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Massage and effleurage are two types of cutaneous stimulation used during labor for effective pain relief and comfort. Effleurage is a French word. When Dr. Fernand Lamaze's notes were translated from French into English, one of the few words kept was effleurage.
Practiced for over 5,000 years, touch is one of the oldest therapies. The whole person is treated using four basic techniques:
- Effleurage (stroking)
- Friction (pressure)
- Percussion (drumming)
- Petrissage (kneading)
All forms of massage use oil. Treatments restore relaxation and peace while reducing or ousting problems. Massage is now incorporated in other therapies such as Acupuncture, Rolfing (tissue massage), Aromatherapy, Reflexology and Shiatsu.
Effleurage is any light massage that glides over the skin but does not use pressure or movement of deep muscle masses (Tappan, 1978). Effleurage is performed by the laboring woman or by her partner/husband or her labor support (doula). Rhythmic slow circles are "drawn" with fingertips on the abdomen, thighs or arms. The sensation of pain is reduced by varying amounts, depending on the individual.
This illustrates the Gate Control Theory ( Melzack & Wall 1965) and is the same basic principle at work when you stub your toe and then rub it, reducing the pain. Pain fibers taking the pain stimulus to the brain are smaller and the sensation travels slower than the touch fibers, which are large. When touch and pain are stimulated simultaneously, the touch sensation travels to the brain and "closes the Gate" in the brain, limiting the amount of pain perceived by the brain. Touch may also include counter-pressure, backrubs, heat/cold therapies and even acupuncture.
When other non-pharmacologic pain relief methods such as a focal point and music therapy, the cerebral cortex of the brain focuses more on these comfort measures than on the pain stimulus. This adds to the limitation of pain sensations perceived by the brain. Finally, memory or the cognitive processes are stimulated by taking childbirth education classes/having been exposed to and practicing relaxation and breathing techniques. Again, these also add to the limitation of pain sensations perceived by the brain.
While no one can honestly promise that childbirth will be a pain-free process, the use of non-pharmacologic comfort measures such as the stimulation of touch is an effective pain management strategy.
References:
- Melzack, R., & Wall, P.D. Pain Mechanisms: A New Theory. Science. Vol. 150. 1964.
- Nichols, F. & Humenick, S. Childbirth Education: Practice, Research & Theory. Saunders, 1988.
- Reeder, Martin, Koniak-Griffin. Maternity Nursing: Family, Newborn, & Women's Health Care. Lippincott, 1997.
- Simpson K.R. & Creehan, P.A. AWHONN Perinatal Nursing. Lippincott, 1996.
- Tappan, F. Healing Massage Techniques. Reston Publishing, 1993.
Copyright 1999-2004 by Perinatal Education Associates, Inc.
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