Labour Massage TherapyTouch During Labour page2

Tools for Labour

Mom’s Coping Strategies During Labour

Tools for Massage

Massage During Labour page 3

Massage Technique

Specific Relief for Back Labour page 5

Reflexology and Acupressure page 5

Six Reflexology Points to Work page 6

Prepare for Labour with Practice

Kegel Exercise page 7

Massage the Perineum

Aromatherapy Massage

Birth Mandala page 8

Massage Therapy for Labour Guide page 9

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Touch During Labour decreases pain and is one of many things a birth coach or partner to the birthing mom has to offer. Touch helps to focus mom’s mental energy. Touch reminds her she is not alone. Touch will encourage relaxation and convey an expression of care and love with the brush of hair from her face, a touch of the jaw to open her mouth and release clenching, a touch between eyes to release tension in forehead, or a hand to her belly to remind her to breath abdominally.

Listen to what mom wants; does she want a heavy hand for more pressure, a light hand, and a still hand touching or holding, slow strokes, or active massage?

When mom doesn’t want to be touched, be close as possible to feel the support security, closeness and love without touch.

Tools for Labour can be anything that will help you cope and adds comfort. Comfort measures will not eliminate all the pain; it will help you manage the pain.

Observe what brings you comfort now and may help you stay comfortable during labour.

Mom’s Coping Strategies During Labour may include any of the following; Movement Position change Breathing techniques Massage therapy

VisualizationsMandalas Fabric with repeating patternsScenes of nature like water ripples

Positive statements Affirmations Prayer Creative imagery

Tools for Massage are most often used on a mother’s lower neck, legs, arms, neck or any part needing pain and discomfort relief. All activity of support is directed by the mom to be.

Hot packs are to be placed on lower belly for cramping, and back of neck for relaxing. Hot increases blood flow, cold decreases blood flow, and both reduce sensations of pain. Avoid heat applications while pregnant. Heat has a negative effect on fetal growth and development. Use cold for muscle spasm relief.

Frozen water bottles have an analgesic effect to painful muscles. Roll bottle on lower back or as directed by mom to be. Mom can use the frozen water bottle alone by leaning against wall with bottle on lower back controlling the pressure. As ice melts you have ice water to sip to keep hydrated.

Round weights of 1 to 8 pounds may be placed where mom wants pressure. Push or roll to increase pressure. Mom leans against wall with weight on lower back controlling pressure.

Tennis ball may be used to roll in small circles on lower back, or placed on floor to roll foot over. Mom leans against wall with ball on lower back controlling pressure and movement.

Knobby ball used as an acupressure stimulator. Roll around mom’s lower back, foot or any body part as directed by mom.

Foam roller can be used on the floor or against a wall to gently relax back muscles.

Massage Vibrator that is used against the sacrum will calm the nerves and the muscles.

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Rebozo is a traditional Mexican shawl. Having the Rebozo wrapped around the belly feels very supportive on an emotional and physical level. The Rebozo is used for abdominal support, pelvic support, massage, rocking, turning posterior babies and breech babies, and support during labour. Use your Rebozo to carry your baby after birth and for decompressing hips after birth.

Great videos on using the Rebozo can be found at this web website. http://www.pregnancy.com.au/birth-choices/active-birth/rebozos-as-a-tool-for-pregnancy-and-labour.shtml

Massage During Labour has a calming effect, decreases pain, reduces anxiety, relaxes muscle tension, increases energy, gives a feeling of increased control to mom and gives mom a feeling of support directly from her partner.

Massage reduces excessive stress hormones such as adrenaline, which are known to decrease and slow contractions or prevent labour from progressing.

Having chosen a body part (arm, neck, back, leg, face, feet, abdomen) to massage as directed by the mom keep in mind to;

Start before active labour. Stay working that body part and continue touch through several contractions. Work with position mom is comfortable in. Changing position every 20 minutes between

contractions, stretching and moving will maintain good circulation. No tickling. Use more pressure until muscle is relaxed, than use a lighter touch. During

contractions; massage should be slow, firm, predictable, rhythmic strokes or stationary compression.

Final strokes when working the limbs are directed towards the body. Mom doesn’t need constant back rubs. The back will get sore and tired during labour. Remain calm. Your touch helps mom feel calm, and more able to cope. Stay focused. Be fully present. Listen to moms needs. Goal is a Relaxed Mom

Massage Techniques used will change from general relaxation to relieve localized painful areas, to stimulation of and supporting labour progression. Effleurage, kneading, pressure, stroking, and rocking will promote relaxation to muscles, decreasing the sensation of pain.

Abdominal Effleurage is helpful to influence babe to position itself correctly. Superficial long strokes from mid belly to side. Stroking the belly will relax the abdominal muscles. Circular strokes with fingertips from pubic area upward will simulate the lifting of uterus that happens in contractions.

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Kneading the Shoulders and Neck with massage strokes that presses rolls and moves the muscle mass to gently release muscle tension. Make a gentle fist and use the knuckles to press the muscles and roll down the neck and top of shoulders. Place hands on top of shoulders and gently press to encourage relaxing and dropping the shoulders. Use your forearm to roll across top of shoulders and across back. Be cautious; add no pressure to the spine.

Contraction Distraction Technique may relieve some labour pain. Create compressions with forearm across lower back from lower ribs to hips. Locate spine with hand and place and hold hand on spine. Use other arm to place elbow close to hand holding and protecting the spine and roll from elbow to forearm to wrist across back. Encourage a pelvic tilt anteriorly. Ask and listen to what mom has to say as to the pressure needed and the place she needs that pressure and how fast or slow you need to move.

Counter Pressure to Sacrum (low back above tailbone) using elbow, knee or knuckle to apply very deep pressure using your body weight on the sacrum. Maintain continuous firm pressure during contraction. DO NOT PRESS ON THE LUMBAR SPINE. Create direct pressure towards tailbone, creating a passive pelvic tilt. Move to other side of sacrum or farther down, towards tailbone, but still remaining on the sacrum. Relief begins when baby has moved farther down.

Pelvic Press / Hip Squeeze This is the most welcome press. Relieves pressure to lumbar, pelvic floor muscles and sacroiliac joint. Apply pressure on both hipbones using both hands to press toward her midline. Hold pressure during each contraction. Try variations of hands and knees pressing. When mom is side lying press hip into bed. Try slow pelvic tilt with pelvic press. Can use the Rebozo to wrap the hip and hold the press for a longer time without getting tired.

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CranioSacral Therapy Pelvic Diaphragm Release and sacrum decompression will relieve long lasting lower back pain caused from strain to pelvic floor muscles or the bones of the sacroiliac joint having been pulled out of position. To do the diaphragm release place one hand on the lower back across the sacrum and the other hand on abdomen below baby belly. Hold this space with the intention of relaxation and opening up of the area. Mom should feel comforted as the area decompresses and opens up.

Cervical and Pelvic Floor Relaxation is closely related to relaxation of the jaw and mouth. Encourage mouth exhalations to prevent jaw clenching in response to pain. Relax masseter and temporalis muscles by encouraging mom to say lower and deeper vocalizations. Use imagery and visualization of a flower bud opening as her cervix easily opens.

Back Labour can be more painful and last longer when the baby is not positioned head down and facing mom’s sacrum. Most babies rotate into delivery position during labour resulting in back labour subsiding. Specific Relief from back labour may come from: WalkingRockingRotating pelvisKneelingAnterior pelvic tiltChange positions 2 to 3 times per hour

Hot or cold shower to sacrumMassage vibrator to sacrumPelvic tilt while on all foursSacrum counter pressureCold pack to sacrumHip squeeze

Firmly stroke from side of abdomen to center of abdomen to shift babyAvoid semi-reclining position for extended periodsLying on side with knees close to chest for 30 to 45 minutes

Reflexology and Acupressure are similar in that pressure is applied to specific points on the body.

Acupressure works with the body’s natural energy flow by stimulating a specific distal point along a chosen meridian line to activate a response from an organ.

Reflexology works by stimulating reflex areas on the feet and or hands that directly affect the organs and muscles of the body.

Using both reflexology and acupressure will speed your labour quickly and naturally reduce labour pain.

Pressure points are naturally sensitive and feel to mom like you are touching a bruise. Use varying pressure to locate points. Mom will indicate the spot that is more sensitive. Use less pressure as indicated by mom if it is especially painful. Not all pressure points work for everyone. Pressure points will wear off

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and you will need to move on to other points or have other options for managing the labour when points are no longer working for you.

DO NOT USE PRESSURE POINTS BEFORE DUE DATE

Six Reflexology points to work:1. Pituitary Make little crosses and circles on the center of big toe for 25 seconds

2. Thyroid Work ball of foot beneath big toe slowly drawing seven lines up from base of ball up to neck of big toe

3. Uterus Inside (medial) ankle between anklebone and back of heel. Make small circles for ten seconds

4. Ovary Outside (lateral) ankle between anklebone and heel. Make small circles for 15 seconds

5. Kidneys & Adrenals Three thumb steps down from ball of foot along the medial side of foot. Using thumbs to make small circles for 25 seconds

6. Spine Along the medial line of foot. Walk press thumb from big toe to ankle bone, turning and taking five small thumb steps up towards ankle bone ending at the dip in front of ankle bone. Thumb walk five times.

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Acupressure points to work. Please refer to charts from, Natural Pain Relief Techniques For Childbirth Using Acupressure. Promoting a Natural Labour and Partner Involvement, by Debra Betts.

GB21 BL32 GB30 SP6 BL60 LI4 BL67 PC6 KI1 LIV3 Hand points

Prepare for Labour with practice, practice, and practice before the day and time arrives. Practice calming relaxation massage in various positions that is comfortable to mom. Be flexible, experimental and improvise for effectiveness.

Practice relaxation exercises. Deep diaphragmatic breathing filling the lungs slowly and exhaling slowly. Focused relaxation and visualization while listening to your chosen music. Helpful imagery of a flower bud opening as her cervix easily opens.

Prepare the body with self-massage to lower ribs, suprapubic attachments of the abdominals and perineum before the due date. Begin self-massage starting at last 6 weeks of third trimester at week 34 of pregnancy.

Kegel Exercises practiced from early pregnancy to strengthen and prepare the pelvic floor muscles. Reduces likelihood of postpartum urinary stress incontinence. Promotes healing of episiotomies, perineal tears, anal and vulva hemorrhoids.

Practice your kegel exercise 100 times throughout every day of pregnancy.

Breathe normally and relax legs, buttocks, and abdomen while you tighten pelvic floor, contracting as though simulating the movement necessary to stop the flow or urine for 5 to 10 seconds. Release contraction to pelvic floor like an elevator descending gradually, proceeding to the basement and bulge the pelvic floor.

Massage the Perineum (skin between the anus and vagina) with olive or vegetable oil to stretch and lubricate/moisturize for increased elasticity and flexibility. Stretch is from vagina towards the anus.

Using gentle firm pressure of thumb or fingers inserted up to first knuckle placed at the base of vagina, massage in U shape along sides and base stretching perineum. Maintain gentle pressure feeling slight stinging, tingling or burning sensation. Sustain pressure for 2 minutes until numbness begins to occur in area. Maintain pressure for 3 more minutes pushing toward anus, apply firm pressure and stroke slowly back and forth.

Massage up to ten minutes daily starting at week 32 through to 4o. Reduces incidence of episiotomy and perineal tears during childbirth.

Avoid urinary opening with perineum massage. No massage if herpes sore or other vaginal problem is present. Resume massage when condition has resolved.

Aromatherapy Massage in early stage labour massage the sacrum and lower back with massage oil blended with lavender and orange to facilitate contractions and promote calmness.

During active labour massage with massage oil blended with lavender, bergamot, chamomile, rose, ylang-ylang to enhance contractions and decrease pain of established labour.

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GENERALLY AVOID ESSENTIAL OIL AROMATHERAPY BEFORE DUE DATE.

Scents have an individual negative or positive emotional effect. Example being lemon often is a reminder of housework and cleaning products.

Be aware of and be cautious for potential allergic reactions. Headaches can be caused with over use. Aromatherapy can be nurturing, comforting and promote sense of well being easing discomfort. With heightened sense of smell during pregnancy it is best to use less; one drop instead of five.

Avoid using the following essential oils in early pregnancy. Especially avoid if there is a history of miscarriage. After the first four weeks of pregnancy use with caution for sensitivity to mom. AngelicaBasilCedar woodClary sage

FennelHyssopJuniper berryMyrrh

NutmegRockroseRosemaryThyme

Use the following oils diluted after first four months of pregnancy.ChamomileLavenderRose

Do not use the following oil throughout pregnancy.Marjoram

The following list of common aromatherapy essential oils might be calming and relaxing.Black pepperBergamotCinnamonEucalyptusGeranium

GingerGrapefruitLemonMandarinPeppermint

SandalwoodTea treeYlang-ylang

Herbal teas are aromatic, relaxing, calming for tummy and mind. Sip ginger, peppermint, and chamomile.

Birth mandalas give support to the visualization of the transitions of the birthing process. Creating your own mandalas creates a personal, visual map for childbirth. An empowering article can be found at

http://mothersadvocate.wordpress.com/2011/10/03/birth-art-the-mandala-journey/

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The following chart, “Massage Therapy for Labor’, from Carole Osborne-Sheets book “Pre and Perinatal Massage Therapy”, is a useful guide of techniques to be used for each stage of labour.

Drumheller Therapeutic Massage ClinicKim Deering, RMTPhone: 403-823-3020Cell: 403-821-0977www.kimdeering.com

Located at Chiropractic Wellness Centre133-3rd Avenue West, Box 1103Drumheller, AB T0J 0Y2

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