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Case studies

Case Study 1:

Perineal Massage – Massage the perineum

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Down Below Perineum Massage Oil - Episiotomy - Avoid Episiotomy - Natural Skincare - Reduce trauma to perineum | Reduce tears when giving Birth | Second Baby | First Baby

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.

The science

I used a blend of Jojoba and Avocado 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. Avocado oil is quickly absorbed into the skin and is an amazing nourishing moisturiser.  Jojoba is compatible with the our skin, due to it is similar to our own skin’s natural oils. Therefore, it can penetrate deep into your skin giving the skin more elasticity.

References

  1. Jojoba oil has anti-inflammatory and healing properties
  2. Anti-Inflammatory and Skin Barrier Repair Effects of Topical Application of Some Plant Oils – Tzu-Kai Lin  1 Lily Zhong  2 Juan Luis Santiago.
  3. Perineal massage Kettle, C., Tohill, S. (2008). Perineal care BMJ Clin. Evid 2008:1401 (online).
  4. Beckmann, M. M., Garrett, A. J. Antenatal perineal massage for reducing perineal trauma. Cochrane Database Syst. Rev. 2006 Jan 25 (1).
  5. Antenatal digital perineal massage reduces the likelihood of perineal trauma & episiotomies and the reporting of ongoing perineal pain, and is generally well accepted by women. As such, women should be made aware of the likely benefit of perineal massage and provided with information on how to massage.
  6. Avocado oil – Skin Penetration Enhancement by Natural Oils for Dihydroquercetin Delivery – Vytis Čižinauskas,1,* Nicolas Elie,2 Alain Brunelle,2 and Vitalis Briedis1

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 using the blend of ‘Down Below’ oil 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.

***Do not use perineal massage, if you have vaginal herpes, thrush or any other vaginal infections. See your Midwife or Doctor, if you have any infections and stop massaging your perineum. Once the infection has been treated, carry on with the perineal massage.

#childbirth #labor #labour #aromatherapy #massage #pregnancy massage #birth #pregnant #pregnancy #anxiety #stress #nervousness #pregnant women #obstetric labor complications #obstetric labour complications #Parturition #midwifery #birthing unit #maternity

Case Study 2:

Pregnancy Foot and Ankle massage

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FOOT LOOSE TIRED LEGS MASSAGE OIL – SOOTHING | AWARD WINNING | FOOT AND LEGS MASSAGE OIL | HELPS BANISH CRAMPS.

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.

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 daily 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

References

  1. Leonard Price-Carrier-Oils-For-Aromatherapy-Massage
  2. Applied Nursing Research 23 (2010) 153–158 – Effectiveness of foot and hand massage in post cesarean pain control in a group of Turkish pregnant women. – Nuriye Degirmen, PhDa, Nebahat Ozerdogan, PhDa, Deniz Sayiner, PhDa, Nedime Kosgeroglu, PhDa, Unal Ayranci, MDb,

    Abstract:- The foot has 7,200 nerve endings; during pregnancy every one of those nerve endings are affected by elevated hormone levels and extra weight. As your client approaches her third trimester, swelling from fluid retention is common due to relaxin, a hormone that prepares the pelvic ligaments for childbirth. Foot massage not only helps to reduce oedema, but can also increase flexibility and muscle tone and enhance your pregnant client’s sense of well being. Moreover, like many other types of massage, working on the feet can induce relaxation, stress relief and result in more restful sleep. 

  3. Hsiao-Lan Wang  1 , Juanita F Keck
    Foot and hand massage appears to be an effective, inexpensive, low-risk, flexible, and easily applied strategy for postoperative pain management.
  4. Massaging results in a variety of comforts such as general relaxation in the body, deep breath, resting, and drowsiness (Kimber, McNabb, Mc Court, Haines, & Brocklehurst, 2008)

  5. Sleep Quality in Late Pregnancy and Postpartum Depression. 

    Arch Womens Ment Health (2017) 20:695701 DOI 10.1007/s00737-017-0754-5 January 2012 Iranian Journal of Obstetrics, Gynecology and Infertility 14(8):169-173

  6. Sleep Quality in Late Pregnancy and Postpartum Depression. 

  7. The many Benefits of Foot Massage
  8. A 2010 study, “Effect of foot massage to decrease physiological lower leg oedema in late pregnancy: a randomized controlled trial in Turkey,” published in the International Journal of Nursing Practice divided 80 pregnant women into two groups. The study group had 20-minute foot massages for five consecutive days; the control group received only standard prenatal care without massage. The researchers found that the women in the study group had a significantly smaller lower leg circumference, i.e., right and left, ankle, instep and metatarsal-phalanges joint, after five days of massage.

 

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.

#foot massage #leg massage #foot leg massage #leg cramps #swollen ankles #oedema ankles #restful sleep #stress relief #relaxation #pregnant massage #pregnancy massage #c-section massage #Antenatal care #prenatal care #post operation care #muscular cramps #muscle problems #general relaxation #postnatal depression

Case Study 3:

Comforting, Relaxing and Healing Bath

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Motherlylove Pamper Mum Comforting Bath Oil -Postnatal Bath | Postnatal perineal trauma | Relaxing antenatal | Pain Perineum | Aromatherapy Bath

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. 

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. 

References

  1. http://www.amazon.co.uk/Carrier-Oils-For-Aromatherapy-Massage/ dp/1874353026 
  2. http://roberttisserand.com/2011/07/lavender-oil-and-pregnancy/ http://www.quinessence.com/blog/cypress-essential-oil 
  3. Composition, biological properties and therapeutic effects of lavender (Lavandula angustifolia L). A review January 2014 Herba Polonica 60(2) 
  4. Cyprus oil  http://www.quinessence.com/blog/cypress-essential-oil 

  5. Medical_importance_of_Cupressus_sempervirens- A_review January 2016 Project: pharmacology of medicinal plants Ali Esmail Al-Snafi
    Conclusion The previous pharmacological studies revealed that Cupressus sempervirens possessed antibacterial, antifungal, antiviral, antiparasitic, insecticidal, antioxidant, wound healing, anticancer, estrogenic, anticoagulant and many other effects. This review was designed to highlight the chemical constituents and pharmacological importance of Cupressus sempervirens. (Cypress essential oil)

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 recommended an aromatherapy bath with lavender and cypress oils, and she was happy to try it. Both Lavender and cypress essential oils are antibacterial, so help healing and soothes.

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.

Conclusion

Lavender essential oil has good antioxidant and antimicrobial activities and a significant positive effect on the digestive and nervous systems. Lavender extract prevents dementia and may inhibit the growth of cancer cells, while lavender hydrolate is recommended for the treatment of skin problems and burns. 

#antenatal aromatherapy bath #postnatal aromatherapy bath #antibacterial bath #relaxing bath #comforting bath #perineal trauma #trauma of the perineum #soothing #healing #c-section #caesarean section #caesarean delivery #vaginal birth #vaginal delivery #ease pain 

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Case Study 4:

Labour Massage – Child Birth

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Motherlylove due date pregnancy & labour massage oil -| Aromatherapy Massage | Massage | Hypnobirthing | Antenatal Depression | Prenatal Depression | Postnatal Depression

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.

The science

The blend of essential oils –  mandarin, roman chamomile, and frankincense used were chosen for their harmonious blend with Apricot and Jojoba carrier 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-inflammatory agent and has been used for psoriasis, eczema, sunburn and chapped skin. The wax esters in Jojoba are similar to sebum in our skin. 

References

  1. Read about Carrier oils in this book: Carrier Oils for Aromatherapy & Massage
  2. Tiffany Field  2007, Massage therapy reduces pain in pregnant women, alleviates prenatal depression in both parents and improves their relationships
  3. Massage reduced severity of pain during labour: a randomised trial –Rubneide Barreto Silva Gallo1, Licia Santos Santana1, Cristine Homsi Jorge Ferreira2, Alessandra Cristina Marcolin1, Omero Benedicto PoliNeto3, Geraldo Duarte1, Silvana Maria Quintana1
  4. Janula Raju, Mahipal SinghEffectiveness of Aromatherapy in Reducing Labour Pain and Duration of Labour among Primigravidas: A Pilot Study  2014 . Conclusion – aromatherapy is a cost effective, non pharmacological effective midwifery intervention. It is suggested that it can create a positive birth experience and decrease the pain during labour.
  5. Alyson L Huntley, Evidence for complementary therapies for labour pain 2003, Focus on Alternative and Complementary Therapies 8(3) DOI: 10.1211/fact.2003.00302_
  6. Evidence for complementary therapies for labour pain – Burns, E., Blamey, C., Ersser, E., Barnetson, L., Lloyd, A., (2000).
  7. An investigation into the use of aromatherapy in intrapartum midwifery practice,  The Journal of Complementary Medicine. Volume 6, pp141-147.  

———————————-

Tiran D., Essential Midwifery Practice: Intrapartum Care, 2010, in book: Essential Midwifery Practice: Intrapartum Care

Therapies_in_Labour_A_Woman-Centred_Approach

Bastard J., Tiran D., Aromatherapy and massage for antenatal anxiety: Its effect on the fetus, 2006 Complementary Therapies in Clinical Practice 12(1):48-54 DOI: 10.1016/j.ctcp.2005.07.001 SourcePubMed 

Effects of aromatherapy with Rosa damascena on nulliparous women’s pain and anxiety of labor during first stage of labor.  Journal of Integrative Medicine 16 (2018) 120–125  a, Soheila Nazarpour b, Masoumeh Simbar c,, Sepideh Hajian a, Faraz Mojab d, Atefeh Talebi e 

This study showed aromatherapy with R. damascena decreases pain and anxiety during labor without any effects on the neonates’ Apgar scores or mothers’ mode of delivery. R. damascena can be recommended as a complementary medicine for decreasing pain and anxiety during labor by care providers in maternal hospitals. 

Cassar M, Massage in pregnancy. Practising Midwife 2001; 4(3):10-4,

Tiran, D. (2000) Clinical Aromatherapy for Pregnancy and Childbirth. 2nd Edition. Churchill Livingstone. London.

Labour – Child Birth – Birth

In my role as a midwife and 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 55-60 seconds and irregular. 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 and 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 on her sacral area, during contractions, I was able to induce effective uterine contractions and Primrose could cope with the 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 9 lb 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.

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

Testimonials

Lorena Ranson – 25th February 2017

“Beautiful quality oils, that smell amazing & are luxurious to use. I recommend them to all my pregnant & postnatal clients. Due date pregnancy/labour massage oil is wonderful to use in late pregnancy & I have used it on mums in early labour to reduce pain & anxiety with really good results”

Lorena Ranson- motherhood massage therapist, Midwife

Ann Bentley R.M. – 10th July 2016

“I can recommend the Due Date – pregnancy and Labour massage oil. I have been using it for some time now on our busy labour ward and it is wonderful for back ache labours when baby is in an OP position. Also used during the second stage when baby is putting pressure on the sacral vertebrae when counter pressure relieves the ache. Wonderful scent.”

Sharing Experiences

Throughout my experiences I’ve learned that some of the traditional ways still benefit us today, but being a medical professional, I wanted to understand how they worked. I always knew that doctors would accept the practice more happily, however, if the science behind it were available, and have spent much of my career promoting the benefits of natural birth and massage aromatherapy.

Now to share my expertise as a midwife, clinician and aromatherapist, I have created a range of luxurious Motherlylove products for pregnancy, birth, baby and all mothers  to use at this exciting time of their life. www.motherlylove.co.uk

#childbirth #labor #labour #aromatherapy #massage #pregnancy massage #birth #pregnant #pregnancy #anxiety #stress #nervousness #pregnant women #obstetric labor complications #obstetric labour complications #Parturition #midwifery #birthing unit #maternity