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Hi, everyone. In this video, we’re going to talk about using a rebozo during labor for pain relief.
Hi, my name is Rebecca Dekker and I’m a nurse with my Ph.D. and the founder of
EvidenceBasedBirth.com. In today’s video, we’re going to continue our pain management series
by talking about using a rebozo during labor for pain relief. The rebozo technique is a non-drug,
traditional way of helping manage pain during labor. It originated out of Southern and Central
Mexico and it’s easily available and non-invasive.

What is a rebozo?
Mexican birth culture has a long tradition of using the rebozo before, during and after birth. There
are regional differences in the color, texture and pattern of the rebozo but it’s a beautiful, long,
woven piece of fabric that can also be used for caring infants after the birth.
Use of the rebozo has recently become more common in other parts of the world. For example,
researchers in Denmark looked to see how frequently the rebozo is used during birth there. They
found that before the year 2014, rebozos were only used in about 2% of planned vaginal births;
however, today rebozos are used with about 9% of Danish women.

How is the rebozo used during labor?

Rebozo can be used in many different ways during labor but one of the most common is to use it
on the birthing person’s hips, using controlled motions to help move the hips or sway them from
side to side a little bit. These movements have been described as pelvic massage, rocking or
jiggling. A care provider or support person typically uses the rebozo while the birthing person is
on hands-and-knees, lying down or standing.
A lot of people think that the rebozo is especially helpful for correcting poor fetal positioning, so
if the baby is in what we call, “Posterior position.” which may make labor more painful, longer or
more difficult, a lot of care providers and doulas are well versed in using the rebozo to help
encourage the baby to shift into a better position for birth. However, rebozos are not used to
manually turn the fetus into a better position. Rather, it’s thought that the rebozo helps relax the
muscles around the pelvis, which helps the baby get into a more optimal position for labor and
birth.

How might the use of a rebozo during labor

work to relieve pain?
Researchers aren’t really sure how the rebozo might work at this point. It really hasn’t been
studied well enough. Part of it could be that the rebozo creates a positive psychological effect
from the feelings of teamwork and labor support that the birthing person gets from the support
team as they’re using the rebozo with her.
Helping a baby get into a better position could also relieve pain associated with longer labors and
fetal malpositioning. The rebozo could also act through the gate control method of relieving pain.
This is when non-painful or pleasant stimulations help block the more painful stimulations that
are coming from the contractions.

What’s the evidence on using the rebozo for

pain relief during labor?
Unfortunately, there are no scientific studies on the rebozo technique; however, that does not
mean that it’s not effective. Its current use is based on midwives, individual experiences and
individual narratives from women who’ve used it over many, many years in Mexico. Rebozo is a
traditional practice, more than an evidence-based practice.
The World Health Organization has stated that the lack of studies on traditional practices should
not become an obstacle in their application or development. There have been two papers
published in peer-reviewed journals about using the rebozo during labor.
2017 Study from Denmark
Iversen et al. published a qualitative study in 2017 in Denmark. Qualitative means that they
interviewed people and looked for narratives about their experiences.
In this study, participants could be included if they used the rebozo during labor. They were
recruited shortly after the birth and then later on, the Danish researchers interviewed them by
phone. There were 17 participants in the study and the lengths of the interviews ranged from 28
to 55 minutes. Some of the women had epidurals but most did not. Some were having
spontaneous labors and some had induced labors.
Most of the participants said that they used the rebozo because their baby was not in an optimal
position. They were using it for fetal malpositioning. Only one person out of the 17 used the
rebozo primarily for pain relief. They described using the rebozo in the standing, hands-and-
knees and lying down positions. Through the interviews, they found that the women’s
experiences with the rebozo were overall very positive.
Many participants reported that the rebozo created sensations that reduced their labor pain.
Common themes included feeling relaxed and having a positive source of distraction during
labor. In addition, many of the participants reported that they really liked how the rebozo got their
partner and their midwife more actively involved in the labor and birth process.
Some mentioned how it contributed to a more casual, relaxed atmosphere in the birth room and
many said that they smiled and laughed while the rebozo was being used- feeling like it added an
element of entertainment, which they appreciated. A few of the women described unpleasant
sensations from using the rebozo. Some said that they didn’t like using it in the standing position
because it made contractions too intense. A few said that they didn’t like the jiggling sensations
that they experienced.
2015 Review by Cohen and Thomas
In addition to that study which we just talked about, there was also a review published in 2015 by
Cohen and Thomas. In this review that was published in the Journal of Midwifery & Women’s
Health, the researchers described three different techniques that could be used with the rebozo to
correct fetal malpositioning.
They talked about the lying-on-the-back position. In this position, the participant lies on the
rebozo so that it covers the lower back and buttocks. And then there are three maneuvers that can
be done with one or two people assisting: quick tug, rocking, or knee bounce (which is when you
have bent knees and feet resting on the bed). They have photographs of these maneuvers in their
journal article.
They also talk about using the hands-and-knees position with rebozo for fetal malpositioning. In
this hands and knees position, the rebozo goes under the lower abdomen, including covering the
hip bones to form a sling. Then the support person stands behind, pulling up and back with both
hands. The goal is to create a gentle, rapid, rhythmic motion in the mother’s pelvis. They use this
technique in between contractions, so not during a contraction, and then during the contraction
they apply firm counterpressure on the person’s sacrum.
The third technique that they taught about in this article was called child’s pose. With this
position, the mother lowers down from the hands and knees so that her butt is raised up in the air.
And the rebozo goes over the woman’s behind and then by grasping the rebozo on either side of
the hips from behind the mother, they rock the hips from side to side or forward and back. That
would be done in between contractions- during contractions, again, they would stop and perform
counterpressure.

Cultural Appropriation and the Rebozo

One more important thing I want to talk about with regards to using the rebozo during labor is
something called cultural appropriation. According to the Cambridge Dictionary, “Cultural
appropriation means taking or using things from a culture that is not your own, especially without
showing that you understand or respect the culture.” Several authors have suggested ways to
avoid cultural appropriation with the rebozo. First, they say that “The word rebozo should not be
used to refer to anything that is not, in fact, a rebozo.”
This, (shown in the video), is a real rebozo and so I can call it as such, but you would not call a
sheet or some other kind of babywearing sling a rebozo. Traditional midwives in Mexico have
also expressed the wish that the rebozo should not be taken away from its cultural context. They
wish that the oral tradition of honoring the teacher who transmitted the rebozo wisdom would be
expressed before using the rebozo. This could be done in any manner that the person feels
appropriate.
In addition, traditionally, the person using a rebozo technique on someone else first asks
permission to enter that person’s space.

Where Can I Purchase a Rebozo?

It’s also important to purchase authentic, traditional Mexican rebozos. We’ll link below to several
different websites where you can purchase your rebozo. Now, the authors of the Cohen and
Thomas (2015) review say that the traditional rebozo is ideal to use because of its strength and
grip of the fabric. However, if you work in a hospital where you were going to be using a rebozo
with a high volume of patients, it cannot be heavily cleaned in a commercial laundering facility
over and over, without sustaining damaging. So, birth facilities that would like to have this option
available to a large number of women could use a sheet that could be laundered to that hospital’s
standards. However, that is not a rebozo and it should not be referred to as one.
If you’re an expecting parent and you would like to use a rebozo during labor, you can either
purchase one yourself, or often you can hire a doula or midwife who already owns one or more
rebozos that they use with their clients.
Some people have asked if there’s any reason why you could not use a rebozo, in other words,
what are the contraindications?

Contraindications to Using a Rebozo During

Labor
The authors of the 2015 review on rebozo said that “There are certain situations where you would
probably not want to use a rebozo during labor. These are situations where there’s a concerning
fetal heart rate, a breech baby where the membranes have already ruptured and there’s a risk of
cord prolapse, a condition called placental abruption, abnormal vaginal bleeding, maternal
discomfort, and other contraindications for a vaginal birth.”

Conclusion
In conclusion, the rebozo has a long history of traditional use and I would like to honor those
midwives who passed down that knowledge to other women around the world today. It likely
offers benefits to fetal positioning and increased comfort during labor. However, we do need
randomized, controlled trials and other studies on its use. In the resources section, we will link to
several resources- those papers we mentioned about the rebozo as well as other sources of
information and several links where you could consider purchasing a rebozo.
That’s it for this video. I hope you found it helpful. If you like our videos please click subscribe
and subscribe to our YouTube channel, as well as consider watching all of the many other videos
we have in our pain management series for managing pain during labor. Thanks, everyone. Bye.
The Rebozo Technique Unfolded:
Traditional Comfort Measure for
Labor
posted in: Doulas, Orgasmic Birthing, Rebozo Technique | 0

Simpan

Lots of midwives and doulas have discovered in the last years how to use the Rebozo for their
pregnant and birthing clients. This way of relaxing and moving during Pregnancy and birth comes
from traditional midwives from Mexico (like Naoli Vinaver and Angelina Martinez). They have
taught this all over the world during Midwifery Today Conferences or workshops organized by
midwives and doulas. Thanks to them so many women know now how comfortable a treatment
with the Rebozo is and how helpful it can be when there are difficult moments during birth.

Together with Naoli Vinaver, Mirjam de Keijzer and I wrote a handbook in which we explain
rebozo techniques in different situations. This book is now also available as an eBook! For those
who are interested in the book but don’t know what to expect I will give a preview of two
techniques that are described in ‘The Rebozo Technique Unfolded’.

Giving support to the pelvis

A mother expressed her desire to have support of her belly during her birth. Mirjam, her doula,
stood behind her and lifted her belly with both her hands. But the mother also wanted some
pressure in her lower back. Mirjam explained that she only had two hands and that this request
seemed impossible. Then she got the idea to use the Rebozo for this special situation.
She folded the Rebozo twice and covered the lower belly of the mother. She took both sides of
the Rebozo at the backside in one hand and pulled firmly. This brought relief of the pain in the
front. Mirjam put her other hand on the sacrum and when she pulled the Rebozo she pushed at
the same time at the backside of the pelvis. This was a wonderful way to give support at the belly
and in the meantime it gave pressure in the back. The mother loved it.

Since then we teach this rebozo technique in our workshops. It can be used during labor: during
or in between contractions. It depends on what the woman likes. Some pregnant women who
have pelvic problems like it also during Pregnancy. Be careful, don’t pull or push too hard. Adjust
your strength to what the woman want.

Coping with contractions using

Rebozo techniques
In early labor it is (most of the time) important to keep on moving and standing upright. This helps
the baby to bear down in the pelvis. When the mother has the Rebozo wrapped around her
pelvis she can lean in it and the partner (or midwife or doula) can take both sides of the Rebozo
and wrap them also around his/her waist. He or she holds the ends of the Rebozo tight to the
rest of the Rebozo so there is a circle around them.

The women leans with her butt into the Rebozo. She makes a movement like sitting down with
slightly bended knees. The partner tries to find a good balance with her. Now the woman starts to
move like dancing, swaying her pelvis in the Rebozo and the partner follows.
Together in the circle of the Rebozo they will have a intimate and nice moment to cope with the
contractions, to have fun in between contractions and it is the best way to start the birth process!