Alternative medicines in labour

Drugs and epidurals not your style? We asked six midwives for their insider tips on which complementary therapies really work in labour

Contrary to popular belief, not all midwives are traditionalists who’ll turn their noses up at your aromatherapy oils and insist on you giving birth flat on your back with your legs in stirrups.

These days, more and more midwives realise the benefits of complementary medicine, and are training as alternative therapists to help women during labour.

We asked six midwives, who also specialise in alternative therapies, for their tips on giving birth naturally.

Massage

Linda Kimber, research midwife at the Horton Maternity Unit, Banbury, Oxfordshire, teaches a massage programme for before, during and after childbirth

‘Touch stimulates the release of oxytocin, the hormone which initiates contractions,’ says Linda. ‘It also releases another chemical, central oxytocin, which we believe helps with pain relief and decreases anxiety.’

Linda teaches a massage programme to couples from 35 weeks of pregnancy. She encourages women to develop slow, rhythmic breathing control and use visualisation techniques, and also teaches partners how to massage the back and limbs, to help mums-to-be relax during labour.

‘According to a study we carried out in 2003, 80% of the women who used massage techniques got by with no pain relief, or just gas and air,’ says Linda.

Linda’s self-help tip

• Get your partner to massage your back slowly in late pregnancy, and practise your breathing to co-ordinate with his touch. When you breathe in, your partner should massage you in an upwards direction. When you breathe out, his hands should work downwards.

For more info… 

• Order the CD A practical guide to childbirth massage techniques (£15.95, Talking Pictures, 01753 655744)

• Visit childbirth-massage.co.uk

Sarah Budd, midwifery sister/acupuncturist at Derriford Hospital, Plymouth, is one of a team of three midwives who have been using acupuncture since 1988

Acupuncture is part of traditional Chinese medicine, based on the principle that energy (qi) flows through the body along invisible channels called meridians.

Needles are inserted into acupoints, specific areas of the body that correspond with a particular organ.

‘Acupuncture in labour works on the endocrine system, which is responsible for producing hormones, including oxytocin – the hormone that makes the uterus contract and also helps with relaxation and pain relief,’ says Sarah.

Half-inch needles are inserted in points in the upper and lower limbs and on the ear during labour. These points correspond to the pelvis and endocrine system, producing the hormones needed for pain relief, relaxation and contractions.

A Swedish study found that 58% of women who had acupuncture managed their deliveries without any other pain relief, compared to only 13% of those who didn’t have acupuncture.

Sarah’s self-help tips

Only a tiny number of NHS midwives are trained in acupuncture, and you can’t administer it yourself. If you can’t afford to hire your own private acupuncturist for labour try some acupressure techniques instead:

• The ‘hand points’ (along the crease of the hands where the fingers join the palm) are thought to help release endorphins – your body’s natural painkillers. Try, gripping a small comb to apply pressure to this point as a contraction builds.

•  For more acupressure techniques for labour, log onto New Zealand acupuncturist Debra Bett’s website: home.clear.net.nz/pages/debra_betts.

For more info…

• Contact the British Acupuncture Council for information on acupuncture and a list of qualified practitioners (acupuncture.org.uk, 0208 735 0400).

Aromatherapy

June Cavin, team midwife at the Southern General Hospital, Glasgow, is one of 25 midwives at the unit trained in aromatherapy techniques

Aromatherapists use essential oils derived from plants. Many have healing properties and can be inhaled or applied to the skin in carrier oil such as grape seed oil.

‘We use lavender and geranium oils in labour, in aromatherapy baths and back massages,’ says June. ‘Lavender is effective for pain relief and has a calming effect, and geranium helps to reduce stress and is very relaxing.’

Anecdotally, aromatherapy has positive effects during labour. ‘Women are very calm, and the intervention rate seems to be lower,’ says June.

June’s self-help tips

• Always consult a trained aromatherapist about using essential oils in pregnancy or labour.

• Mix three drops each of cypress, lavender and geranium with a blob of lubricant like KY Jelly, and use to massage your perineum (the skin between your vagina and anus) if you have stitches or a tear. Cypress has anti-inflammatory properties, reduces swelling and has a cooling effect. Lavender and geranium also promote healing.

For more info…

• Ask your midwife if any staff at your hospital are trained in aromatherapy.

• Contact the International Federation of Professional Aromatherapists on 01455 637987.

Reflexology

Midwife Denise Tiran, director of Expectancy, a consultancy service for pregnant women looking for complementary medical advice, is a qualified reflexologist
Reflexology is based on the theory that reflex points on the feet and hands act as nerve receptors for organs in the body.

It can help start labour, as it stimulates the release of oxytocin, the hormone that triggers contractions. It also helps the body to stay relaxed and calm, and can help with pain control.

‘During labour, there are specific points on the heels of the feet that can help stimulate and strengthen contractions,’ says Denise. ‘Reflexology is also thought to act in a similar way to a TENS machine by intercepting pain messages to the brain. There’s evidence that regular reflexology in late pregnancy can help you cope with pain in labour.’

Denise’s self-help tips

• Heel grasp: Get your partner to grasp your heels in the palms of his hands, fingers on the outside of your foot and thumbs inside. He should apply pressure evenly and squeeze harder as a contraction reaches its peak.

• Chinese burns: Your wrist relates to the nerve endings at the top of the ankle, which in turn relate to your fallopian tubes and reproductive tract. Applying a ‘Chinese burn’ type pressure here stimulates the whole area, and may act as a pain distraction technique too!

For more info…

• Call Expectancy for details of midwives trained in reflexology and other complementary therapies for pregnancy and labour (0845 2301 323)

• To find a qualified reflexologist contact the Association of Reflexologists (0870 567 3320, aor.org.uk)

Hypno-birthing TM

June Poole, a midwife at Jersey Maternity Unit, runs private Hypno-birthing classes for couples

Hypno-birthing is a specific technique for labour, which combines self-hypnosis with breathing, visualisation and relaxation. ‘If you’re frightened, your body produces the hormone adrenaline, which is linked to your “flight or fight” mechanism,’ says June.

‘Blood and oxygen are diverted to the arms and legs and away from the uterus, causing constriction and depriving the muscles of oxygen, which causes pain. Hypno-birthing aims to break the fear/tension/pain cycle.

‘Self-hypnosis is a state of profound relaxation,’ June continues. ‘Far from being “out of it”, you remain fully aware of what is going on and stay in control. Women focus on what they’re doing, and feel physically and emotionally relaxed.

I’ve been a midwife for 29 years, but when I first witnessed a hypno-birth I was blown away – the woman was so calm and enjoyed her labour.’

Research published in the Journal of Family Practice found that on average, hypnosis patients’ labours were three hours shorter than those who had no hypnosis. Another study found 55% of hypnosis patients managed without pain relief, compared to 22% of those who didn’t use hypnosis.

June’s self-help tips

• June advises doing classes to learn the techniques properly, but you can pick up the principles from books and CDs – visit natalhypnotherapy.co.uk.

• Birth Breathing: ‘Rather than pushing before they feel ready, we ask women to visualise their baby gently nudging down the birth canal,’ says June. ‘This shortens the pushing stage and there is less damage to the pelvic floor muscles.’

For more info

• Visit hypnobirthing.co.uk for details of hypno-birthing classes, self help books and CDs

• June Poole teaches five-week courses to groups of four couples for £295. For more details log onto hypnobirthingjersey.com

Homeopathy

Kathleen Thomlinson, is a practising midwife and homeopath at the Southern General Hospital, Glasgow

Homeopathy uses remedies prepared from natural substances to stimulate the body’s own defences and natural forces of recovery. 'The remedies are usually chosen following an in-depth consultation, looking at the person as a whole and how they’re coping with pregnancy, so it’s an individualised treatment,’ says Kathleen.

‘The remedies have never been reported to cause harm, but it’s still important to seek advice from a qualified homeopath, especially if you’re on medication or suffering from any complex or chronic conditions.

‘Homeopathy in labour can help both physically and emotionally,’ adds Kathleen. ‘It can be used to relieve pain and help you cope.'

Homeopathy is used throughout the world as a safe and effective form of medical treatment, and is even available on the NHS. Although some studies have suggested that it has no medical effect, it’s been proven to be more than a placebo in most scientific trials to date.

Kathleen’s self-help tips

• Arnica 30c: Good for coping with exhaustion and for easing pain and bruising after the birth. Take three doses a day for up to three days. Take as soon as labour begins and immediately after your baby is delivered.

• Aconite 30c: Used to ease anxiety if you’re fearful, restless or shocked during labour. Particularly useful for the transitional stage. Take three doses a day for up to three days.

• Belladonna 30c: Useful for women suffering sudden spasmodic pain, particularly in the back and thighs. Dosage as above.

• Chamomilla 30c: Good for unbearable contractions and emotional irritability.

For more info…

• You can buy homeopathic remedies from most chemists and health food stores.

• Find a homeopathically qualified healthcare professional via the British Homeopathic Association (0870 444 3950, trusthomeopathy.org)

Reasons to be cautious…..

• Pethidine can make you sleepy and woozy, so may affect therapies like self-hypnosis, where you need to concentrate

• Arnica should not be used if you have a blood clotting disorder, unless you’re under the guidance of a medically qualified homeopath

• The essential oil clary sage must not be used in pregnancy, as it can trigger contractions. If you use it in labour, you must inform hospital staff – if any of the staff are pregnant you could be putting them at risk.

Finding a specialist midwife

To find out if any complementary therapies are available at the hospital where you are planning to give birth, ask your midwife. If she doesn't know, write to the director of midwifery at the hospital.

According to the Royal College of Midwives, only a small number of NHS midwives are trained in complementary therapies. The chances of being able to guarantee that one of these practitioners will be on duty when you’re in labour are small.

If your hospital doesn’t have any midwives skilled in alternative therapies, you may like to book a private therapist to accompany you in labour. You will need to
check whether this is acceptable with either/both your consultant and/or the director of midwifery, and you may have to sign a legal disclaimer.

Alternatively, your own birth partner could learn the basics of alternative therapies, such as massage and hypnosis, to help you during labour.