The rest of this blog post is for everyone else: partners, doulas, friends, anyone who might be assisting someone as they give birth. If you have provided counter pressure to a laboring person, you are a saint. You will forever be remembered as part of their labor survival kit and they will refuse to do labor in the future without it.
There are a few things to note about it, though, especially for anyone who has never used counter pressure as a tool. So let’s go over some basics:
How does it work? See this picture below? Look in the middle of that person’s back - that’s their sacrum. Sometimes laboring women feel pain in that place as their baby’s head passes by it on the way down - and yes, it’s generally more uncomfortable when the baby’s head is in the posterior position, meaning the bony back of the baby’s head is pushing against the sacrum. However, even anterior-positioned babies can cause discomfort - so counter pressure helps by pressing back against the baby’s head and lessening the sensation of pain. It doesn’t necessarily fix the problem, but it can be a great coping strategy for the laboring woman in that moment. If it works, do it!
Communicate. You have to communicate with the owner of the back you’re providing counter pressure to. If you don’t know exactly how to do that, here’s a little labor role play you can practice:
Partner: Can I try some counter pressure on your lower back during the next contraction?
Pregnant person: Uuuuuuggggghhhhhh. [Assume that’s a yes.]
<Attempt counter pressure throughout entire contraction.>
Partner: How did that feel?
Pregnant person: OMG, do that forever.
If they LOVED it, do it again! If they hated it or want you to try again, but in a different spot, try again but in a different spot. If they hated it and never want you to touch their lower back again, that’s ok! Try not to let your feelings get hurt. She’s not trying to make you feel bad, she’s just in an intense place in her life. Laboring women don’t always know what they want, so it’s important for her birth team to be flexible and not take thing personally.
Keep communicating. Sometimes as the baby’s head moves down, the perfect spot for counter pressure moves down, so keep communicating with your laboring person! What works in early labor might not work later, and that’s ok. Counter pressure might work against the lower part of the person’s spine, or further down towards their tailbone - you just have to try it and find out.
Some laboring women like the pressure to be steady and unmoving. Some women find that they like to feel some movement, so you can try a firm circular or stroking pattern and see what she likes better. (Remember to communicate!)
Positions, anyone? The laboring woman can be in lots of different positions to receive counter pressure: on her hands and knees on the floor or bed or couch, sitting on a birth ball, laying on the birth ball, sitting on the toilet, leaning over a kitchen counter, laying on her side, standing up, in the tub, in the shower. Anywhere she is comfortable where you have access to her back is a good place.
Test drive during pregnancy. There’s no need to wait until the contractions get intense before you try counter pressure. It can provide relief throughout pregnancy, especially in the third trimester, and give pregnant women and their partners something to do while they wait for the big day. This kind of labor preparation also provides couples a sense of partnership and togetherness, which is always a positive thing as parenthood approaches.
So, what do you think? If you’ve had a baby, did you enjoy counter pressure? What made it work or not work for you? If you’ve assisted as someone had a baby, do you have any tips to give to other birth partners? Feel free to share your experience with us! We love your stories!