How to Use Counter Pressure in Labour: Pelvic/Hip Press

An effective technique for managing the intensity of labour.

WHAT IS COUNTER PRESSURE?

Counter pressure is a massage technique used during labour to alleviate pain and pressure in certain areas of the body.

Like many natural pain management options for labour, some people find counter pressure incredibly beneficial while others experience heightened discomfort from it. Oftentimes, until you try it on the day you won’t know if it’s helpful for you or not. What works in one birth may not be useful in another, so even if you’ve tried it in a previous labour, you might feel differently in your next birth. Regardless, it’s certainly a useful tool to have in your labour kit.

WHAT IS A PELVIC PRESS?

Similar yet slightly different to the double hip squeeze we’ve explained previously, a pelvic or hip press can help ease the discomfort of contractions, especially for a birthing person experiencing back labour or intense pressure in their pelvis. This technique focuses more on the sides of the hips, rather than the sacrum. Like other counter pressure techniques, this pelvic/hip press can be useful in encouraging the baby the adjust their head into a more favourable position.

For this technique, the birthing person may want it done during or between contractions – everyone is different so it’s best to experiment and see what they favour.

HOW TO PRACTISE IT

Option one:

1. Have the birthing person lying on their side on the bed, whichever side they feel most comfortable with is fine. You may want to stand beside the bed or kneel on the bed next to them, depending on how much stability you require.
2. Place one hand on the top of the hip bone, looking for the iliac crest, and the other beside it down by the buttocks, with your fingertips facing towards their back.
3. With the meaty part (palm and heel) of your hands, apply firm pressure down onto the meaty part of their hips.
4. To ensure you are providing relief, and not causing more discomfort, you may need to experiment with the amount of pressure the birthing person requires. If they want more pressure, simply lean in further and put more of your body weight into your hands.
5. You may also need to adjust the positioning of your hands to get it just right.
6. The birthing person may prefer to have you hold this pelvic press or repeat it multiple times during a contraction.
7. Alternatively, they may want you to only practise this technique in between contractions.

Option two:

1. Have the birthing person on their hands and knees, either on the floor (with a birthing mat beneath them for padding) or on the bed.
2. Kneeling behind them, place your hands on the outside of either side hip, looking for the iliac crest or the top of the hip, with your fingertips facing down to the ground.
3. With the meaty part (heel) of your hands, apply firm pressure, squeezing the hips inwards. It can be helpful to imagine pressing your hands together.
4. Experiment to determine the amount of pressure the birthing person requires as it is possible to do this too intensely and cause more discomfort than relief. You may also need to adjust the positioning of your hands to get it just right.
5. The birthing person may prefer to have you hold this position or repeat it multiple times during a contraction.
6. Alternatively, they may want you to only practise this technique in between contractions.