Working with the birth team
It is always a great privilege to work with a woman through pregnancy and an even
greater one to be invited to support her during labour and delivery. Although I have
worked with many women through pregnancy and also treated some during labour,
I felt that this was a particularly special home birth…
Kate came to see me at 21 weeks of pregnancy. She already had a two year old and
was working in a stressful and demanding job. She presented with a number of
issues, some pregnancy-related and others not. She was waking frequently at night
to empty her bladder and was getting (at most) 5 hours’ sleep a night. She was also
experiencing constipation and sinus congestion, which are both fairly common in
pregnancy. Additionally, some issues at work were contributing to elevated stress
and anxiety levels and most probably worsening the conditions she was
experiencing.
Added to this, she had been 2 weeks overdue with her first baby, with an induced
birth and a difficult labour and delivery; this was obviously an experience she was
very keen not to repeat! She was determined that she would like to have this baby in
the calm, peace and tranquillity of her own home. This felt like quite a ‘tall order’,
but I became determined to do all I could to support her, as long as her medical
practitioners were happy for me to do so.
We began by focusing on the bladder frequency, constipation and sinus congestion,
along with using techniques for reducing her stress levels. She responded very well,
but the constipation needed constant management, as did her stress levels. After
each monthly treatment, there was an improvement of symptoms for a period of
time, but they returned by the time she was scheduled for another treatment.
After seeing her midwife at 25 weeks of pregnancy, Kate was told that the baby was
transverse (i.e. lying horizontally, rather than cephalic (head down) or breech
(bottom presenting)). This is not a major concern at this stage as there is still plenty
of room and time for manoeuvring. However, at 29 weeks, this was still the case.
We began using some techniques to try and ‘encourage’ the baby to move into a
better position. It is usually fairly easy to be able to palpate the position of the baby
in the uterus reflex points at this stage of pregnancy. We used some gentle
movements on these points to encourage the baby to move into a cephalic position.
After this treatment she was aware of some significant ‘baby movements’.
At Kate’s next midwife appointment at 33 weeks, the baby had moved into a
cephalic position, but was now lying in a posterior position i.e. baby’s back to mum’s
back (the best position is an anterior lie, baby’s back to mum’s front). You may see
this noted as LOA/P or ROA/P – Left Occiput Anterior/Posterior or Right Occiput
Anterior/Posterior, with an Anterior presentation meaning baby is presenting its
occiput to the left or right front of the abdomen.
In addition to this, at 34 weeks, Kate developed symphysis pubis pain. At this stage I
used the techniques taught by Susanne Enzer, as these are the only ones that I have
found that work for this condition, and they work extremely well. Using these
techniques, we managed her symptoms well throughout the rest of her pregnancy.
By 37 weeks, this little baby had decided that it would like to return to a transverse
lie and was obviously quite comfortable there. Again, we tried reflexology ‘turning
techniques’ and at the next midwife appointment a week later, baby had returned
to a cephalic and anterior position, much to our relief!
At 38 weeks, Kate spoke to both her midwife and consultant about a home birth and
the use of reflexology within that. As the baby was now in an excellent position,
they were happy to support both.
At approximately 36 weeks, I offer to all couples/birthing partners a session where
we teach them useful reflex points to work during labour. This allows me to provide
telephone support if I am unable to be with a client. We did exactly this with Kate
and her partner. I usually teach them how to work the pituitary, thyroid, ovaries,
uterus and solar plexus on hand points, as these are easier to access. We also
discuss breathing techniques and other support that might be appropriate.
At 40 weeks and 2 days, my phone rang at 7.30 am – it was Kate’s husband to say
that she was in labour; her contractions were 3-4 minutes apart and lasting 60
seconds. He asked if I could come and support them.
I arrived at 9am and the midwives were already present. I introduced myself to them
and checked again that they were aware I would be attending and that they were
happy for me to treat Kate. They were very open and accepting, as Kate had
discussed this with them previously. They gave me a brief handover as follows:
Kate was 4cm dilated and was coping well. Baby was anterior/cephalic presentation.
The forewaters had ruptured spontaneously at 2.30am and she had been using a
TENS machine for pain relief.
Kate and her husband were both upstairs and I made a quiet entrance, letting them
know that I had arrived. They were keen to begin reflexology as soon as possible, so
we stimulated the following reflex points: uterus, ovaries, pituitary and thyroid,
working the solar plexus on the hands in between contractions to aid relaxation and
regulate breathing.
Within 15 minutes, the contractions intensified, lasting longer and becoming more
frequent.
It was at this stage that the midwives came to the end of their shift and had to leave
before the new shift arrived. I was slightly concerned that I was going to end up
delivering the baby myself! Thankfully, the new midwives arrived very shortly after
they left. By now, I was lying on the bed with Kate working the solar plexus reflex
point to allow her some recovery between contractions. The birthing pool had been
filled, but it was evident that Kate was not going to make it downstairs. A beautiful
baby girl arrived at 10.19am just an hour and 20 minutes after I had arrived. Delivery
was excellent, as was her APGAR score.
Kate did have a slight tear, which needed a couple of stitches and the placenta was
rather slow to arrive. I explained to the midwives that there were some reflexology
techniques we could use that might help, and they were happy for me to proceed.
Within 10 minutes of stimulating the thyroid and uterus reflex points, it had been
delivered.
It was now that the midwives became very interested in what I had been doing!
They had thought that they were going to have to use some intervention, so this
success opened the way for some interesting discussions about the benefits of
reflexology!
I left them all at home together having had the wonderful birth they had been
hoping for, and with a lovely warm, grateful feeling in my heart.
Things to consider:

Always ensure that your client has the permission of her medical
practitioners for you to be involved in her care.

When arriving at either the hospital or home, always be polite and introduce
yourself to the medical practitioners.

When arriving, ask what stage of labour your client is at and ask for a brief
handover.

Be prepared to explain what you are doing to them.

If you are asked to stop treatment at any stage by mum or her medical
practitioners, you must do so.

Your role is to support your client during labour.

Ensure that you are appropriately trained and insured to offer this service
Barbara Scott MBRA MAR MARR