Massage in labour

How does massage help relieve pain?

Massage stimulates the body to release endorphins, which are natural pain-killing and mood-lifting substances. Endorphins are responsible for the "feel-good" factor; the "high" you feel after exercise, or a good laugh.

In labour, massage brings you close to the person who is caring for you: your midwife or your birth partner. The touch of someone who wants to help you can be very empowering when you're coping with contractions and are perhaps tired and frightened.

Massage has been shown to ease pain and reduce anxiety in the first stage of labour (NCCWCH 2007: 94-5; Smith et al 2012). It can help you handle your contractions by making them feel less intese and more manageable (Chang et al 2006).

Massage is also linked with shorter labours (Karami et al 2007, Simkin and O’Hara 2002) and a lower risk of postnatal depression (Simkin and O'Hara 2002).

Are massage oils a good idea?

Using oil makes massage easier to carry out and more pleasant to receive. Be careful which oil you choose for labour, however.

Before buying or using an essential oil, consult a properly accredited aromatherapist to make sure you choose one that is safe for pregnancy and labour. Essential oils are powerful substances and can interfere with contractions if used incorrectly. Always dilute essential oils with a carrier oil or base oil.

Try diluting two drops of essential oil with a teaspoon (5ml) of base oil (Tiran 2011a), such as sweet almond or grapeseed. You might want to avoid sweet almond if you have a nut allergy or are worried about nut allergies (Tiran 2011b).

Different oils suit different needs. For example, lavender and clary sage are relaxing and may aid contractions. Bergamot, chamomile, neroli, rose and ylang ylang are relaxing and uplifting (Tiran 2011a). Or you can just use a base oil on its own.

Shoulder massage

During labour, keep your shoulders relaxed, as this will help you breathe rhythmically. Rhythmic breathing maximises the oxygen available to both you and your baby. Massage can help you relax your shoulders and breathe rhythmically.

Your birth partner should place his hands on your shoulders and lean lightly on them. This will help you drop your shoulders if they're already hunched because you've become stressed.

Next he can stroke down from your shoulders to your elbows, maintaining a rhythmical action and applying firm pressure. Tell him whether the massage is helping you and how he could make it better.

He could also try resting his hands on top of your shoulders and using his thumbs to massage in small firm circles behind your shoulder blades. Tell him if he's pressing too hard or not hard enough, or if he's massaging too quickly. It's important for him to avoid frantic massage as this serves only to speed up your breathing when the aim is to slow it down!

Back massage

Many women feel contractions strongly in their lower back, so back massage can be very helpful.

In early labour, your partner can use the flat of his hand to stroke down the side of your spine, from shoulder to bottom. He can then use his other hand to stroke down the other side of your spine, maintaining a rhythmical movement, with one hand constantly in contact with you. These long, slow strokes can be very soothing.

Make sure that he is massaging you using the whole of his hand and not just the heel. His fingers need to be in contact with your body as he tries to respond to the tensions he finds there.

In advanced labour, your birth partner can use the heel of his hand to massage firmly over the base of your spine. He will need to apply quite a lot of pressure to counteract strong contractions. Or he can use his thumbs to make circles over the dimples in your bottom. Tell him what you find most helpful.

Foot massage

Even if you don’t usually like having your feet touched, you may still enjoy a firm, rhythmical foot massage. The massage does need to be firm, however, or it will be unbearably ticklish.

If you find yourself sitting down or in bed for long periods of your labour, foot massage is ideal. Your partner can simply stroke your feet firmly from ankle to toes, or make circles with his thumbs all over the soles of your feet.

You may find that your feet become very cold in labour, and a foot massage will help warm them up.

Hand massage

If you have had an epidural and are lying in bed, shoulder or back massage is difficult. And if you can't feel your feet, there's no point in your partner offering you a foot massage. In these circumstances, hand massage is very soothing.

Your birth partner can simply stroke each hand in turn, first on the back, then on the palm, sweeping firmly down from your wrist to your fingertips. He can make small circles all over your palm, and gently pull each finger in turn to release the tension.

This is a lovely way of being close to each other and making your labour special.

Not all women like massage

If your birth partner is keen to massage you in labour, he may be disappointed if you don't like it. Some women, however, simply can’t bear to be touched when they are having contractions. The contractions are so strong that even the slightest extra stimulus may be more than you can cope with.

Other women find massage so helpful that they want their partners to keep rubbing their backs for hours on end!

Your birth partner needs to be flexible and understand that massage techniques that bring great comfort in early labour may not help later on. Being able to listen, respond to your needs, and not take things personally are key qualities of a good birth partner

Where can my birth partner learn to massage me?

You and your birth partner can practise the massage techniques outlined above at home. Or you may both benefit from having a one-to-one with a massage therapist before you go into labour (MIDIRS 2008: 11).

Some, but not all, antenatal classes offer physical skills, such as positions and massage techniques for you and your birth partner to practise. So check before you book a course.

Check out more ideas for non-medical and complementary therapies for pain relief during labour.