Why Counter Pressure During Labor Helps (and How to Do It Right)
Curious about counter pressure during labor? This hands-on technique is more than just a massage, and it can make a real difference in managing labor sensations. In this post, we’ll explore what counter pressure is, why it works, and how to use it for a more comfortable, empowering birth experience.
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Chances are you’ve heard people recommend “counter pressure” for labor. But what do they mean? Is it just a massage or is it more than that? That’s exactly what we’re going to cover in this blog post.
In short, while counter pressure is similar to massage, it’s more than that. It’s constant pressure applied to a specific area during a contraction. Many women find it to be an indispensable part of their unmedicated labor experiences.
So let’s get into what counter pressure during labor is, different ways to use it, and other things to know.
What is Counter Pressure?
Counter pressure is heavy, steady pressure applied to specific points of the body as a way to lessen discomfort in labor. Typically, counter pressure is applied to 5 different areas of the body, 4 of which are on the pelvis.
Counter pressure works exactly how it sounds like it would—one of your support people applies pressure to a point on your body counter to or in opposition of internal pressure you are feeling to lessen the sensation of discomfort.
Benefits of Counter Pressure
During labor, counter pressure can help in several ways.
Loosens Things Up
First, because of the ways and areas counter pressure is applied to, it can help to loosen ligaments and relax your pelvic floor. Looser ligaments hold less tension and therefore less pain. And the more relaxed your pelvic floor is, the easier birth is likely to be and the less likely you are to tear as your baby is born.
Opens the Pelvis
Some kinds of counter pressure help to open the pelvis in ways that give baby more room to maneuver, potentially making labor faster, easier, and less painful.
Inhibits Greater Pain
The heavy pressure applied by your support people may cause a minimal type of pain. That is helpful because of the principle of “pain inhibits pain.”
If you’ve ever dug your fingernails into your palm to distract yourself from a stubbed toe or some other painful thing, you know what I mean. A lesser pain added to a greater pain actually decreases your perception of how much pain you are feeling because your brain only has so much bandwidth to process painful stimuli.
This physiological phenomenon also helps release endorphins, which are natural pain-relieving hormones.
Closes the Pain Gateway
Finally, counter pressure is a way to utilize the Gate Control Theory of pain. When we feel pain, what’s happening is a stimulus (like a hot stove) sends a signal through our spinal cord up into our brain.
The spinal cord acts as a gate for those signals, and we actually have some degree of control over that gate.
Counter pressure works to close that gate and therefore decrease our experience of pain. Positive stimuli—like touch from someone we know and trust—travels to that gate faster than negative signals and so can shut the gate to negative stimuli, like pain.
Counter Pressure Techniques: 5 Methods
Now that you know why counter pressure works, let’s talk about how to do it. Then we’ll go over some important tips and things to consider if you’re hoping to use counter pressure during labor.
There are 5 ways to use counter pressure. Or rather, there are 5 areas to apply counter pressure to. Let’s go over each.
1 – Double Hip Squeeze
One of the most common counter pressure techniques is the double hip squeeze. And it’s just what it sounds like: pressure applied to both hips, pressing in toward the spine. The hip squeeze can provide a lot of relief to tight ligaments and tissues during a contraction.
It may also encourage widening at the base of the pelvis to give baby a little more room to maneuver later in labor.
3 Ways to Do the Hip Squeeze
There are several ways to do a double hip squeeze.
First, you can use your hands. Place your palms in the fleshy part of mom’s hips/glutes, right above the bony part of the pelvis where the leg bone connects. Because of body build and preference, the placement may be slightly different for each woman.
With your hands pointing diagonally in toward the spine, apply constant pressure in and slightly up for the duration of the contraction.
Second, you can use your legs. Depending on how tall you are, you’ll use either your knees or your shins. With mom on hands and knees, stand so your legs align with her hips. Then squeeze in, pressing on her hips, for the duration of the contraction.
Third, you can use a long piece of fabric like a sheet, scarf, or rebozo*. Place the scarf around her hips, NOT across her belly, and cross the ends in the back around her glutes. One person can pull on both ends to tighten it or two people can work together, each pulling on one side.
The neat thing about using fabric to do the hip squeeze is that it can be done with mom in any position, including lying on her side.
*The rebozo techniques shown in the linked article are NOT counter pressure. When using a rebozo for counter pressure do not wrap directly around the belly. But feel free to try the rebozo techniques she shares at a different time.
Gina from Mamaste Fit demonstrates each of these techniques in this video:
2 – Sacral Pressure
The other most common counter pressure technique is sacral pressure, or pushing on the base of the spine, just above the tailbone. When used earlier in labor, sacral pressure may widen the opening of the pelvis just a bit, making it easier for your baby to enter your pelvis.
How to Apply Sacral Pressure
To apply counter pressure to a mother’s sacrum, place the heel of your palm or your closed fist at the base of her spine (knuckles down) between her glutes, and press in with a consistent, heavy pressure. You can even use both hands for added strength.
3 – Pelvic Press
The pelvic press is different from the double hip squeeze. Rather than pressing in and up on the middle of the pelvis, you press in on the very tops of the hips, on the area called the iliac crest.
The pelvic press can help loosen ligaments. It can also help to widen the opening at the base of the pelvis, potentially making it easier for your baby to finish making their way down and out.
How to Do the Pelvic Press
With mom on hands and knees, place your hands on the bony part of her hips, with your fingers pointing toward the floor. Press in, holding for the duration of the contraction.
Alternatively, if mom wants to lie on her side, you can press down on her top hip while supporting her lower back with the opposite hand.
4 – Sitz Bone Press
This technique is less common but some women find it helps during the pushing phase of labor. Pressing on the base of the pelvis can help to relieve tension. It may also help some women push more effectively, as they have a tactile reminder of what to push toward.
How to Do the Sitz Bone Press
For this counter pressure technique, mom can be either on hands and knees or in lithotomy position (lying on her back with legs up). Use your fists to press against mom’s sitz bones, the bony part right at the base of the glutes. As mom pushes with a contraction, apply pressure.
5 – Knee Press
The final counter pressure method isn’t actually applied to your pelvis—it’s applied to your knees! This press back and up can shorten ligaments that are being pulled tight and relieve some tension.
How to Do a Knee Press
The knee press counter pressure technique can be used when mom is sitting up—on the birth ball, on the toilet, wherever. Place the heels of your palms on her knees and push back and slightly up. Hold for the duration of the contraction.
Tips for Using Counter Pressure
Now let’s go over a few tips and reminders to help you get the most out of counter pressure during labor.
Tip #1: Only for Contractions
I’ve mentioned this but as a reminder: counter pressure is great for contractions, but it typically isn’t helpful in between contractions. Once each contraction is ended focus on relaxation and hydration instead.
Tip #2: Not Universal
While many women (most, even) find counter pressure to be an incredible comfort measure during labor, not every woman will. Some may not like the pressure at all.
And some will have very specific areas and amounts of pressure that feel good while everything else isn’t helpful.
Which leads us to tip 3…
Tip #3: Communicate!
Of all the things to remember about counter pressure, perhaps the most important is to communicate. Whoever is doing the counter pressure (dad, doula, midwife, etc.) should be checking consistently with mom to know what is feeling good and what isn’t.
Tip #4: It’s Tiring
For the one applying the counter pressure, it gets tiring…fast. Ideally, multiple support people will know how to do counter pressure so one doesn’t get worn out before labor is done.
Tip #5: Try Variations
As you communicate and as labor progresses, you’ll need to make changes to how counter pressure is being done. Besides adjusting as mom directs, consider moving through the counter pressure techniques in this order, according to where mom seems to be in her labor:
- Early Labor: Sacral Pressure
- Active Labor: Double Hip Squeeze or Pelvic Press
- Pushing: Sitz Bone Press
Use the knee press whenever she’s sitting or you need a different option.
Now You Try It!
Counter pressure can be a game-changer during labor. If you want an effective way to manage the intensity and have a better experience in labor, grab your partner and try these techniques out today.
Until next time,
Allison
READ MORE:
The Ultimate Guide to Comfort Measures for Labor
