Massage during labour can either be completely relaxing and help speed up the process, or completely irritating and make the whole event last longer. So how do you know if you’re doing it right?Labour massage is very different from the type of massage you would get on a therapy bed and rightly so. During labour a woman needs to relax and switch off her thinking, judgemental brain so her body can feel safe and open up. Massage, when done correctly, will stimulate the body’s natural feel good, relaxation and labour hormone, oxytocin. The keys to making labour massage effective are repetition, a slow steady speed, comfortable pressure and a confident masseuse.Repetition allows the thinking brain to tune out. There’s no thinking of ‘what are they going to do next’ or ‘go back to what you were doing’. If you’ve ever stroked a cat, you’ll know the effects of repetition and a slow and steady speed. Go too fast or keep changing what you’re doing and the cat will stay wide eyed and interested. Keeping a slow and steady pace just stroking down the back will have the cat purring and lying down in no time. Labouring women are the same… slow and steady repetition will have her relaxed very quickly, even through contractions.Labour massage should never be painful. The techniques used must be solely concentrating on relaxation and not trying to dig into tight muscles. If you’ve ever had a sports massage you’ll know what I mean. We tense and hold our breath when we feel pain. Tensing during labour will affect the whole body and make the pain more intense. So, labour massage needs to be inducing relaxation and pleasure to help the woman cope with strong contractions. She will be able to relax and go with her body far more easily if she is being supported in a relaxed and caring way.
Let’s look at a popular technique that I would not recommend; circling up each side of the spine. During a normal massage, this circling technique is lovely to relieve muscle tension but it makes the receiver think ‘ooh that’s a sore bit, I didn’t realise I was tense there… just a bit higher/lower/left a bit/ right a bit’. This is not the dialogue you want a labouring woman having with herself. The same is true for shoulders, hands and feet. What you’re after is repetitive, steady and comfortable techniques that don’t make her think about either helping you (lifting fingers up for you to massage the next one) or what you might do next.
And lastly, the masseuse needs to be confident in what they are doing so lots of practice before the big day is essential. The labouring woman may not want to be touched, or think she does and then change her mind. A confident masseuse will not take this personally. A masseuse who is fearful, stressed or worried will not give as soothing a massage as someone who is relaxed and confident. Having said that, massage is a great way to relax the masseuse too so it may benefit both.
Here are some good techniques I’ve had great results with during the births I’ve attended…
This is a very relaxing and soothing massage stoke. To do effleurage is to stroke up the back from the sacrum using the flats of your hands, around the top of the shoulders and then sweep back down the sides. If done slowly and with a positive pressure (not too hard, not too soft), the recipient will feel totally supported and soothed. Massage oil is needed for this technique unless the woman is sweaty as that will act as a lubricant.
Using oils during labour should be kept to the absolute minimum. Grape seed oil is my favourite as it has very little odour and is absorbed nicely. Sweet almond oil is too thick and greasy for labour massage, as is baby oil.
Using one hand resting on the floor or bed (be careful not to put weight from this hand on the body) use your other hand to slowly stroke down the spine. Start from the base of the neck and keep a continuous stroke going down to the very base of the spine. This is a deeply relaxing technique that can greatly help to reduce blood pressure and anxiety. You may be wanted here for a long time!
During labour a woman’s jaw can become very tight and cause a lot of tension in the rest of her body. Some women may also screw up their faces creating a lot of tension around their eyes and cheeks and also in their scalp. A great way to relieve stress and tension is to gently stroke the labouring woman’s brow, stroking from her brow and through her hair. Using circular movements with the flat pads of your fingers on the temples (light pressure) can help with eyestrain and forehead tension. And likewise, circular moves all along the jaw, right up to near the ears will help the labouring mother’s jaw to loosen. This has a nock on effect to the whole body. If the forehead and jaw loosen, tension can also be released in the stomach and abdominals. Also, a loose mouth means a relaxed pelvic floor (and thus not trying to hold baby in).
Head massage is often deeply relaxing and can help relieve headaches. Practise this technique before the birth to find out what preferences your pregnant partner has. There are two slightly different techniques: rotate the skin of the scalp under the pads of your fingers (move the skin not your fingers), or using circular moves, rub your fingers all over the scalp helping to get the muscles loosened. The former is very relaxing, the latter can also be invigorating depending on how fast and deep you do it. It may be that an invigorating head massage will help a tired woman find the extra energy to birth her baby.
Hands & Feet
When experiencing pain and discomfort, it is a natural reaction to clench the hands and tighten the feet. It’s difficult to tense your hands and no other part of your body. The more you can release tension in the hands and feet, the more tension is relieved in all other areas of the body. Even stroking a hand as you hold it has great benefits. Never underestimate the power of holding someone’s hand, especially if you’re helping them to relax it.
Holding her hand with both your hands you can use the length of your thumbs to loosen up the tension. Using stretching movements outwards on the palm will help ease tension and remind your partner to relax. The slower the moves the more relaxation you will induce. Start from the middle with both thumbs, and move them apart.
For the feet, rubbing the heel of your hand down the sole of the foot (from the balls of the toes to the heel) while support the top of the foot with your free hand will be deeply relaxing and prevent any tickling or pain.
Neck & Shoulders
Massaging the shoulders allowing them to drop down is often much appreciated during labour (and any other time!). You can use as much pressure as is comfortable for your partner. Be careful not to pinch the shoulders causing pain (ask for feedback). And do not over work tight muscles, or dig into them. Ensuring you are using a comfortable pressure will create more relaxation. Remember you’re not trying to do a therapeutic or sports massage, you’re intending to help the birthing woman relax. Use circular movements with your thumbs across the top of the shoulders, your fingers dropping down the front of the body.
When massaging the neck, make sure the head is supported either with the other hand, or by having the birthing woman with her head on a pillow. Have your thumb sweep up one side of the neck and your fingers sweeping up the other side.
Using your effleurage techniques, you can help to relieve tension in the abdominal muscles by very gently stroking a labouring woman’s belly. The uterine muscles are more than capable of squeezing out a baby without the need of the stomach muscles. In fact tensing the stomach muscles can inhibit and slow down labour. By using gentle upward strokes with the whole of your hand, or gentle circular moves up the belly with the pads of your fingers, you can help the abdominal muscles to relax. If the labour has been induced with an oxytocin drip, this technique may be very useful to help a woman’s uterus relax between contractions.
NB Remember not to poke or prod the belly. Gentle pressure is essential.
There are several techniques you can use to help ease back ache (different from back labour pains caused by a posterior baby) and uterine pains.
If sore spots are felt in the sacrum area (if you have been practising your relaxation techniques you will be more aware of locations of pains rather than all over pain), then you can use elbow, knuckle or thumb pressures to help relieve the tension. The pressure must be no more than pleasure pain and hold until the discomfort subsides (which may be a while so make sure you’re comfortable!). Do not press on the spine, but on the muscles around the buttocks and either side of the sacrum. I have found this a very supportive technique for women who have experienced slipped discs or any chronic or acute back pain.
NB the sacrum is part of the pelvis that moves outwards during labour to make more room for the baby. This can be quite painful. It’s important not to put pressure on the sacrum bones themselves during labour as they need to move out (and not be pushed back in). Working either side of the sacrum itself is an effective way to make this process more comfortable.