A support person who is ready to follow your lead but who can be assertive and encouraging when the time is right is a great help. Most of the time, the support person’s job is to follow the mother’s lead – talking when she needs a soothing voice, massaging her back when she asks, wiping her forehead with a cool cloth, and responding to the changing moods and needs of labour.
For most women, however, there are intense times in labour when it’s difficult to know exactly what you want, or to remember any of the comfort measures you practised. This is the time when the support person can take the lead and make suggestions for comfort measures or position changes, remind mom to keep breathing, and assure her she’s doing a great job.
| If you are the support person… Be comfortable with laboring noises Some women will be very vocal during their labour and that is what is right for them. A woman who is making rhythmic noises and who is moving around during her contractions is not necessarily in great distress. In fact, a woman who follows her body’s cues to get into certain positions, breathe in certain patterns, or make certain sounds, is working well with her body as it goes through labour. |
Giving a massage
Your support person can help you relax by putting their hands on your body. The approach can be as simple as touching your tense muscles with warm, comforting hands and saying, “Relax into my hands.”
Your support person can also give you a massage. Massage is very helpful in distracting you from the pain of uterine contractions. Massage will help you release tension in parts of your body that do not need to be tense, and it can be a wonderful way for a partner to feel included in the labour process.
Instructions for the labouring woman
Sit sideways in a chair or straddle a chair facing over the back so your support person can have clear access to your shoulders, back, buttocks and thighs. If facing over the back of a chair, you may want to place a pillow over the back for greater comfort. This will be a good opportunity for you to practice your body/breath connection while you relax and enjoy the massage. Remember your support person cannot read your mind, so if they are doing something you don’t like, let them know. It is also rewarding for them to feel like they are being helpful, so be sure to praise their efforts.
Instructions for your support person
There are two things you need to remember no matter what kind of a massage you are giving or what technique you are using: pressure and tempo. It is important to do the massage as firmly or delicately as she would like. The only way to know this is to ask as you are doing it, “How is this pressure for you? Is this pressure okay?” Use the same approach for tempo. Ask what she likes best, but make sure you do not move so quickly that it causes her to speed up her breathing pattern.
Massage techniques
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With the labouring woman seated, step behind her and place your hands on the tops of her shoulders with thumbs ready to massage the small muscles at the base of her neck. Begin by using your thumbs in a rythmic motion, as if to knead these two muscles. Remember pressure and tempo, so be sure to ask her how it feels.
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Slide your hands to the outside of her shoulders and gently (if that is the pressure she desires) squeeze her shoulders when she inhales and release when she exhales. This can be hard to coordinate at first so be patient. With practice you will get it! Continue sliding your hands all the way down her arms to her wrists, gently squeezing to her inhale and releasing with her exhale, pausing a few times in each spot. It may take a minute or more to travel from the top of her shoulders to her wrists. This massage might take the entire contraction to complete. Speed is not the point of the exercise. The point is to help distract her by the rhythmic movement of your touch on her skin.
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At this point, or perhaps before now, you will need to come around to face her. Be sure you stay as comfortable as possible when you are comforting her, otherwise you may be suffering from a sore back when you meet this darling new baby! If she is sitting, kneel in front of her and take one of her hands in yours. Do not make her move her hand to you. It is your job to reach for it, slowly and gently. Apply even pressure to her hand with both of your hands, one on top of her hand and the other underneath her palm. This will stimulate the receptors in the palms of her hands that release endorphins, the ‘feel good’ hormones. Hold this pressure steady for about a minute, or the duration of the contraction. Repeat on the other hand and on both feet so she feels evened out.
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Another great hand massage is taking her one hand in yours and opening her hand so that you can slowly ‘walk’ through her palm with your thumbs. Again, as in everything you do with massage, pressure and tempo are crucial.
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When finished with the palm of her hand, you can start to ‘milk’ each finger. Do this by starting at the base of her finger (where it connects to her hand) and gently squeezing it all the way to the fingertip. Do each finger one at a time, as well as the thumb. When you are finished, put her hand back gently and move to the other hand.
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Have the labouring woman sit sideways in a chair or straddle a chair facing over the back so you have clear access to her shoulders, back, buttocks, and thighs. Rest your hands on the top of her shoulders. Remember the two basic rules of massage, pressure and tempo. Begin by using the heels of your hands as the points of pressure and just let your fingers drag. Move your hands down a path from the base of her neck and down along both sides of her spine. When you get to her lower back, start again, or proceed by pushing all through her buttocks and then along the tops of her legs and ending at her knees.
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If you finish at her lower back or her knees or another spot, remove only one hand from the massage and place it at the top before removing the second hand. This way, you will not break the flow of the massage. This is an important aspect of any massage!
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Another great back massage is to use the same pathway, but instead of the heel of your hands with your fingers dragging, use your fingertips. Use two or three fingers on each hand and make little circles, progressing from her neck to her lower back. It is very easy to get carried away with this one, especially if the labouring women is in intense labour and needs a great deal of support. Remember your massage strategies; pressure and tempo! When you are doing these circles on her buttocks, it will probably be more helpful to use your fists instead of your fingertips (turn your rings so you do not poke her with them).