Pregnancy Massage: the importance of working with the Birth Partner


I. Foreword

When I trained as a Doula (Professional Labour Supporter), my aim was to help couples who were expecting a baby as much as I could, whether it was during pregnancy, during labour or after birth. My role was to give them informational, emotional and physical support.
During my experience as a Doula, I realised that what I really loved was to prepare couples for the birth, which meant giving them as much informational and emotional support as they needed.
But I was lacking a tool; I felt I needed to be able to support them more physically and that is when I became very interested in massage.

I had already learnt baby massage, so I knew what the benefits of massage were. It is nurturing, gentle, comforting and soothing, so why wouldn’t it be for a mother to be, at a time of her life when she needs it most: during pregnancy.

I knew that through massage, I would really be able to support women; before, during and after birth.

Moreover, when I became pregnant with my second child, I wanted a massage, and I found it very difficult to get a pleasant and efficient pregnancy massage in my area; so these were the motivations for doing this course. The course turned out to be exactly what I needed, using a holistic approach, and including work with the birth partner.

As I progressed through my case studies, my clients were getting closer to their due date. So, for three out of four clients (the last one being due in September), I had the opportunity to do a session with their partners (in this instance, the fathers of the babies).
During that time, I felt like being “Doulaing” again…except that I was able to give more “Hands-on”, practical support by teaching the partners some of the massage techniques and Shiatsu points.

Each time, I noticed how involved and curious the fathers were, and especially how they felt more confident following our session. I also loved seeing how reassured and happy the mothers were. And by happy, I mean the glow on their faces as they were “working” together with their partners to prepare the birth of their child.

Therefore, I decided that this would be my project: Demonstrate the importance of working with the birth partner (for a pregnancy massage therapist) to prepare him for the labour.

II. Introduction

Giving birth is a key life experience that the mother will remember all her life. Therefore, it’s essential that these memories be positive ones, and that’s where the birth partner can help.

By birth partner, I’m thinking primarily about the father of the child, but that person can also be a mother, a sister, a friend, or a Doula.
Please note that throughout this project, I have chosen to use the word “he” – meaning the father of the child, when referring to the birth partner.

Towards the end of the last century, the role of the birth partner changed, especially when the birth partner is the father of the child.
There was a time when they were not even allowed to stay with the birthing mother! Nowadays, with a shortage of midwives (and beds) in Irish Maternity Hospitals and the number of births still rising, the presence of the birth partners is very much needed, as midwives are busier, looking after several women at once.
The birth partner is therefore left on his own with the birthing woman, during most of the labour. It’s a very demanding role and indeed a very important one, and without some preparation, the birth partner may feel helpless.

A pregnancy massage therapist can help prepare the partner for the birth, thus creating a safe and nurturing environment for the birthing mother.

III. The role of the birth partner

In the past, the birth partner was the midwife. She would have stayed with the labouring mother throughout the birth and helped her emotionally, physically, as well as assisting the obstetrician delivering the baby.

Nowadays, one only sees the obstetrician if there are complications or if one has chosen to go through the “Private” Medical Healthcare System. As most births are normal (55% Normal Births against 25% C-Sections in average, in Ireland – a high rate of caesarean compared to the World Health Organisation (WHO) guidelines), midwives usually deliver babies without any doctor’s help. Therefore, their role is now more demanding and they often have to cope with more than one woman at a time. Therefore, they rarely get the opportunity to stay beside the birthing woman throughout labour (unless they choose to be Independent Midwives and do Home Births – which not every woman can afford).

Furthermore, it often happens that a mother is introduced to more than one midwife during her labour (due to changes of shift), which can be disturbing. In that case, the only partner that the mother will have throughout her labour is her birth partner, who would usually be the father of the child.

So we should not underestimate the role of the partner who will be supporting the labouring woman, because receiving good support will largely contribute to having a very positive labour experience. According to Tracy Donegan (Author of “The Better Birth Book”), the woman’s role is to give birth and the partner’s role is to do everything else…

But what does that involve?

• Creating a Safe Environment (at home and at the hospital) by dimming the lights, putting on some relaxing music, preparing a nice bath; anything that the mother really likes, that makes her feel safe and comfortable and that her partner knows best.

• Giving Emotional Support, by positively encouraging the birthing mother throughout the pregnancy and labour and understanding her emotional needs

• Giving Physical Support (mainly what the Pregnancy Massage Therapist would teach), through massage techniques and physical comfort measures

• Attending to the Mother’s Needs, if she is too hot or too cold, if she is hungry or thirsty, if she needs to go to the loo, anything that arises

• Looking after Logistics, which may be to organise siblings’ care, put the bag in the car (and petrol!), call the maternity to let them know of the arrival

• Discussing the Birth Plan with the medical staff and answering their questions in order to leave the mother birthing peacefully, allowing her to stay in her own “space”

• Staying by the side of the labouring woman throughout the entire labour
The birth partner has definitely a big responsibility; therefore it’s important to give him “tools” to prepare him for that big day so that he can really be helpful to the mother.
According to the WHO Recommendations: “The training of professional midwives or birth attendants should be promoted. Care during normal pregnancy and birth, and following birth should be the duty of this profession.”
This is where the role of the massage therapist comes in.

IV. The benefits of pregnancy massage & the role of the massage therapist

Touch is the first sense a baby experiences while still in the womb, and continues to be one of the principal ways of learning and developing throughout childhood.

No wonder no one can live without touch. In infancy and in adulthood, massage – which has been practiced in China since at least 3000 BC – has been proven very beneficial for physical and mental well-being.

During pregnancy, more than at any other time of her life, a woman needs to be nurtured, and one way of doing this is through massage and nurturing touch.

The benefits of Pregnancy Massage include:

• Relaxation– it reduces stress, therefore reducing tensions and anxiety related to the fear of labour

• Improvement of circulation (reducing pregnancy related oedema)

• Improvement of all physiological functions (respiratory, gastrointestinal and urinary)

• Relief of tension in the back, neck and weight-bearing joints (such as ankles, lower back and pelvis)

• Helps ameliorate sciatica, improves sleep, and relieves headache and sinus congestion

• Reduction of aches and pains relating to the musculoskeletal strains of pregnancy

Throughout her work, the massage therapist not only physically treats and nurtures the mother, but also prepares her for the labour and postpartum period, through a series of evidence based aftercare advices and exercises.

The pregnancy massage therapist understands the physiology of birth and the emotional needs of a mother to be. With knowledge and experience, she’s a good listener and adviser (referring the client if necessary).

While working with the mother on a regular basis, the therapist gets to know her very well, and monitors the physical changes (swelling relating to oedema for example), and in some cases, may find a condition that needs to be referred (ie. Pre-eclampsia), thus having a preventive role.

Planning one session with the birth partner before the birth is essential to teach him how he can support the labouring mother, by using different massage techniques, Shiatsu Points, physical comfort measures and teaching some theory on the physiology of birth.

This session is also very beneficial in involving the partner in the pregnancy and the whole birthing process.

V. The benefits of working with the birth partner

It’s a real privilege to be able to share this very special time in the life of a couple, and to help them have the best experience possible. After massaging and supporting three of my “case studies” throughout their pregnancy, it was a pleasure to meet with their partner and to help them feel involved in the birth of their babies.

It can be very hard for the partner to understand the physiological changes that happen to a woman during pregnancy, at birth and after birth. With the huge hormonal changes that she experiences, she may exhibit a behaviour that can be very hard to deal with for her family circle and friends, and especially for her partner. It can also be very hard for them to understand that they are going to become fathers since they don’t experience all those changes. Until they hold their baby in their arms…

Therefore, getting them involved with the pregnancy can be very positive. I was amazed to see how curious and interested the partners I worked with were.

From my own experience, I remember my husband was not involved that way in any of my pregnancies. He was not so interested or curious about the changes I was experiencing. Maybe he was overwhelmed… He was present at both my births but didn’t know what to do to support me…he looked helpless! Obviously, I was happy that he was there, but at times, I felt like I was on my own because the midwife was not (physically) supportive either and was in and out of the room all the time.

Here’s a list of the benefits of preparing the birth partner (father) to the birth; for the mother, the father himself and the therapist:
• Mother:
o Nurturing
o Reassuring
o Comforting
o Supportive
o Pleasant
o Romantic!

• Father:
o Bonding (with the baby and the mother)
o Gets involved in the pregnancy
o Learning process: the father gets to learn a lot about his partner
o Reassuring; the father becomes more confident that he can support his partner at birth
o Pleasant
o Romantic!

• Therapist:
o Informative: the therapist gets to learn a lot about the couple and the way they work with each other. It gives a good idea on how supported will the mother be during and after birth.
o Rewarding: it feels so good to get a positive feedback from the couple on how useful the session was, especially when they got to use what they have learnt during the birth
o Very pleasant to get to be a part of their journey towards parenthood

When I do a session with a birth partner, I usually start by going through some theory about the signs of labour and the different stages. Then, I give some ideas on how the partner can support the labouring woman, whether emotionally, by taking care of all the “logistics” – petrol in the car, bag in the car, organise siblings to be minded; also by creating a “safe environment” – with relaxing music, a bath, gentle hand or foot massage, and by dealing with all the questions that will arise at the maternity – ie. discussing the Birth Plan. All this to ensure that the labouring mother can concentrate on labouring.

When I worked with T and her husband, she really enjoyed that part, especially because her partner was not present at her first birth. So the theory was new to him, and talking about what happens during labour reassured him. I find that men are very practical, so if they are told what to do and when to do it, then they will happily do it. But they need some guidance. T was really nervous about this birth, because her last experience in the maternity hospital was traumatic. Going through the theory and explaining how to avoid some of the procedures she didn’t want (ie. Episiotomy) helped a lot. In a way, it was like a “Fear Release” session. She had a baby boy and this time, all went really well. She was delighted with her birth and her partner was very helpful.

Then, I show some simple massage techniques that the partner can perform on the mother in order to physically support her by relaxing her (holding her abdomen to feel her breath and connect with the baby) or relieving some tension/pain experienced in the back during labour (counter pressure in the lower back and around the sacral area) especially if the baby is in posterior position. A lot of the work is done with the mother on “all fours”, lying against the bed or a birthing ball.

B and her partner found that part of the work very helpful. Her partner was very good at practising the different techniques with B’s guidance. She had a great first birth, and was not nervous at all about this one. She was confident that everything would go well this time. And she was right: all went well and she had a beautiful baby girl. After the birth, B sent me a message saying: “Thank you for all your massage tips…they came in very handy: M (her partner) was great!”

I also show some Shiatsu pressure points to relax the mother (in the hand and in the foot) or to help labour progress if it’s too slow.

A was very sensitive to those. I had noticed how sensitive she was to energy work and to lymphatic work. That couple looked so closed to each other and her partner was very much involved in her second (and first) pregnancy. However, no matter how well prepare they were, the outcome was different to what they were expecting… The baby decided to turn into a breech position while she was overdue, so the decision was to have a C-Section. But they were happy about the decision made and had a lovely baby boy. A also sent me a message saying “My little B is very relaxed, thanks to all your massages.”

Finally, I suggest different positions that can be used to help labour progress and allow the mother to feel as comfortable as possible during surges (ie. all fours, squatting, slow dance).

I think the main thing is to keep it simple, so that it is informative but not confusing for the partner when the time comes for him to support the mother. Each session that I had with the different couples has been adapted to their own needs.

Each time, I felt the partners were becoming more confident and were really involved, as they showed a lot of interest. I also noticed the mothers enjoyed working together with their partners as a “team” to prepare the birth of their child.

VI. Conclusion

Throughout my work and my experience, I have realised how important it is for a mother to be to have a birth partner who is well prepared for the birth. Actually, it has been proven how the presence of a Doula contributes in having a good birth experience for the couple (even reducing C-Section rates). However, not everyone can afford or would like to hire a Doula, that is why preparing their birth partner (here, I am thinking especially of the father of the child) can be very beneficial for the mother.

By being trained, they can be more active during the labour, they know what they can do to help the birthing woman, and therefore they feel more confident and helpful.

Consequently, the mother can really relax that her partner is in control, and will support her in all her needs, thus giving her all the tools for a positive birth experience.

As a Pregnancy Massage Therapist, I believe this session with the Birth Partner is really important to accompany the mother thoroughly throughout the pregnancy and at birth, especially in the career that I have chosen. Working with a pregnant woman does not only mean massaging her; I prefer to have a more holistic approach and supporting her in all her different needs: physically (through massage and exercises) and emotionally (through listening and referring). At birth, they need the same support, and what a better person than the father of the child to assist her delivering the baby, after all they conceived that baby together!

Working with the birth partner has been an enriching and fulfilling experience. I taught them a lot but they did too: I realised how involved and curious they were, but also how scared and helpless they felt. Initially, I thought it would be difficult to get to do a session with a birth partner because they wouldn’t want to be there, but I was wrong, they were delighted to get some advice on how to support their partner.

In my career to accompany women and couples through pregnancy, birth and beyond, I have one wish: for them to have a positive experience throughout. By working with the birth partner, I work towards that wish…

Tissy Guillou

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