A gentle technique that uses a long piece of cloth can help a woman in labor relax and relieve some of the pain. It may also help the baby move into a better position for birth.
The technique has several names, including sifting the hips, jiggling the hips, or rebozo manteada. A rebozo is a long, woven cloth that can be used as a birthing aid. Rebozo means shawl and manteada comes from a Spanish word meaning to toss into the air on a blanket, but also means to bump or jiggle something.
Rebozo manteada or hip sifting is actually several similar techniques that use a long scarf or cloth wrapped around the birthing mother. The techniques can help the woman’s body to relax, help loosen tight muscles and ligaments, and provide support for the abdomen and back.
The practice is originally from Mexico, where rebozos are woven especially for use during birth. They are usually four to five feet long and two to three feet wide; long enough and wide enough to wrap around the hips and the belly of the mother. Rebozos come in solid colors or stripes and can also be used to wrap the baby and mother right after the birth or later can be used as a baby sling, fashion accessory, or shawl. Although using a rebozo for sifting started in Mexico, the techniques are being used all over the world.
A sheet can be used instead of a rebozo as a birthing tool. It may be more convenient for a hospital or birthing center to use a sheet or other cloth in a hospital setting where it would need to go through commercial laundering. However, a sheet should not be called a rebozo. A birthing mother can use a rebozo purchased in advance of the birth or use one brought by the doula or midwife.
In sifting the hips, the midwife or doula wraps the rebozo around the abdomen or around the abdomen and hips of the mother. As the mother leans on, sits on, or kneels over a birthing ball or other support, the birth assistant holds the ends of the cloth and gently rocks the woman hips and belly rhythmically. The birthing mother may also be standing or leaning forward against a wall or be on her hands and knees.
The gentle moving of the abdomen and hips helps reduce tension in the hips and pelvis and is thought to help relax the ligaments and muscles. The jiggling or rocking can help the baby reposition in the uterus, but this is because the muscles in the mother’s pelvis have relaxed, not because the sifting actions have actually repositioned the child, according to Rebecca Dekker, PhD, writing at EvidenceBasedBirth.com. In other words, the sifting doesn’t move the baby, it makes changes that help the baby move into a better position.
The sifting and rocking motions can also help relieve the pain during birth. This may be another effect of the relaxation of the muscles and ligaments, but the pain relief may also be caused by the physical sensations of being rocked or jiggled, which distracts from the pain of contractions. Having the rebozo tied firmly around the abdomen also can provide support to the extra weight there, which can give some relief from back pain.
In addition to being wrapped around the hips and used to rock the body, a rebozo can also be used as a pulling tool when it is time to push. When used this way, a doula midwife, or the woman’s partner hold tight to the end of the rebozo while the mother pulls. This “tug-of-war” can help the mother bear down during pushing.
There are circumstances when sifting techniques should not be done. Using a rebozo to move or rock the hips should be stopped if there are any signs of fetal distress. It should not be used if there is any unexplained bleeding or if the movements cause the mother any pain. It also should be avoided if there is an anterior placenta, which is when the placenta is at the front of the uterus. Jiggling or rocking should also be stopped if the mother is uncomfortable with the practice in any way.
Many midwives, doulas, and labor and delivery nurses use sifting techniques during birth, but not all do. You might ask about these techniques when you create your birth plan. You can ask about your midwife, obstetrician, or doula’s experience with the techniques and ask if they can bring a rebozo along with them for the birth.
Rebozos are also available for sale for use in birthing at several sites.