My first time in the delivery room, when I helped two mothers birth their babies, was an amazing experience, which I will never forget.
The Use of Reflexology in Childbirth
By Moshe Kruchik
Being a Reflexologist in the birthing room is so different from normal practice, where client has a treatment, probably once a week, and the results happen over a period. Here, the practice is intensive, it can take more hours than you can imagine, in constant attendance, and the results are immediate.
It was some years ago, before I relocated to Denmark, that I practiced as a Childbirth Therapist (Doula) at the Meir Hospital in Kfar Saba in Israel, assisting mothers during birth.
This experience was the first of a special course for experienced touch therapists, with an accent on Shiatsu and Chinese Medicine, but not particularly Reflexology. Much emphasis was put on stimulating the meridians, and this for me, was a great breakthrough in my understanding of Reflexology and the process of birth.
The first consideration when coming to the birthing room is that our task is to help the mother have her baby in the most effective way possible. This means to help her in relieving pain, inducing her to relax, regulating contractions, inducing labour when necessary and facilitating an effective response of her body.
In Israel, where I reside and work, most of the women come to the birthing room with an idea of how the labour will proceed:
Induction - Monitor - Epidural Anesthesia.
The great majority of women in Israel have their babies in what is called "conventional labour", which in almost all the cases will have at least one of the above elements, and in many cases, all three. The use of touch therapies in the birthing room can advocate awareness about the advantages of the active birth and reduce the dependence on chemicals or technology.
The use or Reflexology in labour was very rare some years ago as only a few practitioners all over the world used Reflexology as a stimulating tool. However, the popularity of Reflexology in the maternity process is fortunately growing. The medical staff should be interested in the use of Reflexology as in other touch therapies. Results, when applied properly, are simply extraordinary.
The fact that almost every woman I treated at the beginning was connected to a monitor was certainly an advantage, because it gave me a way to measure the effectiveness of the treatment in real time. A Monitor is a device that measures mainly three important things:
- First, the intra-uterine pressure, giving an idea of intensiveness of the contractions and accurately measuring their periodicity.
- Second, the baby pulse
- Third, the mothers blood pressure.
It also has a speaker, which reproduces the baby heartbeat.
The monitor allowed me to measure the positive and immediate effect of specific purposes:
- Provoking or stimulating induction. Regulating or sedating contractions. Other very important processes in which Reflexology worked wonderfully, were however impossible to measure by the monitor:
- Stimulating intestinal evacuation, as a way to facilitate further contractions.
- Stimulating urinary evacuation, as a way to release pressure over the uterus and to widen the birth channel.
- Helping to regulate body temperature.
- Releasing back pain, especially lower back pain.
- Stimulating the uterus to expel the placenta after the birth.
The use and the abuse of chemical induction in labour
The chemical induction in labour is very common, at least in Israel.
Protocols admit the necessary use of Pitocin when the baby or the mother is in danger. Risky situations must be avoided, for example, when the baby's pulse slows down or when the mother's blood pressure rises. These situations can very much complicate the development of birth and the medical staff must act quickly.
However, there is a certain abuse of this permission, and Pitocin is given in many cases when the mother has not been granted with the possibility of trying natural methods to induce labour.
A drug called Pitocin is given, whose synthetic formula replaces the natural hormone Oxytocine, which is released by the pituitary gland and works as a positive feedback, provoking the contraction of the uterus. When Pitocin is administrated, a fixed dose of the hormone is released into the bloodstream, provoking an immediate response in the pituitary, which releases great amounts of Oxytocine, causing generally uncontrolled and often very painful contractions. Depending on the dose given, the body is usually unable to control the hormone, contractions become stronger and the pain is in many cases so hard, that it doesn't take long before the mother demands Epidural anesthesia. This can often interrupt the active birth process as the woman doesn't feel the need to push and labour is retarded. In an active birth, the hormones are released gradually according to the body's needs.
When it was suggested by the midwives to stimulate contractions with Reflexology, the results were so effective that the whole birth was definitely a less painful experience, not only because the contractions were natural and controlled by the body, but because it saved hours or worthless suffering, making it shorter than expected. Considering the intensiveness of pain during labour, saving some hours of pain to the mother is of great importance.
Several months after my first birth as a qualified therapist, I treated a young lady who wanted to have her baby naturally, without monitor, induction nor anesthesia. After 14 hours of having released the amniotic liquid, she was only two cm dilated and was only having weak contractions every eight minutes. In other words, she was not in labour.
The doctor in charge of the birth ordered Pitocin to be administered to provoke induction. She was asthmatic, and she would probably have strong contractions, however, after a short period she would probably have breathing difficulties. Considering that she would need to help the labour progress with correct breathing exercises in the later stage, I asked the doctor to postpone the administration of Pitocin for at least one hour to see how her body reacted to Reflexology. He fortunately agreed, and after one hour of stimulating contractions with Reflexology, dilatation was four cm and contractions were every three minutes. There was no further need to administrate Pitocin, nor either Epidural anesthesia. From that moment, many doctors recognized that Reflexology could be an excellent option when considering induction.
We have to understand that pain is positive when the mother-to-be is able to deal with it and when she can work with it. Pushing and breathing correctly are not only excellent exercises to stimulate labour, but also the body instinctive response to pain makes them a necessary step in the expelling process. When there are contractions, and because of the contractions, there is dilatation, then contractions are effective. When there are contractions without further dilatation, we only have worthless pain.
During labour, the midwife checks dilatation once or twice every hour, depending on the stage of the birth. The standards for good dilatation are 1 cm every hour. When giving Reflexology to stimulate contractions, further dilatation happened in 75% of the cases with an average rate of 1,5 cm every hour. In the remaining 25 %, was never less than the standard.
In those cases in which there is much pain and strong contractions without dilatation, it is worthwhile reducing the intensiveness of the contractions allowing the mother-to-be to relax and conserve energies. It is possible to do this by working very gently on the uterus reflex and the lower spine reflexes.
My experience was that Reflexology is an excellent tool used during labour, not only because its effectiveness, but also because it is pleasant, friendly and non invasive. The mothers' predisposition and attitude to labour had a positive response in a great majority of the cases. After the birth, those women were positive that they would have Reflexology and touch therapies the next time.
The midwives would give an intuitive but logical forecast on the length of delivery based on a number of parameters: age, number of previous births, dilation, timing of contractions, releases of amniotic fluid, blood pressure, pain, stress, etc. In reality, the deliveries stimulated with Reflexology lasted an average of 30% less than forecasted. Some midwives were a bit suspicious at the beginning, while some were positive about the use of natural techniques. After a long time working together, their general attitude to Reflexology was much more than positive.
I was honored to conduct a number of special seminars about the use of reflexology in the birthing room for all the midwives staff in two hospitals - Meir in Kfar Saba and Tel Hashomer in Ramat Gan, after that. The interest and the respect they showed for Reflexology opened the doors of the birthing room.
(The present article was published in Zoneterapeuten - Association of Danish Reflexologists magazine - February 2002 (in Danish) and in Footnotes - Scottish Institute of Reflexology magazine, March 2004)
Copyright Moshe Kruchik, 2002-2005