Upper back/shoulder massage
This massage can be performed to facilitate breathing and relaxation. The same technique is used as for the circular hip massage, but using the upper back (Fig. 6).
Sacral pressure massage for labor
This massage can be used in combination with the circular hip massage at the end of the contraction when the hands return to the starting position, or on its own, depending on what the woman finds most useful at the time. It is done in the positions outlined for the circular hip massage and it follows the same principles: the massage is slow, rhythmic, firm and in time with the breathing. The masseur uses the palm of the hand over the sacral area and massages firmly, in a clockwise direction if using the right hand and anticlockwise if using the left hand (Fig. 7). The hand not being used to massage is supporting the woman either on the hip or shoulder (whichever feels more comfortable).
The massage hand should remain flexible and fluid with all the pressure coming through the body.
Some women find this massage very helpful if there is intense backache.
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