One of the most common complaints in labor is back labor. Back labor is typically caused by a baby not being in the most ideal position for delivery.
I will discuss different presentation positions and cardinal movements in future posts so I’ll be very basic here. The most ideal presentation of the baby at delivery is left occiput anterior (LOA). The baby is head down, back facing the left side of mom’s belly, and face toward the right hip. This position allows for the baby to curve along the mother’s belly rather than against her hard spine. It also allows the head to present with the smallest diameter through the birth canal.
In the case of back labor, the baby is usually presenting in a posterior manner rather than an anterior. This can slow down labor and increase back pain significantly. Unfortunately for my mother, this is the way I decided to come into this world.
Even if your baby is presenting in the best possible position, you may experience pressure and discomfort as your ligaments relax and your pelvis opens wider. Counter-pressure is a favorite comfort measure for mothers when experiencing back labor or other labor pain.
What is counter pressure?
According to Birthing Naturally, counter-pressure is “direct pressure applied gradually and steadily over boney areas of the body.” It is not like acupressure that covers a small area or like massage where the pressure is moved. Rather, counter-pressure is a continuous and firm pressure that typically covers an area about the width of the palm of your hand.
As the baby descends into the pelvis, he presses against mom’s bones of her pelvis or, in the case of a posterior baby, against her spine and sacrum. Counter-pressure is applied by pressing against those bones to alleviate the pain cause by bones being pressed out of their natural position.
Counter-pressure may also aid in the rotation of the baby into a more optimum position. As the mother’s pain is relieved, she will release the tension she has been holding with her muscles. This may allow the body to relax more and allow the pelvis to open wider giving the baby more room to move into a better position. Helping mom to relax and be more comfortable can increase her production of oxytocin, in turn, speeding up her labor.
How to perform counter pressure?
One of the favorite counter-pressure techniques is sacral pressure. This is typically performed while mom is on hands and knees or leaning over a chair or bed. A doula, the father, or another labor support person places the palm of their hand on the sacral area and presses firmly. The mother will let the person pressing know if she needs more or less pressure and if the location is correct. Typically as labor progresses and the baby moves deeper into the pelvis, the mother will want the counter-pressure lower.
Another popular request is the hip-squeeze. This is performed by pressing on each side of the pelvis. This is usually a better job for the father since men typically have more upper body strength than women. An alternative to performing the hip-squeeze is to use a rebozo or scarf tied tightly around the hips. This site is very informative about how to use a rebozo to assist with the hip-squeeze.
Counter pressure against the knees while the mom is sitting helps ease lower back pain as well. The mom sits in a chair while the doula or husband kneels in front of her. Placing a palm on each knee, she/he presses her legs straight back. This releases some of the pressure in her pelvis and hips.
Counter pressure is a great and free way to combat some of the discomfort of labor. It is best to have two people assisting a mother when she desires counter pressure. The doula may be able to offer counter pressure behind a woman while the husband holds his wife’s hand or strokes her face while telling her how proud he is of her. When one of them gets tired, they can switch. The husband can offer a hip squeeze while the doula helps mom have a snack or get something to drink or offer her encouragement and assurance that everything is progressing normally and that she is a rock star.
If you are in the Denton, TX area and are interested in hiring a doula for your birth experience, contact me today to schedule a free consultation. If you are interested in learning about more comfort measures in labor, check out my Comfort Measures page.
Feature Image: This work, “Comfort Measures in Labor: Counter-Pressure,” is a derivative of “Радуем вместе со Студией” by BeGreen_Studio used under CC BY 2.0 This work is licensed under CC BY 2.0 by Pillar of Strength Doula Services.