Throughout your client’s pregnancy, you’ve helped her survive many challenges, from swollen ankles and a sore back to varicose veins and sciatica. But the benefits of massage don’t stop when she enters the hospital in labor. In fact, a special type of massage may assist her through some of the most trying moments associated with childbirth.

Ice is typically used to reduce discomfort from perineal lacerations and episiotomy after delivery. But what about using ice before the baby arrives.

A Case Study

Based on the theory that cold temperatures diminish nerve sensitivity, Bette L. Waters and Jeanne Raisler conducted a study in 2003 in which they sought to determine the effectiveness of ice massage in reducing labor pain.

Twenty-nine Hispanic and 20 white women, ranging in age from 16 to 38 years, participated in the study. All subjects were Medicaid recipients who were receiving care at a women’s clinic staffed by certified nurse-midwives and obstetricians from a 250-bed hospital in New Mexico. Sonogram indicated that the gestational age of the women ranged between 37 and 41 weeks.

All participants received a reactive fetal heart rate monitoring strip, were experiencing contractions at least every 10 minutes and had some cervical changes, either effacement or dilation.

The researchers crushed approximately one-third cup of ice and placed it in the center of a soft, thin terry washcloth; they lifted the four corners of the washcloth and twisted them at the center to make a small ice bag that fit securely between the thumb and forefinger.

The target placement for the ice massage was the acupressure energy meridian point of the large intestine 4 (LI4), which is located on the medial midpoint of the first metacarpal within 3 to 4 mm of the web of skin between the thumb and forefinger.

The ice bag was placed on the palm side of the hand and rocked back and forth over the area with a pressure equivalent to light scratching, which was intended to mildly irritate the nerve endings in the skin. Massage began with the onset of a contraction and stopped when the contraction was over.

This process repeated on one hand for 20 minutes, or throughout three or four contractions, whichever occurred first. The technique was then repeated on the other hand.

The Results

Participants reported a mean pain reduction on the Visual Analog Scales (VAS) of 28.22 mm on the left hand and 11.93 mm on the right hand. When ice massage was administered to this same anatomical area after delivery, the participants reported a decrease from a number three (distressing) on the McGill Pain Questionnaire (MPQ) to a number two (discomforting).

In 2012, researchers from the Behavioral Sciences Research Center & Nursing Faculty Baqiyatallah University of Medical Sciences in Tehran, Iran, conducted a study that compared ice massage and acupressure techniques to reduce labor pain. They found both methods to be effective; however, ice massage delivered more persistent pain relief.

When it’s time to head to the hospital, your client might want to make sure you are on her call list. After all, you’ve helped her from the beginning of her pregnancy. It would be nice to complete the cycle and assist during the birth.

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