Reflexology during labour

Working successfully with fertility reflexology has meant that I have often continued to treat clients during pregnancy as they have enjoyed their treatments and wish to continue the feel good factor. This has also led to the opportunity of working with clients during labour, a real honour and privilege. Whilst there have been quite a few missed opportunities, I am pleased to say that I have managed to attend stage 1 labour on a number of occasions.

I gave birth to my children over 25 years ago and I can still remember the faces of the midwives involved, this just goes to show the important part played by anyone who works with mothers during childbirth. I would say women are at their most vulnerable during labour, which is why it is so important that everything is right for this very special occasion. Nature has put in an understandable proviso in the name of preservation of life, so that when a woman gets agitated or extremely stressed her contractions and labour will halt until things settle and she is calmer.

Before a woman goes into labour many physical changes take place; in the final weeks there are hormones released that will soften the cervix, as well as the ligaments between the bones allowing the baby to move lower down into the pelvis, this is referred to as the head being engaged, assuming that the baby is the correct way around of course. Pre-labour contractions may have taken place, these are irregular and are often referred to as Braxton-Hicks, this is the body preparing itself and are typically experienced as tightening around the abdomen but often without pain. Some women are aware of the mucous plug that has been in the cervix throughout the pregnancy coming away as the cervix softens, others will experience a rupturing of membranes as their waters break. These are all signs that the body is readying itself for labour.

Towards the end of the pregnancy things will often start to get very uncomfortable and once a woman has gone past her due date, things can start to get very tedious with every extra day feeling a week long. Women will often have to control their response to questions such as ‘are you still here’ from friends and neighbours as they waddle down the road. This is the stage where women will try all sorts of methods in desperation to instigate labour.

Some of the methods I have been told my clients have either tried or been suggested that they try to induce labour are uncomfortable and unwelcome. But after nine months that feel like an eternity, women could be persuaded to do anything to get the baby delivered and into their arms - if only to put them down for a while rather than carry what begins to feel like a ton of extra weight. These suggestions have ranged from castor oil, a vegetable oil made from the castor bean which most definitely causes muscle cramps, pain, discomfort and diarrhea but does not always result in labour, right through to eating spicy foods, drinking raspberry leaf or cumin tea as well as the more physical alternatives of sex, exercise and nipple stimulation!

However, this is when the services of complementary therapists can come be very helpful. I myself have had a few opportunities where clients have asked for a treatment as they want the baby to come now. Sometimes because they were nearing the date set for induction (usually two weeks past their due date depending on whether or not there are any other health considerations), or because they were paying rent on a water bed that needed to be returned imminently!

I truly believe that a baby will come only when both the woman’s body and the baby are ready for this to happen. Certainly, in my experience, reflexology may help support the body with the changes in order for labour to occur, and often midwives have reported reflexology will speed up the second and third stages of labour. But it has also been my experience that if the baby is not ready for moving – the baby will not move.

As you are probably aware, a mother in labour has an absolute right to decide where the baby is born, as well as who attends the occasion and anyone acting against these wishes may be sued for assault. In real terms this means if a woman decides she would like a complementary therapist to assist in the birth, whether that be at home or in hospital, this is her right. That said, I think it is important to stress that if as therapists we do attend we should act as complementary to procedures and not get in the way of any medical professional, and most certainly get out of the way at crucial points in the procedure.

As there is no written constitution in this country, in common law a woman can have her baby wherever she wishes, although medical practitioners often seem to prefer a controlled hospital environment especially with a first baby. It is still the right of the woman to state where she would like her baby born, whether that be outside of her catchment area or at home. This seems to be becoming increasingly difficult as more and more pressure is placed for the baby to be born in a hospital environment.

Home vs Hospital

According to the Office of National Statistics, the majority of births in this country occur in hospital as only 2.3% of women in the UK and Wales give birth at home, a figure that has remained unchanged since 2012. This seems a peculiarly low figure to me since many women I speak to would like the birth to be what they deem as natural i.e. not having to go to hospital as if they were ill or suffering with anything other than what is completely normal and natural. It may even demonstrate that many women are talked out of a home birth, possibly as a result of staffing issues and logistics, as one overworked midwife can care for a number of women in a hospital environment, whereas for a home birth there needs to be one midwife present during labour and two during the birth. This protocol for home births is in order to avoid any one person having to make a decision alone which is an eventuality that would never occur in a hospital setting.

Doing a little research myself I have had very mixed feedback depending on who I spoke to, as well as what London Borough I was in. My findings were that often women say they are almost ‘frightened’ into having their baby in hospital. In one instance, a woman was told everything was normal and when she then decided she would like a home birth was told she was a risk factor and so this was not an option.

I have also spoken to many midwives who feel that women are best giving birth at home, as they are more relaxed and so the labour will often be smoother as they are in their own environment. These midwives went on to say that they would always encourage women who express an interest in a home birth wherever possible. Like most things, this is probably a bit of a postcode lottery which is a shame as the most important moment in a woman’s life should be a matter of her choice, rather than be based on availability of resources and dependent on where she lives.

Many women may be unaware that they are allowed control over circumstances during labour including deciding who they can have present, even to the extent that if a woman decides she doesn’t want a midwife present she can ask her to leave. I have spoken to a few midwives who have had to wait outside the door whilst the woman gives birth. I only make this point as it is important for women to realise that women in labour should feel in control at all times, at a time when typically everything feels a little out of control!

The birth of a baby should be in an environment of the mothers choosing during one of the most profoundly moving life events. The law defines the role of a midwife and states that delivery of babies should be done by qualified midwives. This ensures that no one can set up and call themselves a midwife unless they are qualified to do so as midwives need to adhere to statutory regulation, this also applies to Doctors. The only difference being that a doctor can refuse to attend labour and a midwife cannot; if a midwife is for any reason not able to attend she would need to get another midwife to cover for her. It is probably worth adding here that in a situation of emergency delivery anyone can help and support as necessary.

Nowadays, many women are opting for more natural birth plans in an attempt to reduce the amount of pain relief and there is evidence to show that this can work successfully. Water births are increasingly common, whether that be from getting into a shower or a bath/birth pool, as it is believed this helps with the management of pain from contractions. According to the Care Quality Commission (CQC) in 2013 about 30% of women giving birth in England elected to use water for coping with pain during labour, with about 6% remaining in the water to give birth.

Research supports use of complementary therapies during labour

There is also research which demonstrates that complementary therapies are of benefit in labour. In 2015 Dr Kate M Levett et al evaluated the effect of an antenatal integrative medicine education programme in Sydney, Australia. This research concluded that complementary therapies for a labour and birth study protocol significantly reduced epidural use and caesarean section, providing evidence for integrative medicine as an effective adjunct to antenatal education.

There is also evidence to show that 11 out of 14 women experiencing retention of the placenta after giving birth avoided any intervention as a direct result of foot reflexology. The same research showed that new mothers who received reflexology, initiated lactation in 43.47 hours (+12.39 hours) in comparison to the control group average of 66.97 hours (+28.16 hours). At 72 hours satisfactory lactation was documented in 98% of the foot reflexology group and 67% of the control group.

I have worked with somewhere in excess of 50 clients who lived relatively locally many of whom came for fertility reflexology treatments and became pregnant. I always offered my services to go give reflexology treatment whilst they were in labour, primarily to gain experience for myself and have been privileged enough to have been invited on a few occasions. On these occasions I have experienced evidence of some of these conclusions myself. I have definitely witnessed a lessened sensation of pain of contractions and often women will say that they are less aware of the contraction as their focus is somehow moved to the treatment of their feet. I have also been able to treat baby shortly after birth resulting in a calm and happy baby that is able to make the huge adaptation to life outside the womb.

An interesting case study on pain relief

I would like to finish this blog with an interesting occurrence that happened the last time I was present during stage 1 labour. My client had begun having contractions and had called me to come to give her a treatment. She was very laid back as this was her second child and she had previously been labouring for days and therefore wasn’t expecting the arrival of baby number two to be imminent. When I arrived she was having painful contractions but they were not very regular at this point. One thing to notice when you are treating a woman who is either in labour or about to go into labour is a very distinct change of…. Energy. This would be the only way I could describe it. Also the feet change in texture and often in colour too. At this time, I began with my maternity labour treatment and focused on the diaphragm line and solar plexus to bring about deep breathing and a feeling of calm by instigating the parasympathetic nervous system. I also included hip opening movements, these movements should never be used on a pregnant client until they reach their due date. As time went on I was aware that things were progressing quite quickly and so I incorporated the endocrine system as part of the treatment as well as the lungs to aid breathing and lower back and abdomen to ease pressure in this area. Now, here is the thing, whilst my client was feeling the pain of a contraction I treated the adrenal gland on the right foot as I did this she looked at me with a strange expression in her eye and asked what I was doing. I explained that I was treating her endocrine system in order to allow it to function more efficiently and she explained that when I touched that point on her foot she could no longer feel the contraction pain. During the next contraction I treated the adrenal gland on her left foot but this did not have the same effect at all; the pain relief was only felt whilst I was treating her right foot. As reflexologists we know that right and left foot have different meanings whether that be male/female or physical/emotional to name but two; so I wonder which applied in this case? At this point I would like to add that Mum went on to give birth to a gorgeous bouncing boy that evening. So now my next venture is to attend labour with a new mum who is having a baby girl to see if the opposite is true!

At Complementary Health Professionals, I offer a one day workshop in fertility reflexology as well as maternity reflexology training (in conjunction with a qualified midwife). I am also the personal tutor on the professional reflexology diploma course. For more information and course dates visit the website: http://www.complementaryhealthprofessionals.co.uk/cpd

References

Office of National Statistics 2015 Birth Characteristics in England and Wales http://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/bulletins/birthcharacteristicsinenglandandwales/2015 <accessed 25/11/16>

Levett KM et al 2015 Complementary therapies for labour and birth study: a randomised controlled trial of antenatal integrative medicine for pain management in labour

http://bmjopen.bmj.com/content/6/7/e010691.full <accessed 25/11/16>

Pregnancy Reflexology Benefits – Clinical Studies Research

http://www.baby-bumps.net/pregnancy-reflexology/research <accessed 25/11/16>

Images

Mother in labour image courtesy of www.babycenter.in

http://www.babycenter.in/c511/labour <accessed 25/11/16>

Water Birth image courtesy of www.babycentre.co.uk

http://www.babycentre.co.uk/l25005439/water-birth-photos <accessed 25/11/16>

Mother and newborn baby image courtesy of National Institute of Clinical Excellence

https://www.nice.org.uk/news/article/women-in-established-labour-should-receive-one-to-one-care <accessed 25/11/16>