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ability activity acupressure analgesia anesthesia anxiety Apgar scores autogenic training baby back labor behavior biofeedback birth educator birth experience body breastfeeding breathing patterns cervix child childbearing childbirth classes childbirth education classes childbirth experience childbirth preparation class members clients coach cognitive comfort contractions coping couples decrease delivery develop discuss effective emotional endorphin enhance epidural epidural anesthesia episiotomy exercise expectant parents feedback feel fetal fetus goals imagery important increase individual infant influence instructor interaction laboring woman Lamaze learning massage maternal mother muscle newborn Nursing Nursing Research outcomes paced breathing pain management participants partner pelvic pelvic floor physical physiological position postpartum preg pregnancy prepared childbirth progressive relaxation psychological relationship relaxation techniques relaxation training response role sexual skills social stage of labor stimuli strategies stress supine position teaching techniques tension Therapeutic Touch tion uterine uterus women York