January 28, 2008

Paging Dr. Feel Good

Massage is one of the most useful tools for non-medicated pain relief I can bring to a birth. It has been credited with helping to reduce pain, anxiety, and fear by increasing endorphin levels in the body. A study reported in ‘Mental Health Update’ that “the women in a group that received physical touch (light massage and counter pressure) and emotional support, as compared to controls, had 56% fewer c-sections, an 85% reduction in the use of epidural anesthesia; 70% fewer forceps deliveries; 61% decrease in the use of oxytocin; a 25% shorter duration of labor; and a 58% drop in neonatal hospitalization” (Midwifery Today #84 Winter 2007 pg 32). Another study from the Touch Research Institute reported that “women whose partners massaged them felt less depressed, had less labor pain, and had lower stress and anxiety.” (Midwifery Today #84 Winter 2007 pg 32) These statistics are amazing!

Keep in mind: The more relaxed the body is, the less painful the contraction will seem. The more stressed the body is, the more painful the contractions will seem. There is an idea referred to as the “gate control theory”, which posits that pain is experienced not as a result of the activation of individual pain receptor neurons, but rather by the interaction between neurons, and also that pain signals can be interfered with by stimulating the periphery of the pain site. Massage, counter pressure, water pressure, heat, and ice can help to block the pain signals.

Several of the common areas that the laboring mom may enjoy having massaged are the lower back, neck, shoulders, hands, and feet. Often times I find that birth partners want to offer this kind of support but are apprehensive about how to massage and touch their partners. One need not be a trained massage therapist in order to deliver hands-on support. Rather, knowing and understanding your partner and paying attention to her verbal and body language will let you know if you are on the right track or if you need to shift gears and try something new. I do not have a specific massage I use every time, since all women experience the sensations of childbirth differently. Nor are the same techniques used throughout the whole labor. The needs of the mother will change as she moves through her labor, so the type of support you offer will also need to evolve. What feels good in early labor may not work during active labor. Some women may even find that touch is too intense during contractions but welcome in between.

Here are a few techniques to try:

Counter Pressure As the uterus is contracting, residual pain occurs in the lower back and sacrum area. Counter pressure can relieve some of this discomfort. This can be accomplished in a variety of positions: The mother can be on her side, in child’s pose, or leaning against her birth ball or a wall. Apply downward pressure to the sacrum while elongating the lumber (lower back) spine.

Counter Pressure with Heat or Cold The mother may enjoy counter pressure with the added sensation of a hot water bottle or an ice pack.

Double Hip Squeeze Locate the top of the mother’s pelvis (the iliac crest) and from there draw an imaginary line to her tailbone. Along that line, at the center of her upper buttocks, squeeze or press in and upwards during a contraction.

Long Massage Strokes I generally focus on the lower back and stroke upwards towards the mother’s shoulders. Often she has tightened her shoulders, jaw, and neck during contractions, so some time spent on these areas can be beneficial.

Bath or Shower Sometimes human touch can be too much for the mother, in which case the water pressure of a bath or shower may be ideal.

Leg Massage and Foot Massage If the mother has been walking, standing, or squatting a lot, massage can ease some of the fatigue of the legs and feet. I find leg and foot massage especially useful when a mother has opted for an epidural anesthesia, as her legs and feet often get swollen from the increased fluids. Massage can be very helpful to move the fluids which could be pooling in her lower extremities.

Besides the few that I have suggested, there are many different ways to massage your partner and help ease her discomfort during childbirth. Many yoga studios, massage therapists, and childbirth educators offer classes and workshops on partner massage. It could be a fun way for you and your partner to start to explore what may feel good during labor, as well as help alleviate some of the aches and pains of pregnancy.



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