Case study 1: Labour Massage – Motherlylove Due Date Pregnancy & Labour Massage Oil


From despondent labour to light hearted delivery

Primrose* had been in labour all night and was exhausted. This was her first baby and she was desperate to give birth naturally. At 6:45 am, fatigued and despairing, she had far to go yet was still determined to deliver her baby without an epidural.

Labour 

In my role as a midwife aromatherapist I was asked to see Primrose by the attending midwife. When I entered the delivery room I found Primrose standing, leaning on a bean bag which was on the bed. Her contractions were every 2-3 minutes, lasting 60-70 seconds. She was using gas and oxygen (Entonox), and both she and her husband were weary and gloomy after having been up all night.

She was 9cm dilated, but everything was going medically well for both her and the baby. Our concern was that Primrose was extremely anxious and was breathing very quickly during contractions. The most urgent need for Primrose was that she relax, so she could be more in control of the birth and hope for an uncomplicated delivery.

I had a brief discussion with Primrose, and offered her an aromatherapy massage of mandarin, roman chamomile, and frankincense in a carrier oil Jojoba. She was happy to try it.

With a gentle stroking motion and using steady pressure during contractions, we were able to induce uterine contractions and relieve their pain.

After the massage

Primrose was now coping with the contractions and her breathing had slowed both between and during contractions, which meant that baby would be getting more air. She said she was relaxed and less anxious, and her spirits had lifted from despondency to light heartedness. There was a dramatic shift in the feeling in the room, as she now had the energy, the urge and the will to push.

But nausea interfered. Only half an hour later, Primrose’s contentment with her delivery was interrupted by a sudden feeling of wanting to be sick.

The midwife called me back to the delivery room. I placed two drops of peppermint oil on a cotton wool ball for her to smell. She told me that she felt better and that she’d also enjoyed the aroma.

Ten minutes later 

Only ten minutes later, Primrose was on all fours on the bed, and delivered a healthy baby boy weighing 9lb 8 oz (4.4 Kg). Everyone was delighted.

Primrose and her baby were discharged from hospital on the third day after delivery. The baby was breast feeding well, and she and her husband were over the moon with their new baby.

Mum and Dad were delighted and grateful of the care they had received. On the 10th day after delivery the community midwife informed me that Primrose and baby were discharged to the care of her health visitor, as all was well.

*Name changed to protect confidentiality

Please inform the midwife or doctor, when you are using complementary therapies.

The science

The essential oils of mandarin, roman chamomile, and frankincense used were chosen for their harmonious blend with Apricot, Baobab, Kukui vegetable oils for being appropriate in pregnancy, effectiveness and quality, specifically for aromatherapy massage in labour.

Jojoba is beneficial for most skin types. Studies have shown that it is an anti-inflamatory agent and has been used for psoriasis, eczema, sunburn and chapped skin.  http://www.goodreads.com/book/show/873063.Carrier_Oils

For an investigation into the use of aromatherapy in intrapartum midwifery practice, see Burns, E., Blamey, C., Ersser, E., Barnetson, L., Lloyd, A., (2000). The Journal of Complementary Medicine. Volume 6, pp141-147.  http://www.ncbi.nlm.nih.gov/pubmed/10784271

The peppermint oil was used as Tate (1997) demonstrated it relieved post-operative nausea for women who had gynaecological surgery. It was very effective in this case.  Peppermint oil: a treatment for postoperative nausea.J Adv Nurs. Sep;26(3):543-9.  http://www.ncbi.nlm.nih.gov/pubmed/9378876

 

Case study 2: Relaxing and Healing Bath – Motherlylove Pamper Mum Relaxing Bath Oil

Now she can sit and enjoy her baby 

Jasmin’s* pregnancy  and the birth of her first child were healthy and normal, though as she’d  just left  all her family in India two months before giving birth in the UK, she and her paediatrician husband felt they were in it on their own.

After the birth  

A postnatal (postpartum) (prenatal)midwifery sister asked me to come and see Jasmin* after the birth of her son, in my role as a midwife and aromatherapist.  She had no known skin sensitivities, no history of medical or surgical problems, and all her pregnancy and antenatal care observations were normal. She had an epidural in labour, so apart from slight lower back pain during pregnancy, her entry into motherhood was relatively free of discomfort.

After the birth, however, she suffered greatly from the episiotomy she’d received during labour. As helpful as her husband was, there was nothing he could do to help relieve the pain in her perineum.

The pain was intense and was interfering with her ability to enjoy the precious first days of motherhood. Sitting down only aggravated the very tender wound, but also meant she was unable to relax and breastfeed her baby due to the pain ‘down below’. She allowed me to examine her, and I found that the area was healing. For some relief I recommend an aromatherapy bath with lavender and cypress oils, and she was happy to try it.

A bath

Jasmin needed a combination of essential oils which would help her to relax as well as to assist with her healing, so I prepared an Aromatherapy bath of lavender and cypress. To make sure the essential oils dispersed in the bath water, I prepared these in a tablespoon of milk.

Jasmin slipped away for her bath, and later said she’d enjoyed the fragrances and found the bath soothing and relaxing. She seemed more peaceful, and told us that her perineum felt more comfortable and less painful. The bath therapy also gave Jasmin more independence and confidence to care for her baby and deal with her birth experience. She continued with the aromatherapy bath treatment every day for 2 weeks.

Happy mum

A week after Jasmin was discharged from her midwife, I phoned Jasmin at home to check on her. She was clearly happy and confident, and was excited as she’d just heard that her parents were flying over from India. She said the aromatherapy bath had helped her to relax during the healing, and that she and the baby were well.

*Name changed to protect confidentiality

Please inform the midwife or doctor, when you are using complementary therapies.

The science 

All these essential oils were blended harmoniously for being appropriate in pregnancy, effectiveness and quality for postnatal (postpartum) perineal pain .

The lavender and cypress were chosen because of their pharmacological action to ease pain, encourage healing, soothe swelling and to promote relaxation to enable sleep.

http://www.amazon.co.uk/Carrier-Oils-For-Aromatherapy-Massage/dp/1874353026

http://roberttisserand.com/2011/07/lavender-oil-and-pregnancy/

http://www.quinessence.com/blog/cypress-essential-oil

 

 

Case study 3: Foot and Ankle massage – Motherlylove Foot Loose Soothing Massage Oil

From cramped to relaxed: restoring a good night’s sleep  

Rose* was a healthy mum-to-be, 36 weeks pregnant and still on her feet all day working happily as a hairdresser. All her antenatal (prenatal) observations were normal, apart from slightly swollen ankles.

Caring for the whole patient

At the midwifery-led clinic I ran, I was able to offer aromatherapy as a treatment for any of the problems that pregnancy can introduce. And though Rose was energetic by day, she went to bed every night with tired swollen feet and leg cramps. This kept both her and her partner awake much of the night, and neither of them was enjoying the pregnancy, nor getting the rest they both desperately needed.

I read through Rose’s booking history and found she’d had no previous medical problems or surgery. All her blood tests, blood pressure and urine were in normal limits, and her unborn baby’s heart rate was normal. Apart from the leg problems and tiredness they were all happy, and even the baby moved enough to keep mum satisfied that all was well.

I talked Rose through the benefits of aromatherapy foot and leg massage, and she agreed to try the massage.

For Rose’s tired limbs I chose a foot and leg massage with peppermint and lavender essential oils, in a blend of  carrier oils apricot and Jojoba seed oil. I showed her partner how to massage her feet and legs, and then I blended and labelled these oils, so he could perform the same massage for her at night. They were willing to try it, and we booked an appointment to see each other the following week.

One week later

When I saw Rose a week later she was very happy, as she was sleeping much better.  The aromatherapy massages were good for her partner as well, as he was able to get involved by helping her, and he knew that their rest depended on him giving her the massage.  He also sent me a separate message of his own to thank me, as she was sleeping peacefully, and also no longer waking him up with leg cramps.

*Name changed to protect confidentiality

Please inform the midwife or doctor, when you are using complementary therapies.

The science 

All the essential oils were blended harmoniously with Sweet Almond oil and Baobab oil for being appropriate in pregnancy, effectiveness and quality for leg cramps, swelling of ankles and swollen legs in pregnancy.

The peppermint and lavender essential oils were chosen for relieving every day aches and pains Studies have shown that lavender soothes inflamed skin and researchers have demonstrated that cyprus essential oil eases swelling and muscular cramps.

I also chose natural vegetable oils which were a blend of Sweet Almond oil, Baobab oil and coconut oil chosen for their richness in omega oils, vitamins to nourish, moisturise and soothe the skin.

Cyprus oil  http://www.quinessence.com/blog/cypress-essential-oil 

Leonard Price http://www.amazon.co.uk/Carrier-Oils-For-Aromatherapy-Massage/dp/1874353026

 

Case study 4 : Induction of Labour – Motherlylove Due Date Pregnancy & Labour Massage Oil

Complementary Therapy – bring on Labour – normal birth

As a midwife, aromatherapist and trained in pregnancy reflex zone therapy, Cherry* was referred to me by her community midwife. She was 40 weeks +4 days and was booked in for a medical Induction of Labour in 6 days time. All her scans, blood tests had been in normal limits. She had no problems during her pregnancy and she had no previous medical or surgical problems.

Not in Labour

She wished to prevent medical intervention to induce her labour and wanted to try complementary therapy treatments to bring on labour. After a discussion of the benefits of receiving the treatment, possible side effects and the treatments, a written consent was obtained. I palpated the uterus and the baby was in the correct position and I listened to the babies heart beat. The community midwife had performed a membrane sweep the day before. Cherry was not in labour and there were no signs of early stages of labour

Caring for mum to be and her baby

I used a blend of Lavender, Roman Chamomile, and Mandarin essential oils in apricot, kukui and baobab. all natural vegetable oils. Cherry was made comfortable by positioning pillows, so she could lay on her left hand side. Cherry loved the fragrance of the aromatherapy oils and agreed to a gentle back massage, plus stimulation of the sacro-iliac joints acupressure points. She sat up for her pregnancy reflexology treatment and I performed stimulating pressure on certain points of her feet. I also used 3 pressure points (Gall bladder 21, Colon 4 and Spleen 6 ) and showed Cherry how to use these points. Cherry was feeling relaxed and very happy with her treatment. I was to see her again in a few days times.

Complementary Therapy to a happy birth 

I received a message from the community midwife to cancel Cherry’s next appointment as she had gone into labour. When I visited delivery suite that afternoon, Cherry and her husband were delighted to introduce me to their baby girl. Cherry had a normal birth using entonox and pethidine, as pain relief. She was well and her baby was healthy with a “good set of lungs”

She was very pleased with her care and couldn’t believe that her complementary therapy treatments to bring on labour, worked so well for her. Cherry with her baby were happy to be discharged from her community midwifery care on the 10th day.

*Name changed to protect confidentiality

Please inform the midwife or doctor, when you are using complementary therapies.

The science 

All these essential oils were blended harmoniously with Apricot, Baobab, Kukui vegetable oils for being appropriate in pregnancy and labour. Their effectiveness and quality were specifically blended for Induction of Labour (IOL).

Lavender and Roman Chamomile See an investigation into the use of aromatherapy in intrapartum midwifery practice, see Burns, E., Blamey, C., Ersser, E., Barnetson, L., Lloyd, A., (2000). The Journal of Complementary Medicine. Volume 6, pp141-147. http://www.ncbi.nlm.nih.gov/pubmed/10784271

Lavender essential oil http://roberttisserand.com/2011/07/lavender-oil-and-pregnancy/

Mandarin essential oil is very useful when your energy is low and the fragrance lifts the mood for the body and mind for a positive attitude. http://www.tribune.com.ng/news2013/index.php/en/component/k2/item/27839-citrus-oil-extract-works-on-stress,-bad-mood,-poor-sleep.html

Pregnancy and labour massage Tiffany Field http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2870995/

Please inform the midwife or doctor, when you are using complementary therapies.

 

Case Study 5: Perineal Massage – Motherlylove Due Date Perineum Massage Oil

From fear of episiotomy to small tear at delivery

Rosemary* was 34 weeks pregnant with her second baby when she contacted me. She had heard that in my practise as a midwife I had been trained in  many aspects of complementary therapies. All her scans, blood tests had been in normal limits. She had no problems during her pregnancies and she had no previous medical or surgical problems.

Avoiding episiotomy 

Her first baby was a forceps delivery, after having had a medical Induction of Labour (IOL) at 41weeks +11 days and she was eager to avoid another episiotomy. She had experienced lots of perineal pain after her last birth and this had lasted for many months, affecting her relationship with her partner.

I explained there were many studies on perineal massage during pregnancy, which have shown there were less tears to the perineum, if you massaged this area from 34 weeks of pregnancy. As she had the previous episiotomy scar, massaging the perineum to make this area to have more stretch, would give her more confidence to deliver her baby.

Perineal massage 

She agreed to try it, especially as she also wanted to have less perineal pain after the birth and wanted to avoid tears. I blended carrier oils (vegetable) and no essential oils, as this is a very sensitive area. I also gave her a leaflet on ‘How to massage the perineum’, as it is important to massage correctly. When she left me she was very enthusiastic to massage ‘Down Below’ with the oils I had blended.

Contact after the Birth

I phoned Rosemary at home when her daughter was 3 weeks old. She was delighted to talk to me. She had a vaginal birth with just a small tear, that didn’t require any stitches. She felt that the whole experience had been totally different and wished she had massaged her perineum, when she was pregnant with her first baby. She was very pleased, as ‘Down Below’ was a great improvement from last time, enabling her to enjoy her daughter.

*Name changed to protect confidentiality

Please inform the midwife or doctor, when you are using complementary therapies.

The Science

I used a blend of Jojoba and apricot vegetable oils (carrier) and these were suitable for a perineal (perineum) massage in pregnancy. Their effectiveness and quality were specifically blended to massage the perineum. Apricot oil is quickly absorbed into the skin and is an amazing nourishing moisturiser.  Jojoba is compatible with the skin due to its likeliness to the skin’s oils and therefore it can penetrate deep into your skin giving the skin more elastacity

Kettle, C., Tohill, S. (2008). Perineal care BMJ Clin. Evid 2008:1401 (online).

Beckmann, M. M., Garrett, A. J. Antenatal perineal massage for reducing perineal trauma. Cochrane Database Syst. Rev. 2006 Jan 25 (1).

Do not use perineal massage, if you have vaginal herpes, thrush or any other vaginal infections.