Aromatherapy In Childbirth
Aromatherapy is known to aid relaxation, calm fear, promote a feeling of well-being, act as a distraction tool and even enhance contractions 1. Pain in labour is caused by heightened anxiety, which results in muscle tension, which prevents the uterus and cervix working effectively. Fear will also inhibit hormones, such as oxytocin, which is required to counteract pain and will contribute to an unnecessarily elongated labour 2. Aromatherapy is a simple, effective, non-intrusive, low-cost and completely non-pharmacological option to consider for managing labour and potentially prevent pain occurring 3.
My Birth Experience
I was first introduced to the concept of aromatherapy in childbirth as a student midwife. Unfortunately, I was only informed of its existence, as the trust I trained at did not support its use. It was not until I completed an elective placement at a different hospital, that I was able to see how powerful and impactful it could be. At this particular unit, it was especially popular, with indisputable results and positive feedback from the clients. I found myself intrigued and began purchasing books on the topic, which eventually lead to it becoming the focus of my final year dissertation. Around this time, I also learnt that I was expecting my second child and decided to use the knowledge I had acquired to incorporate aromatherapy into my birthing process.
I was intent on having a home birth, so that I could utilize a number of methods of transmission. I also decided to blend multiple oils, as I knew that it would enhance the properties of each oil and provide several benefits 4. I made the preparations in advance and included my partner in the process, so that he could provide support throughout the birth. I purchased a diffuser to allow the aroma to be intermittently circulated into the birthing space, as I wanted everyone involved to feel the effects and to promote a sense of calm 5. I also prepared two different massage oil blends, so that my partner could apply them for a direct effect, with the added benefit of relaxation. Finally, I organised strips of fabric containing drops of an oil, so that I could inhale an aroma rapidly, when it was required 6.
I had a long and sporadic latent phase, which is something I was unfamiliar with as my first labour was fast and intense. I welcomed this change of pace, as I gained a sense of control and was able to feel fully immersed in the experience. I used clary sage in a diffuser during this time, as its sedative effect allowed me to sleep, whilst the surges were mild and infrequent 7. The sound of the intermittent release of aroma and the soft, colour-changing, glow of the diffuser acted as an anchor and aided my rest.
As the surges increased in intensity, sleep became unobtainable. I started to utilise a birthing ball, whilst mobilising around the bedroom. My partner was busy preparing the birthing pool but was able to help massage the first blend into my lower back and bump. It contained lavender, chamomile, jasmine and rose, as I felt these were the most appropriate for creating a sense of calm and easing anxiety 8. It succeeded in maintaining the mood I needed, until the arrival of the midwife, at which point, my surges came to an abrupt halt.
I decided to return to resting in the bed and recommenced the clary sage in the diffuser. I also used strips of fabric containing drops of clary sage to take an immediate and more intense intake of the scent, which helped my body to relax. The surges then began to return and gathered momentum. Clary sage is most commonly associated with the ability to stimulate the uterus, so I feel it was pivotal to my labours progression, following a pause 9.
As the labour became more intense and the birth approached, I began to feel tired and increasingly uncomfortable. I was massaged with the second blend, which contained frankincense, bergamot, mandarin and grapefruit. I knew this would provide an analgesic effect, whilst also being uplifting and stimulating 10. It definitely gave me confidence, eased the pain and helped to power me through the feelings of doubt.
Soon after that, I entered the pool, as I knew the end was imminent. The diffuser containing clary sage was placed near to the pool for me to inhale. I was also using hypnobirthing breathing techniques, throughout the labour and I remember the distinctive scent of clary sage filling my senses with each long, in-breath. It made the slow out-breath easier to relax into and helped me to access a mindful space, at this crucial point.
The final stage was intense, powerful and swift. I intuitively used my hands to steadily guide my baby into the world. I lifted her out of the water and onto my chest with an enormous sense of relief. The clary sage continued to flow through the air as I soaked in the first precious moments with my baby. My placenta was also birthed easily, without intervention, shortly after emerging from the pool and this could be attributed to the clary sage 7.
Although, I used a number of aids to facilitate a relaxed and gentle birth, aromatherapy definitely felt like the central component that tethered all the other aspects together. It gave me a sense of control, worked as a distraction, formed a connection with my partner and provided relief from discomfort and worry. Most importantly, the aromas will forever be bonded to happy, positive memories that will be remembered for the rest of my life.
Useful Information & Tips
• If you are considering the use of essential oils in your pregnancy and birth, remember that certain oils are not recommended.
• Clary sage should not be used until you are full term, as it enhances uterine activity but also relaxes 1.
• All the oils I mentioned are suitable and you could also consider peppermint or spearmint to combat nausea or regain focus 11.
• Lavender is the most commonly used to alleviate anxiety and is even suitable for helping a baby to settle to sleep, so it is the perfect oil to kickstart your collection 8.
• Bergamot is an adaptogen, so it can calm or uplift depending on what your body requires. Other citrus oils such as mandarin and grapefruit are generally used to support energy 6.
• Oils such as frankincense are analgesic, when applied topically 1.
• Lavender and tea tree can be combined with witch hazel in a spray. This can then be applied to a maternity pad, following the birth to expedite healing of the perineum 8.
• Fennel is often recommended to help increase breast milk supply, so it is useful to have if you are planning to breastfeed 8.
• Rose and jasmine are incredibly expensive because of the quantity needed in the distilling process. Therefore, if you find an affordable version, it is likely to be synthetic, poor quality or unsafe; so always source your oils from a reputable supplier 12.
It is also important to consider the mode of transmission. The small, molecular size of essential oils means that they can be absorbed quickly into the body system in numerous ways 13. These include a diffuser, strip of fabric, fan, bath, compress or massage. They are all viable options and can be selected according to personal preference.
The essential oils are powerful and are only needed in small quantities and can even be harmful if used incorrectly. Only use 1-2 drops in most cases and dilute into a neutral oil, such as jojoba, almond or vegetable oil before using for massage. You can use up to 6 drops in a diffuser or bath as it is not being used on a concentrated area and up to 4 on a compress soaked in a bowl of water 14.
There are a few studies that suggest that massage is the component that is more effective at relieving anxiety, rather than the properties in the oil 15. Massage is definitely proven to heat the skin, which can alleviate pain. This also allows quicker absorption of the oils, so they have the potential to work quicker. Therefore, it may be wise to prioritise massage as the mode of transmission, as you are most likely to achieve the desired outcome 1.
There is a lot of research surrounding aromatherapy, with varied results but it is predominantly positive. The Cochrane Review in 2011 concluded that the use of essential oils had no substantial effects or benefits. However, it can be argued that this study was poorly conducted, is outdated and lacked robust studies for consideration 16. Since this report, there have been numerous studies that suggest that the use of essential oils can reduce the use of further analgesia, shorten the length of labour, decrease intervention rates and most women reported decreased pain and anxiety 17. Therefore, it is difficult to dispute its effectiveness.
Links to resources
Essential Oils For Childbirth: Using Aromatherapy To Reduce Stress, Alleviate Anxiety, And Lessen Pain With Any Birth Plan By Michaela Boldy, RN
Aromatherapy in Midwifery Practice by Denise Tiran
Complementary Therapies in Maternity Care: An Evidence-Based Approach by Denise Tiran
Labour pain control by aromatherapy: A meta-analysis of randomised controlled trials, Women and Birth. Volume 32, Issue 4, August 2019, Pages 327-335
1. Boldy, M., 2018. Essential Oils For Childbirth: Using Aromatherapy To Reduce Stress, Alleviate Anxiety, And Lessen Pain With Any Birth Plan. 1st ed. Canada: Atlantic Books.
2. Dick-Read, G., 2013. Childbirth Without Fear: The Principles And Practice Of Natural Childbirth. 2nd ed. London: Pinter & Martin.
3. Brown, S., Douglas, C. and Flood, L., 2001. Women’s Evaluation of Intrapartum Non Pharmacological Pain Relief Methods Used during Labor. Journal of Perinatal Education, 10(3), pp.1-8.
4. Tiran, D., 1996. Aromatherapy in Midwifery Practice. 1st ed. London: Bailliere Tindall.
5. Tillett, J. and Ames, D., 2010. The uses of aromatherapy in women’s health. The Journal of perinatal & neonatal nursing, 24(3), pp.238-245.
6. Price, S. and Price, L., 2012. Aromatherapy for Health Professionals. 4th ed. Edinburgh: Churchill Livingstone.
7. Horowitz, S., 2011. Aromatherapy: current and emerging applications. Alternative and Complementary Therapies, 17(1), pp.26-31.
8. Worwood, V., 2016. The Complete Book of Essential Oils And Aromatherapy. 3rd ed. Novato, Canada: New World Library.
9. Smith, V.C., 2012. Aromatherapy as a comfort measure during the childbearing year. International Journal of Childbirth Education, 27(3), p.26.
10. Chang, S.Y., 2008. Effects of aroma hand massage on pain, state anxiety and depression in hospice patients with terminal cancer. Journal of Korean Academy of Nursing, 38(4), pp.493-502.
11. Anderson, L.A. and Gross, J.B., 2004. Aromatherapy with peppermint, isopropyl alcohol, or placebo is equally effective in relieving postoperative nausea. Journal of PeriAnesthesia Nursing, 19(1), pp.29-35.
12. Tiran, D., 2016. Aromatherapy in midwifery: a cause for concern. MIDIRS Midwifery Digest, 26(2), pp.141-144.
13. Herz, R.S., 2009. Aromatherapy facts and fictions: a scientific analysis of olfactory effects on mood, physiology and behavior. International Journal of Neuroscience, 119(2), pp.263-290.
14. Lis-Balchin, M., 2006. Aromatherapy Science – A Guide for Healthcare Professionals. 1st ed. London: Pharmaceutical Press.
15. Murakami, S., Shirota, T., Hayashi, S and Ishizuka, B., 2005. Aromatherapy for outpatients with menopausal symptoms in obstetrics and gynecology. Journal of Alternative & Complementary Medicine, 11(3), pp.491-494.
16. Smith, C.A., Collins, C.T. and Crowther, C.A., 2011. Aromatherapy for pain management in labour. Cochrane Database of Systematic Reviews, (7).
17. Namazi, M., Akbari, S.A.A., Mojab, F., Talebi, A., Majd, H.A. and Jannesari, S., 2014. Aromatherapy with citrus aurantium oil and anxiety during the first stage of labor. Iranian Red Crescent Medical Journal, 16(6).