Schloss, Aromatherapy, Childbirth Pain article

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Coping with the pain of childbirth by means of:
Reflexology, massage and the use of essential oils
By: Yaffa Kabla (MA)
Nurse, midwife and experienced therapist of natural medicine, rexlexology, aromatherapy and massage of babies and pregnant women.

One of the greatest fears every pregnant woman faces is how to cope with the pain during labour and birth. Even to this day there are people who say that pain is an integral part of birth. “In sorrow will you bring forth children” they say, and ignore the fears of the woman. Today there is a much greater awareness of the pain of childbirth, and also an increase in awareness of the different methods and techniques that women can learn today, especially during preperatory classes for childbirth, in order to ease the pain.

In this article you will find a wide range of techniques that have proved to be particularly helpful - reflexology, massage and the use of essential oils during the birth process,with special awareness of the different stages of birth.

Definition of pain
Pain - an unpleasant sensory experience caused by damage to cells -(destruction, ischemia, pressure, irritation)

Pain of childbirth
The pain is an experience affected by a number of factors. The physical element is very important, and we cannot ignore the emotional and social elements. Pain is the main reason for stress and pressure and requesting help. Childbirth pain is a personal and private stimulation, a pain that only the woman giving birth can feel, The husband/supporting team can neither measure nor experience her pain, but only empathise. The body feels that there is something, some factor disturbing it. This same factor is translated by thought, motivation and emotion.

Characteristics of childbirth pain
The advantage of labour pain is that its duration is limited to a number of hours, and not weeks or months. The pain appears with the start of contractions. It lasts for 30-90 seconds, increases gradually until it reaches a peak and then recedes until there is a pause, in most cases at least 3 – 5 minutes. This pause between contractions allows time to relax, refresh and prepare the body to cope with the next contraction.

In the first stage, the inter-uterine pressure is less than 20-25mm HG and there is no sensation of pain. With the strengthening of the contractions the pressure rises to up to 100mm HG and crosses the pain threshold.

Pain relief during labour is the sole perogative of the woman giving birth and she should not be coerced in any way into taking it.

Coping with pain during labour involves two stages:

Understanding the source of the pain and its passage at each stage of labour.
Learning and practising different pain relieving techniques on a daily basis, to ease the pain at each stage of labour.

The woman is recommended to start preparing her body and her awareness of these stages during her pregnancy (preferably during preparation courses with the help of a coach experienced in different techniques). It is also recommended that she not do this alone, but rather with a partner who is important to her and will continue to support her during labour and birth. Natural medicine offers a wide range of ways in which to ease the pain of childbirth. This article deals with three main techniques.

Different reflexology techniques suitable for childbirth
Massage using different “soft” techniques
The use of essential oils

Reflexology treatment during labour
Reflexology treatment during labour relates to two main elements:

Stages of labour during which the woman………..and they are: length of contraction and length of time between contractions.
Rate of labour (this changes as the labour process progresses)

The techniques used will be either different relaxation techniques such as stroking various reflex points on the top of the foot, for areas such as the uterus, pituatory gland, cervix sphincters and pelvis, techniques which relax and calm the woman, or intensive and powerful techniques which help advance the labour process. Intensive techniques include elements of deeper penetration while manipulating the bones in the foot, working simultaneously on the calves with one hand and the reflex areas of the foot with the other. During treatment, each therapist chooses for herself when and which technique to use in accordance with the woman she is treating. She prepares a series of techniques according to the stage and pace of labour the woman is in. This should be open to adaption during the treatment itself depending on the woman’s condition and needs, so the therapist needs to have a thorough understanding of the different stages of labour, and to be competent in reading the moniter, and to listen to and work with the midwife at every stage.

Massage – “soft” techniques
In natural medicine there is a wide range of massage styles, some of which are not suitable for use during labour. The preferred techniques at this time are a combination of styles such as different types of effleurage on the back and sacrum, thighs, calves etc, elements of Swedish massage and “lumi lumi” style massage on calves, thighs, shoulders and arms. During massage, pay close attention to the woman’s position and to any equipment that she may be attached to.
During labour, the face undergoes a great deal of strain. Massaging the temples, chin and eye area during labour is a wonderful way to relax the woman and reduce stress and aprehension from the pain.

Use of essential oils
Use of essential oils during labour/birth must be done with great care. As the woman is very sensitive to smells during labour it is not recommended to use a lot of essential oils or oils that have a very strong aroma. The preferred oils to use during labour are: lavander (either diluted in a base oil for massage, or in a burner), essential oil of orange, and sometimes it is worthwhile to use essential oil of jasmine. The use of essential oils is recommended during certain stages of labour only. You must be aware of the potency of the oils, and match them to the different stages of labour.

The choice of a suitable treatment to use during labour from amongst the different techniques of reflexology, massage or the use of essential oils (or a combination of the above), can only be made during the labour process itself, and is based on a number of criteria: the stage of labour that the woman is in, strength of the pain, duration of labour, amount of suffering and rate of progress.

During labour, the pain marks the start of the process, and later on, according to the strength and characteristics (frequency, duration and strength of pressure), the pain marks the progress of the birth process.

First stage of labour
The physical sources of labour pain are contractions of the womb and the dilating of the neck of the cervix. When the uterus is not relaxed enough between contractions, and not enough oxygen reaches the muscles, the pain level increases. The woman usually describes it as a back pain, especially the lower back, or sometimes as similar to menstrual cramps, or pains in the lower abdomen. Sometimes, but less commonly as pain in the leg, knee or groin.

Latent stage
The pain is still peripheral. At this point it is worth helping with:
Movement – rocking the pelvis.
Reflexology – techniques include stroking and calming only, gentle stroking massage of the calves, methods that focus on pain relief. It is not recommended to use active or manipulation techniques.
General massage – this can be done with the woman lying on her left side, or sitting. The massage is done over the whole back, using the palm of the hand (lumi lumi massage can help).
The aim of the massage is to calm the woman and bring relaxation

Use of essential oils – use gentle oils. Lavander is recommended (in a burner, or diluted for massage), or orange (one drop only in a glass of water)

Active stage
When the pain reaches the spinal cord, the strength of the pain reaches a new level. At this point the treatment will be:

Rexflexology – different techniques whose purpose is to advance labour. Careful attention must be given to the woman at this stage, it may be necessary to get her to lie on her side, or to sit up.
It is worthwhile to incorporate breathing excercises during the reflexology treatment, the therapist can guide the woman through these. Between contractions the treatment will be a gentle and calming stroking of the legs and feet.
It is important to combine different massage techniques. The areas the woman most frequently requests are, shoulders, thighs and especially the sacrum. Sometimes it seems as if the stronger the pain becomes the firmer the massage the woman requests - during contractions.
Massaging the sacral area is special and different from massage in other areas of the body. In the sacral area it is important to pay attention to the direction of the massage, which changes in different situations such as: the appearance of contractions and their abating, with the progress of the labour process, or if there is a delay of any kind in the process, or with the advance of the baby’s head in the birth canal. The massage techniques themselves change according to these different situations.
The woman usually finds relief through gentle rocking techniques, whether they are carried out while she is lying on her side, or sitting up, you can combine rocking of her legs, or her pelvis and thighs.
When chosing which side the woman will lie on and the type of rocking to use, attention must be paid to the position of the paby’s head in the pelvis and must be done with the cooperation of the attending team.

At this point the use of essential oils is not recommended.

Plateau stage, and second stage of labour
The source of pain is pressure on the perineum, which steadily increases and concentrates in the pelvis. Other sources of pain at this stage are: dilation of the vagina and vulva, and contraction of the uterus muscles. Some women notice pain in the perineum, and others complain of an uncomfortable feeling of needing to urinate or defecate even though there is no actual need. These feelings announce that the birth is near.

At this point it is worth treating with – reflexology using active and strong techniques, massage – using different techniques to suit the different situations in the labour process. Essential oil of orange can help (one drop only in a glass of water), let the woman moisten her lips and/or inhale it with every contraction.

Third stage of labour
The pain is caused by contractions of the uterus, tears and splits in the birth canal, and/or epesiotomy. This stage is usually short, the recommended treatment is gentle, calming massage of the calves together with coordinated reflexology which encourage contractions of the uterus.