What follows is a detailed description of the programme of massage techniques which I devised in response to the woman’s needs.
Specific massage techniques for labor
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The massage techniques used during the first stage of labor are specifically designed to support the woman with her breathing during contractions. The massage is therefore directional, reasonably firm and rhythmic. Back, leg and arm massage is taught together with the optimum positions to facilitate each of these. Hand and foot massage using circular strokes have no relationship to this breathing/relaxation approach and so are not included in this programme.
It is important that the massage is started early in labor so that the couple can get used to working together with the massage and breathing. In the earlier part of the labor the masseur takes the lead from the woman. Likewise when the contractions get stronger and the woman is breathing more quickly, the masseur needs to follow. It is only at the decreasing stage of the contraction that the masseur takes over, slowing down the hand movements so as to help slow the breathing by the end of the contraction and create relaxation.
Circular hip massage
Purpose
This massage is taught primarily for women experiencing back pain during their labor. However, it has also been found to be of use generally during labor.
The firmness and repetition of this movement in the area of discomfort aims primarily to help relieve pain. In addition, women may be more able to regulate their breathing by focusing on the upward and downward strokes of the massage. This can help with relaxation.
The woman has to be in a comfortable, relaxed position; what this is will change throughout the labor. The masseur also has to be in a comfortable position to utilise energy, convey calm and prevent injury.
Either the woman kneels on the floor (or bed) leaning over a chair or against the head of the bed (or wall) and is supported by cushions or pillows. She can also be on all fours. The masseur kneels directly behind, leaving enough room for movement; or the woman stands with legs apart leaning over a table, against the wall or over a bean bag placed on a bed and the masseur sits on a chair or stool directly behind.
Massage
Before the massage begins the masseur warms the base oil in his hands and applies to the area being massaged. Two hands are placed on either side of the spine in the sacral region with the hands pointing in an upward direction and not placed too far under the buttocks. This massage should never be done directly over the spine (Fig 1 & 2).
When the contraction starts the woman is asked to breathe audibly so that the masseur can hear. The massage is essentially extremely simple but needs coordination between the woman and masseur. During inspiration the masseur’s hands go upwards as he leans forward. All pressure and energy comes from the body and is transmitted through the hands, which need to remain flexible and fluid.
The hands massage up to waist level during the inspiration. Then during the start of expiration the fingers on both hands turn inwards and elbows turn outwards to massage outwards across the back to the hips (Fig. 3).
The hands then move smoothly down the sides of the hips until they arrive at the starting position. This is done during expiration. The masseur must perform the whole move smoothly and firmly in time with the breathing and without losing contact with the woman (Fig. 4). These movements continue throughout the contraction.
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