The double hip squeeze … the darling of doulas?
If, like us here at the OBC, you are a fellow birth geek, I’m betting that you have come across many posts on social media describing the benefits of counter pressure and biomechanics when used to support the body during labour and birth.
Social media platforms are flooded with videos and posts demonstrating these techniques, often portraying them as miracle cures for labour pain and the solution to an easy straightforward birth.
So as a doula using social media, why post about these labour ‘tools’?
Visual Appeal: Both techniques are visually demonstrative and easy to showcase in short video formats, making them ideal for platforms like Instagram and TikTok.
Effectiveness: They offer noticeable, immediate relief, making them popular among doulas and birth workers.
Education and Empowerment: Sharing these techniques empowers expectant parents with practical tools, contributing to a sense of control and preparedness for labour.
However, the downside of this overexposure is the potential for misunderstanding and misuse. Without proper context and instruction from trained professionals, these techniques might be applied incorrectly, leading to ineffective pain relief or even additional discomfort.
Both Alex and I have a real passion for how the body moves during labour and birth, knowing this means that we can hopefully fill our client’s tool kit with body work that they may or may not need! No need to intervene if labour is flowing beautifully … and that brings me to the inspiration of this blog … whilst the use of biomechanics can help prevent unwanted medical intervention, it is also very much an intervention itself.
So if we are to intervene, best we know why, when and exactly how to do it!
Two of the most popular techniques we see on socials are are counter pressure and the double hip squeeze.
While they may appear similar, they serve different purposes and are applied in distinct situations. Let's explore these techniques, their physiological basis, appropriate usage, and why they are so prominent on social media.
Counter Pressure
Physiology: Counter pressure involves applying steady pressure to the lower back or sacrum area of the labouring person. This technique is particularly useful during contractions when the baby is pressing against the spine, causing intense back pain, often referred to as "back labour."
When to Use:
Back Labour: When the baby is in an occiput posterior (OP) position, meaning the back of the baby's head is against the mother's back, causing significant back pain.
Transition Phase: During the later stages of labour when contractions are intense and closely spaced, providing relief through consistent pressure can help the birthing person manage pain.
A doula or birth partner uses the heel of their hand or a closed fist to press firmly on the lower back during contractions, countering the pressure exerted by the baby’s head on the spine. This can help distribute the force and alleviate discomfort.
Double Hip Squeeze: Opening the Pelvic Outlet
Physiology: The double hip squeeze involves pressing the hips inward, which in turn opens up the pelvic outlet, creating more space for the baby to descend through the birth canal.
When to Use:
Active Labour: Can help stabilise the pelvis and relieve the pressure of baby pressing on the sacrum
Pushing Stage: To maximise pelvic opening, aiding the baby's passage.
A doula or partner places their hands on the hips (the top of the illiac crest), with fingers pointing towards the centre of the back, and squeezes inward and upward. This pressure shifts the sacrum and creates
Understanding the difference between counter pressure and the double hip squeeze is crucial for their effective use during labour.
Counter pressure is best for relieving back labour pain, while the double hip squeeze helps open the pelvic outlet, facilitating the baby's descent. Both techniques are valuable tools in a doula's repertoire, offering significant comfort and support during childbirth. While their popularity on social media has made them widely known, it is essential to seek guidance from experienced professionals to ensure they are used correctly and safely.
We work hard here at the OBC as part of our doula training to ensure that our doulas have a basic understanding of birth biomechanics and the practical uses of different pain management tools. You can find out more about our doula training here
If this is something you would love to deep dive into or just want to look into it a little more, below are some of our favourite course providers: