Aroma therapyWhat is aromatherapy?

Aromatherapy is a complementary therapy which involves the use of highly concentrated essential oils that are obtained from plants. These can be used in a variety of ways to encourage relaxation, a sense of calmness and wellbeing, promote healing and soothe discomfort. Aromatherapy can be administered in a variety of ways including massage, inhalation, or by being added to bath water. In many UK maternity units, midwives have undertaken additional training to be able to offer aromatherapy to the women in their care. Midwives wishing to offer aromatherapy to labouring women will need to have completed formal training before they are deemed safe to administer it. This is because like any other substance that is either applied to the skin or inhaled, there is the potential for some women to have an allergic reaction. Similarly, some essential oils are contraindicated for use in certain situations, including pregnancy and labour, and have the potential to do harm. Nevertheless, expectant mothers are increasingly considering aromatherapy as an alternative or complementary therapy for their labour and birth. One of the main reasons for this is because using aromatherapy has been found to widen the range and choice of pain relief during labour.

This article has been written to provide you with a basic overview of what aromatherapy is; how it can be used, and its benefits. However, we advise that you speak to your midwife, doctor or a qualified complementary therapist if you are interested in trying out aromatherapy to ensure you don’t use any oils that could prove harmful to you or your baby.

 

What does the research say about aromatherapy?

Research studies have concluded that there is insufficient evidence to prove the benefits of using aromatherapy as a method of pain relief in labour. However, it has been shown to relax women during their labours – reducing the levels of fear and anxiety experienced. When women feel frightened or anxious during their labour, this is known to influence the amount of pain that they experience. Therefore, where women are able to feel more relaxed during contractions, this can positively influence the amount of pain they experience and their ability to cope in labour. Studies that have looked at the use of aromatherapy during labour have found that only one per cent of women have experienced adverse reactions. Similarly, no adverse effects have been found in babies.

 

How can aromatherapy be used?

To use aromatherapy, essential oils are blended with some type of ‘carrier’ oil. Carrier oils include the use of olive, sesame, or vegetable oil. There are many other types of oils available which can be purchased from health food shops; however, you should always ensure that these are purchased from a reputable source.

Aromatherapy can be administered in a variety of ways:

Massage – Where aromatherapy is given by massage, 10 ml of carrier oil is mixed with four drops of essential oil to produce‘aromatic’ oil that can be massaged into the skin.

Footbath – Some women find a soothing foot bath very comforting during their labour. Where this is the case, a half-sized washing up bowl should be filled with warm water and four drops of essential oils added.

Compress – Soothing compresses can be applied to the sacral area (lower back) or supra pubic area (the bony area directly above your genitalia). To use an aromatherapy compress, you will need to fill a half-sized washing up bowl with warm water and add in four drops of essential oil. A flannel can be soaked in the warm water, wrung out, and then applied to the surface of the skin in the sacral or supra pubic area.

Herbal dropTaper – One drop of essential oil can be applied to the taper and the scent can then be inhaled by the woman as she wishes

Immersion in water – Providing the woman doesn’t have prolonged ruptured membranes (PROM) (where the waters have broken for more than 24 – 72 hrs before the baby’s birth); it can be perfectly safe and very soothing to soak in a bath during labour. A warm bath can be run and 10ml of carrier oil containing four drops of essential oil can be added to the bath water to provide a soothing and aromatic soak. Post birth, Tea Tree Oil and Lavender oil can be added to bath water to help soothe and heal perineal tears or an episiotomy site. NB. Hospital policies for PROM vary and your midwife and doctor will explain what is advised in your area.

Drop on the palm of the hand – This method of using aromatherapy is restricted for the use of only one essential oil – frankincense. The woman can then inhale the scent directly from the palm of her hand.

Essential oil with lavender and rosemary

 

Which oils are useful in labour and immediately following birth?

Oils can be blended together; however, it is recommended that no more than three oils are ever blended together at one time. This next section lists the various essential oils that may be used during labour and post birth; including their benefits, disadvantages and contraindications for use.

 

Bergamot

Bergamot is used to promote relaxation and to help relieve pain, muscle spasm, constipation and flatus (wind). Where bergamot is used, women should avoid skin exposure to direct sunlight for 12 hours following its application. This is because the skin becomes more sensitive to sunburn. The use of bergamot is contraindicated in women who have an allergy to citrus fruit. Bergamot should also not be used for prolonged periods in late pregnancy or shortly after the birth, as it can affect the bloods clotting properties.

Clary Sage

This is used to relieve anxiety. Clary sage also helps to encourage regular uterine contractions during labour and can help to expel (deliver) the placenta (after birth). Its use should be avoided until women are full term (their baby’s due); this is because Clary sage may trigger premature (early) labour. It is also contraindicated in women who have had any surgery to their uterus (womb).

Frankincense

Frankincense is used as a form of pain relief; it also helps to relieve anxiety and fear, and can also help with postnatal depression. Its use should be avoided where women are known asthmatics and where strong odours are known to trigger an asthma attack.

Grapefruit

This is used to help with depression, stress and anxiety. Grapefruit can also help to alleviate nausea and vomiting, headaches and constipation. Its use is not recommended in anyone who has a known allergy to citrus fruit.

Jasmine

This essential oil is known to be calming and soothing, so it helps aid relaxation and can ease pain. Jasmine also helps the uterus to contract more effectively and can be used to help accelerate (speed up) labour. It can also be used to help expel the placenta and relieve after pains. Jasmine is also used to help women with depression. Jasmine has a distinctively strong and overpowering aroma, which may cause some midwives and women’s birth partners to feel nauseous.

Lavender

Lavender is recognised as being very good for pain relief and is effective in reducing fear and anxiety. Its use can also help with expelling the placenta. It can also be used to give relief from migraines, headaches and insomnia. Lavender can also be used to provide relief from backache, sciatica and pelvic pain. It has properties that reduce inflammation and promote wound healing, so is a particularly good essential oil to add to bath water especially where women have perineal tears/an episiotomy, or have had a caesarean section. Its use is not recommended where women are known to suffer from low blood pressure, asthma, hay fever or any skin sensitivities. Lavender is also contraindicated in labours where women have an epidural and/or are being induced. Its use has been known to cause nausea and vomiting in some people.

Peppermint

This is particularly helpful with nausea and vomiting, heartburn and indigestion. Peppermint oil is also good for muscular pain and headaches and is often used to help reduce stress and anxiety. It also has pain relieving properties for labour contractions, as well as helping the uterus to contract effectively. Its use is not recommended in women who have an underlying heart problem or epilepsy. Peppermint oil can cause skin irritation in some women and it may also inactivate other homeopathic remedies.

 

Using aromatherapy safely

It is advised that essential oils are only used by individuals who have received specific training in their use, or have received training about the effects of specific oils. This is because their use can be harmful, even dangerous, where they are used inappropriately and/or in the incorrect dosage. Should you wish to use aromatherapy, we would urge you to speak with your midwife, doctor or a qualified complementary therapist before using any oils to ensure they are safe for you and your baby.

Adams JD (2012). Massage and Other CAM in Pregnancy. International Journal of Childbirth Education 27(3)37-42.

Ager C, Gadsden W (2005). Complementary therapies: moving forward. RCM Midwives 8(5):224-225.

Allright E, Pidgeon K (2003). Supporting mothers and midwives with aromatherapy: a relaxing dream come true. Midwifery Matters (99):4-9.

Barbiero E (2012). Reflexology during Pregnancy and Labour: Labour Trigger Points Explained. Positive Health (201):1.

Berkovits T (2011). Gentle and Natural Birth Induction Part 1. Positive Health (178):1.

Brown ST, Douglas C, Flood LP (2001). Women’s evaluation of intrapartum nonpharmacological pain relief methods used during labor. Journal of Perinatal Education 10(3):1-8.

Burns E, Blamey C, Ersser SJ et al (2000). The use of aromatherapy in intrapartum midwifery practice an observational study. Complementary therapies in nursing & midwifery 6(1):33-34.

Dhany AL, Mitchell T, Foy C (2012). Aromatherapy and Massage Intrapartum Service Impact on Use of Analgesia and Anaesthesia in Women in Labour: A Retrospective Case Note Analysis. Journal of Alternative & Complementary Medicine 18(10):932-938.

Easthope S (2010). Keeping birth woman-centred. Midwifery Matters (125):17-18.

Evans E (2009). Postdates pregnancy and complementary therapies. Complementary Therapies in Clinical Practice 15(4):220-224.

Habanananda T (2004). Non-pharmacological pain relief in labour. Journal of the Medical Association of Thailand 87 (Suppl 3):S194-202.

Hall H (2012). Complementary and alternative medicine in midwifery practice. Australian Nursing Journal 19(8):38-39.

Hall HG, McKenna LG, Griffiths DL (2012). Midwives’ support for Complementary and Alternative Medicine: a literature review. Women & Birth: Journal of the Australian College of Midwives 25(1):4-12.

Jones C (2012). Complementary and alternative medicine in the maternity setting. British Journal of Midwifery 20(6):409-418.

Jones L, Othman M, Dowswell T et al (2012). Pain management for women in labour: an overview of systematic reviews. Cochrane Database of Systematic Reviews issue 3.

Kaviani M, Azima S, Alavi N et al (2014).  The effect of lavender aromatherapy on pain perception and intrapartum outcome in primiparous women. British Journal of Midwifery 22(2):125-128.

McNeil A, Jomeen J (2010). ‘Gezellig’: a concept for managing pain during labour and childbirth. British Journal of Midwifery 18(8):515-520.

Mitchell M (2013). Women’s use of complementary and alternative medicine in pregnancy: A journey to normal birth. British Journal of Midwifery 21(2):100-106.

Mousley S (2005). Audit of an aromatherapy service in a maternity unit. Complementary Therapies in Clinical Practice 11(3):205-210.

Pearce L (2005). Maternal instinct. Nursing Standard 19(17):18.

Pollard KR (2008). Introducing aromatherapy as a form of pain management into a delivery suite. Journal of the Association of Chartered Physiotherapists in Women’s Health (103):12-16.

Sibbritt DW, Catling CJ, Adams J et al (2014). The self-prescribed use of aromatherapy oils by pregnant women. Women & Birth: Journal of the Australian College of Midwives 27(1):41-45.

Smith CA, Collins CT, CrowtherCA (2011). Aromatherapy for pain management in labour. Cochrane Database of Systematic Reviews issue 7.

Steel A, Adams J, Sibbritt D (2011). Complementary and Alternative Medicine in Pregnancy: a Systematic Review. Journal of the Australian Traditional-Medicine Society 17(4):205-209.

Tiran D (2010). Complementary therapies in pregnancy: recognizing and dealing with complications. Positive Health (172):1.