Counter pressure is applied starting at the beginning of a contraction and held for the duration of the contraction for relief. This can be fairly fatiguing for your birth partner, so we definitely recommend working out for BOTH of you during pregnancy!
There are several counter pressure techniques. However, you may find one provides the most relief for you during labor.
How does counter pressure work?
During a contraction the uterus pulls upwards to build into the fundus or top of the uterus. This causes the cervix to efface (thin) and dilate (open). However, when a contraction occurs it also pulls on the attaching uterine ligaments, increasing the tension in these ligaments which can increase pain.
Sometimes baby’s position causes more of a pull on the uterine ligaments, such as an occiput posterior presentation resulting in more of a forward pull on the uterosacral ligaments. The combination of a contraction and the baby’s position can increase pain. Back pain does NOT always mean baby’s position is off though!
Counter pressure is applied to the bony structure of the pelvis and decreases tension in the ligaments. This decrease in tension relieves some of the pain from a contraction.
You may find counter pressure feels good during pregnancy, but you’ll notice it tends to feel so much better during labor! Most of my clients report that they were fairly unimpressed with counterpressure while I was teaching their partner to apply counterpressure, but during labor finally understood why everyone loves it so much!
How to apply counter pressure
There are several techniques that you can use to apply counterpressure. The two main techniques involve either a hip squeeze or sacral pressure.
In our online childbirth education course and birth partner prep program, we explain in videos each counter-pressure technique in more depth. We also incorporate counter pressure techniques in our third trimester prenatal fitness programming in our labor prep workouts!
3 Counter Pressure Techniques for Labor Comfort
1. Double Hip Squeeze
How to do the counterpressure technique:
For the double hip squeeze, you’ll feel the femur head or the bony protrusion on the side of the hip.
Right above that space is an indented portion of the glutes that you’ll put the heel of your palm into.
With fingertips facing inwards, you’ll press up and in.
Experiment with placement! Try it out during pregnancy to find where the perfect spot for YOU is!
Counterpressure is all about communication: you may need to ask your partner to squeeze harder or softer, or move their hands a little higher or lower.
2. Pelvic Press
How to do the counterpressure technique:
- For the pelvic press, you’ll feel for the top of the iliac crest, or top of hip bones.
- Then placing your palm on each side of the crest, with fingertips pacing down, you’ll press directly inwards.
- You may feel the bottom of the pelvis open a little as your hips are pressed in!
It is easy to go TOO HARD with this one, so communication is key to find the right amount of pressure!
This technique is the HARDEST to sustain as a birth partner but can be the best for the later parts of labor as baby has moved lower in the pelvis!
3. Sacral Counter Pressure
How to do the counterpressure technique:
For sacral counter pressure, you’ll feel the triangular bone on the back of the pelvis (the sacrum).
Placing your entire palm flat onto the bone (there may be a tendency to put more weight into the heel of the palm), you will press directly down into the sacrum.
If you want to stand more upright, have your partner hook the front of your hip to keep you from being pushed forward with the counter pressure.
Sacral counter pressure tends to be most helpful if you have back labor!
Considerations
Applying counter pressure can relieve pain from a contraction, but if the pain is from baby’s position being slightly off or less optimal, we also want to work to correct the position.
How can you tell if baby’s position is potentially off??
Your contraction pattern.
If you find your contractions are irregular, such as back to back with a long break; or double peaking, where the contraction starts to come down but then increases again before coming all the way down, then it could be a sign baby’s position is off.
If it’s baby’s position, we want to focus on both helping provide relief so you can relax as much as possible with contractions and also correcting their position.
Usually, strong contractions will move baby into a better position, but we can also use different techniques to help with positioning.
Want to learn more??
Check out our online childbirth education courses, which are completely self-paced and you’ll maintain access forever! Our complete and condensed childbirth education course both include counter pressure and techniques to help with baby’s position.
Local to us or want to learn live with us? Explore our in-person and virtual and virtual childbirth education course we offer once a month on Sunday’s!