, this one has the strongest evidence. A 2017 Cochrane review by Bohren and colleagues pooled 26 trials with nearly 16,000 women and found that continuous one-to-one support during labor was linked to:

• About 25% lower risk of cesarean birth (the biggest effect — 39% lower — was when the support person was a doula rather than a staff member)
• Labors about 41 minutes shorter on average
• 8% more spontaneous vaginal births (15% more with a doula)
• 10% less use of any pain medication
• 31% lower risk of a negative birth experience

These are relative differences, not guarantees — support doesn't bend the laws of physics. But this is the most studied comfort measure in all of obstetrics, and it consistently points the same direction: having one person whose only job is you changes labor.

This is personal for me. As I have said before: being cared for and carried by other women can be one of the most beautiful parts of the experience. There is something about being tended to by someone who isn't watching the clock or the monitor — just you — that lets your body relax enough to do its work. I saw it at Judah's birth, and I see it every time I doula.

2. Move like the law doesn't apply to you

The average laboring woman in a hospital spends most of her labor in bed. Meanwhile, a 2013 Cochrane review of 25 trials (over 5,000 women) found that women who stayed upright and mobile — walking, standing, kneeling, sitting upright, slow-dancing with their partner at 3am — had:

• First stages of labor about 1 hour and 20 minutes shorter on average
• About 29% lower risk of cesarean birth
• About 19% lower likelihood of requesting an epidural

No downside showed up for moms or babies. Gravity is free, and it works. One caveat from the reviewers: once an epidural is in, position didn't change outcomes — so if you want to move, move early.

Practical version: change positions every 20 to 30 minutes when contractions are intense. Lunge on stairs. Hands-and-knees. Birth ball figure-eights. Anything beats the bed, except lying down is fine if you're genuinely resting — don't heroically march the halls when your body wants sleep.

3. Get in the water

The 2018 Cochrane review on water immersion during labor (15 trials) found that women who labored in a tub or birth pool used less regional analgesia — epidural use dropped from about 43% to about 39% — with no clear increase in adverse effects for moms or babies. There was little to no difference in mode of birth, and the evidence on giving birth IN the water (vs. just laboring in it) is more limited.

Honest translation: water is wonderful for coping. It is not a painkiller. The women in these studies still felt their contractions — they just handled them better. Warm water on your lower back during a contraction is one of the most reliably soothing things in labor, full stop. If your hospital has a tub and you're a good candidate, ask about it early — sometimes there's a wait, and one small trial suggested very early entry (before active labor) might slow things down, so most providers wait until you're well into it.

No tub? The shower counts. Sit on a birth ball in the shower and aim the water at your belly or back during contractions. It is unglamorous, and it works.

4. Let someone put their hands on you

Counterpressure — a partner pressing hard on your lower back or sacrum during contractions — is the doula world's greatest hit for back labor, and massage, warm packs, and other manual methods have actual trial data behind them. A 2018 Cochrane review found low-to-very-low-quality evidence that massage may reduce pain, shorten labor, and improve women's sense of control, and that warm packs reduced labor length in two small trials (by about an hour, though that's from only 128 women — small, but promising).

The evidence quality here is honestly on the weaker side, which is worth saying plainly. But the risk is essentially zero, and in practice, having someone's hands on you during a contraction changes the whole emotional weather of the room. Teach your partner counterpressure before labor day — it is hard to learn a new skill while your wife is growling at you.

5. Breathe, relax, and stop white-knuckling

Fear and tension make pain worse — the adrenaline-tension cycle is one of the few things about labor pain that physiologists agree on. Relaxation techniques (guided relaxation, visualization, music, yoga-style breathing) were reviewed in a 2018 Cochrane review of 19 trials. The verdict: possible benefit for pain intensity and satisfaction, but the evidence quality ranges from low to very low. Yoga looked promising in the few trials available, music helped in early labor, and one mindfulness trial found women felt more in control.

Here is the single most compelling piece of evidence in this whole section, though: an Australian randomized trial (Levett et al., 2016) gave 176 first-time moms a two-day course combining breathing, visualization, massage, acupressure, yoga techniques, and partner support. The results were striking — epidural use was 24% in the course group versus 69% with standard care, and cesarean rates were roughly half (risk ratio 0.52).

Was it the breathing? The massage? The empowered partner? The trial can't tell us which ingredient mattered — and that's kind of the point. These techniques work best as a bundle, learned before labor, practiced with the person who will be in the room with you.

What the evidence does NOT say

I take the science seriously, so here is the honest fine print:

• None of this is magic. Every one of these strategies reduces pain or improves coping for many women. None of them eliminates pain, and all of them have limits.
• Low-quality evidence is still real data, but it means we should hold conclusions lightly. Most massage and relaxation trials were small, and you can't exactly blind a woman to whether she's in a tub.
• Correlation is not causation. Women who move during labor might also be having easier labors. The randomized trials help here, but they're not perfect.
• Choosing the epidural is a valid choice. These tools exist so you have options — not so anyone can judge how you used them. An epidural can be the most evidence-based decision in the room, depending on the labor.
• Talk to your provider. Water immersion, for example, isn't right for every pregnancy. Your doula coaches and supports; your provider manages medical risk.

References

1. Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2017;7(7):CD003766.
2. Lawrence A, Lewis L, Hofmeyr GJ, Styles C. Maternal positions and mobility during first stage labour. Cochrane Database Syst Rev. 2013;10(10):CD003934.
3. Cluett ER, Burns E, Cuthbert A. Immersion in water during labour and birth. Cochrane Database Syst Rev. 2018;5(5):CD000111.
4. Smith CA, Levett KM, Collins CT, Armour M, Dahlen HG, Suganuma M. Relaxation techniques for pain management in labour. Cochrane Database Syst Rev. 2018;3(3):CD009514.
5. Smith CA, Levett KM, Collins CT, Dahlen HG, Ee CC, Suganuma M. Massage, reflexology and other manual methods for pain management in labour. Cochrane Database Syst Rev. 2018;3(3):CD009290.
6. Levett KM, Smith CA, Bensoussan A, Dahlen HG. Complementary therapies for labour and birth study: a randomised controlled trial of antenatal integrative medicine for pain management in labour. BMJ Open. 2016;6(7):e010691.

Rachel Gould is a birth doula and maternal wellness coach serving the Phoenix Valley through Holista Health Collective — 1-on-1 support for preconception, pregnancy, birth, and postpartum.