This acupressure point lies midway between the dimples above the buttocks and the lumbar spine (please note that Ciliao BL-32 is not the dimple). If you cannot see the dimples clearly, It lies approximately one of the women's index finger lengths above the top of the buttock crease, approximately one thumb width either side of the spine. When you place your finger on Ciliao BL-32 you can feel the small depression of the sacral foramen where the point lies. As labour begins you can start here and as the labour progresses move down the spine (approximately one thumb width at a time moving slightly closer to the centre of the spine until as you arrive at the top of the buttock crease, your knuckles will be touching). The timing of this movement downwards will depend on the women, who will usually instinctually tell the support person to apply pressure lower as the baby descends during labour.
The support person places their knuckles into the acupressure points and applies firm pressure. This pressure can be increased by the women rocking backwards into the support person at the beginning of a contraction.
From feedback these appear to be the most frequently used points. Producing a pleasant "anaesthetising" effect on the strength of the contractions, noticeably "wearing off" when the pressure is discontinued and building up again when recommenced.
There is a distinct sensation produced when you are pressing into the sacral foramen. This may be felt as a numbness, warmth, tingling, aching or buzzing. If there is sharp pain the support person is pressing on the surrounding bone and need to readjust their pressure slightly.
It is important to note that for some women the sacral foramen are not exactly in a straight line. Be guided by the women's feedback.
This acupressure point is most frequently used with women leaning or kneeling against a wall, table or bed. It can also be effectively used in water; it just requires a little flexibility on behalf of the support people!