3.4 Comfort Measures: Manual Pressure on the Top of the Tubercles

3.4 Comfort measures: manual pressure on the top of the tubercles

In 3.1 & 3.2, we focus on where we place our hands on the mother’s sacrum when applying counter pressure. In 3.3 & 3.4, we focus on where we place our hands on the mother’s iliac crest when applying counter pressure.

The iliac tubercles are the widest point of the ilium. It’s about 2-5 cm posterior to the ASIS (the front bony protruding bone that most people can easily feel). When we place both our hands on the top of the tubercles and apply pressure inwards from both sides towards the mother’s pelvis, we are causing the pelvis to flare open at mid pelvis to outlet pelvis, providing comfort as well as creating even more space within the mother’s pelvis as baby is making its way through the pelvic cavity.

This is most comfortably done with the mother either in a standing position or kneeling position with her birth supporter behind her.

You can use this technique in a non-problematic labor and/or to modify the pelvic opening and create more space in the mid pelvis to outlet pelvis. Any techniques for the second stage are best utilised with good and effective breathing techniques to enable the mother to bear down effectively.

For OMP Active Birth Positions , OMP Pelvic Mobility Protocols and OMP Comfort Measures to be effective, it has to be done during contractions and used for 5-10 consecutive contractions to see if it is effective in enabling labor to progress.