The hip squeeze is a straightforward counter-pressure technique used during labor contractions to alleviate intense discomfort in the lower back and pelvis. Applying this external pressure can significantly reduce the internal pain felt during a strong contraction. The technique involves a support person using their hands, forearms, or a cloth to compress the hips. It provides a means for the labor partner to engage actively and offer tangible relief.
The Mechanism of Pain Relief
During contractions, especially when the baby is positioned facing the front (posterior presentation), the baby’s head can press forcefully against the sacrum. This internal pressure causes the intense, deep lower back pain often referred to as “back labor.” The hip squeeze works by applying stabilizing compression across the pelvic structure, particularly around the sacroiliac (SI) joints.
Applying firm, inward pressure to the sides of the pelvis helps to gently “close” the joint space stressed by the descending baby. This external force counteracts the internal pressure from the fetal head and reduces tension on the uterine ligaments. Physiologically, the intense touch sensation engages the Gate Control Theory of pain, dampening the perception of labor pain by prioritizing the firm pressure signal. This mechanical stabilization and neurological distraction offer temporary relief from the deep sacral ache.
Step-by-Step Application
To perform the double hip squeeze, the support person should stand behind the laboring person. The first step involves accurately locating the target area, which is the soft, fleshy spot just above the bony prominence of the femur head. This area is slightly below the iliac crest and lateral to the sacrum. The support person should place the heel of each palm symmetrically on this spot on both sides of the pelvis, with their fingers angled slightly toward the spine.
The pressure must be applied firmly and consistently, directing the force inward and slightly upward, toward the center of the body. The pressure often needs to be strong enough to require the support person to lean their body weight into the movement. The timing is precise: the squeeze must begin immediately as the contraction starts and be maintained throughout its entire duration. As the contraction recedes, the pressure should be released slowly and completely, allowing the laboring person a moment of rest.
Optimal Positioning and Timing
The effectiveness of the hip squeeze depends on the laboring person’s position. The most common and effective positions involve the laboring person leaning forward, such as standing and leaning over a counter or a birth ball. This forward-leaning posture exposes the hips and allows the support person to use their body weight more easily for the firm, sustained pressure required.
Another effective position is the hands-and-knees, or tabletop, position, which offers the support person a clear angle for compression. Applying the squeeze while the laboring person is side-lying is more challenging, often requiring a variation where pressure is applied from the top hip inward toward the bed. The technique is most beneficial during active labor and the transition phase, when contractions become most intense and the baby is descending deeper into the pelvis.
Practical Considerations and Variations
Effective use of the hip squeeze requires clear and continuous communication between the laboring person and the support partner. The person receiving the squeeze must provide constant feedback, specifying if the pressure needs to be “Harder,” “Softer,” or shifted slightly “Up” or “Down.” This technique can be physically demanding for the support partner, so managing fatigue is important.
Alternative Methods for Compression
To conserve hand strength, the support person can use alternative methods, such as placing their forearms or elbows on the fleshy part of the hips and leaning into the pressure. If the laboring person is on hands and knees, the support partner can use their knees or shins to apply the inward pressure, which leverages leg strength over arm muscles.
Using a Rebozo
A common variation involves using a rebozo, which is a long piece of fabric, wrapped around the hips. The support partner can twist or pull the ends of the rebozo across the back to create sustained compression.