Author: Debby Smith, Licensed Massage and Body Work Therapist
The use of massage during labor is nothing new. Many tribal cultures throughout the world have traditionally incorporated massage into the birthing process. Nurturing touch during labor has been shown to enhance the laboring woman’s mood and ability to cope with labor. In 1997 the Touch Research Institute at the University of Miami conducted a study and on the effects of massage during labor. Researchers found that women who received massage during labor experienced decreased levels of anxiety and pain. They needed less medication and their labors were shorter than those of the control group, who received only obstetrical care.
The onset of labor in preparation for birth is an intricate series of hormonal signals and interactions. It is believed that the baby is responsible for initiating labor with the mother’s hormones taking over to ensure that labor continues to progress. Two important labor hormones, epinephrine and norepinephrine stimulate uterine muscles to contract. Anxiety in the laboring woman overstimulates the production of both of these hormones, resulting in slow, ineffectual and painful labor. A relaxed woman’s hormone levels are more balanced allowing the uterus to be more effective in responding to the body’s hormonal signals. In addition to traditional therapeutic massage techniques, Acupressure and reflexology can also be used to help balance hormone levels and stimulate the uterus. The result is contractions that are strong, rhythmic and effective. Body positioning is also important in encouraging the progression of labor. Standing, squatting and sitting are positions that maximize the use of gravity for the laboring woman, and help open up the pelvis in preparation for birth. However, with the use of epidural anesthesia, the laboring woman loses the ability to utilize these various birthing positions.
If a woman desires to birth naturally, without the use of pain medication, how does she endure the pain that accompanies labor? Massage serves as a distraction to labor and contraction pain. It is believed that flooding the brain with pleasurable sensations will help to override pain signals from the uterus. Massage can be very effective between and during contractions. Acupressure points can be utilized during contractions to decrease the level of pain. The time between contractions can be used to massage tired, clenched and cramping muscles. Managing pain during labor decreases the need for epidural anesthesia and therefore the need for later medical intervention.
Epidural anesthesia administered during the early stages of labor doubles the likelihood of a cesarean section. Because massage during labor has been shown to decrease the need for epidural anesthesia, it may also aid in preventing an unnecessary cesarean section birth. Epidurals also decrease the pushing sensation during delivery and therefore the use of forceps and vacuum extraction becomes more likely.
If a cesarean birth is deemed medically necessary prior to the onset of labor, massage can also be beneficial in preparing for the event. The days and weeks prior to surgery may be filled with stress, anxiety and fear of not knowing what to expect. Massage can play a very important role in helping moms cope with these emotions and help in gaining a sense of empowerment.
Massage for the laboring mother can be performed by a massage therapist or by the woman’s partner. Partners can consult with their massage therapist prior to the onset of labor and then use the learned techniques from the moment labor begins up to the time of delivery. It is important to remember that a laboring woman’s response to touch is unpredictable and may change at any time throughout labor. Open and honest communication with the therapist or partner is essential during the entire laboring process.
Osborne-Sheets, Carole., Pre-and Perinatal Massage Therapy, Body Therapy Associates, San Diego, CA, 1998.
Stillerman, Elaine, LMT, Mother Massage, Dell, New York, NY, 1992.
Field, T., Ph.D.; et al., “Labor Pain is Reduced by Massage Therapy,”Journal of Psychosomatic Obstetrics and Gynecology, Vol. 20, Dec 1997