Pregnancy massage

Definition

Pregnancy massage is the prenatal use of massage therapy to support the physiologic, structural, and emotional well-being of both mother and fetus. Various forms of massage therapy, including Swedish, deep tissue, neuromuscular, movement, and Oriental-based therapies, may be applied throughout pregnancy as well as during labor and the postpartum period.

Origins

Cultural and anthropological studies indicate that massage and movement during the childbearing experience were and continue to be a prominent part of many cultures' health care. Indian Ayurvedic medical manuals detail therapists' instructions for rubbing specially formulated oils into pregnant patients' stretched abdominal skin. Traditional sculptures depict Eskimo fathers supporting and lovingly stroking their laboring wives' backs. In certain Irish hospitals laboring women are held and touched by a doula (labor assistant) or midwife through most of their notably short, uncomplicated labors. For billions of women, over thousand of years, midwives' highly developed hands-on skills have provided loving support and eased childbearing discomforts. As massage therapy resumes its place within Western healthcare methods, pregnancy massage is becoming one of its fastest growing specialized applications.

Benefits

Profound physiologic, functional, emotional, relational, and lifestyle changes occur during gestation and labor, often creating high stress levels. Too much stress can negatively affect maternal and infant health, resulting in reduced uterine blood supply and higher incidence of miscarriage, prematurity, and other complications. Massage therapy can help a woman approach her due date with less anxiety as well as less physical discomfort. Even apart from easing specific aches, massage can act as an overall tonic and increase the expectant mother's body awareness.

Massage therapy can address the various physical challenges of pregnancy: edema ; foot, leg, or hand discomforts; and pain in the lower back, pelvis, or hips. Swedish massage may facilitate gestation by supporting cardiac function, placental and mammary development, and increasing cellular respiration. It can also reduce edema and high blood pressure as well as contribute to sympathetic nervous system sedation. Deep tissue, trigger point, and both active and passive movements alleviate stress on weight-bearing joints, muscles, and fascial tissues to reduce neck and back pain caused by poor posture and strain on the uterine ligaments. During labor, women whose partners use basic massage strokes on their backs and legs have shorter, less complicated labors. After the baby's birth, massage therapy can gently facilitate the body's return to its pre-pregnancy state, alleviate pain, foster a renewed sense of body and self, and help maintain flexibility despite the physical stresses of infant care. For post-Caesarean mothers, specific therapeutic techniques can also reduce scar tissue formation and facilitate the healing of the incision and related soft tissue areas.

Description

When nestled with pillows or other specialty cushions into a side-lying or semi-reclining position, most women are more comfortable for the 30–60 minutes of a typical massage session. A pregnant woman can expect to enjoy many of the same techniques, draping, and professional demeanor offered all massage therapy clients. The lower back, hips, and neck benefit from sensitively applied deep tissue, neuromuscular, and movement therapy . Edema in the legs and arms may be relieved with the gliding and kneading strokes of Swedish or lymphatic drainage massage. Pregnant women should expect a thorough health and prenatal intake interview with their therapists. Cost, procedures, and insurance coverage are similar to those for other massage client populations.

Preparations

In addition to the preparations listed in the massage therapy entry, some expectant women will be asked to secure a release from their maternity healthcare provider, especially those with complications or high risk factors.

Precautions

In addition to those listed in the massage therapy entry, the following other precautions are prudent:

• The abdomen should be touched only superficially with a flat, gentle hand.
• Any pressure applied to the inner leg should also be superficial.
• Women who must be on bed rest for any complication are at higher risk of blood clots forming in their legs; therefore, most massage of the legs should be avoided.
• Massage is safest when a woman is either lying on the side or propped semi-sitting at a 45–70 degree angle rather than lying on her back or belly.
• Because there are many other specific body areas and types of techniques that must be avoided or modified according to an individual woman's health condition, advanced specialized training of the therapist and consultation with her physician or midwife are highly recommended. It is better to avoid massage if the woman has vaginal bleeding, abdominal pain, or diarrhea.

Side effects

There are no known side effects to receiving appropriate prenatal massage therapy.

Research & general acceptance

Current research on the benefits of touch is providing a contemporary basis for its reintroduction into maternity care. Scientists have found that rats restricted from cutaneous self-stimulation had poorly developed placentas and 50% less mammary gland development. Their litters were often ill, stillborn, or died shortly after birth due to poor mothering skills. Women who are nauseated and/or vomiting prenatally experienced a decrease in these discomforts when they applied finger pressure to a specific acupuncture point (acupressure ) on their forearm several times each day. Pregnant women massaged twice weekly for five weeks experienced less anxiety, leg, and back pain. When compared with control groups who practiced relaxation exercises only, the women who had had massage reported better sleep and improved moods, and their labors had fewer complications, including fewer premature births. Studies show that when women receive nurturing touch during later pregnancy, they touch their babies more frequently and lovingly. During labor the presence of a doula, a woman providing physical and emotional support, including extensive touching and massage, reduces the length of labor and number of complications, interventions, medications, and Caesarean sections.

Training & certification

Some massage therapy schools include comprehensive courses in pregnancy massage therapy. More often, however, therapists receive only introductory guidance in maternity applications during their 500–1000 hours of basic training and then pursue specialization certification in pre- and perinatal massage therapy. Several nationwide

programs offer such advanced training in 24–34 hour workshop programs.

Resources

BOOKS

Curties, Debra. Breast Massage. Moncton, New Brunswick, Canada: Curties-Overzet Publications Inc., 1999.

Goldsmith, Judith. Childbirth Wisdom. New York: Congdon and Weed, 1984.

Klaus, Marshall H., M.D., John H. Kennell, M.D., and Phyllis H. Klaus, M.Ed. Mothering the Mother. New York: Addison-Wesley Publishing Company, 1993.

Osborne-Sheets, Carole. Pre- and Perinatal Massage Therapy: A Comprehensive Practitioners' Guide to Pregnancy, Labor, and Postpartum. San Diego: Body Therapy Associates, 1998.

Rich, Laurie. When Pregnancy Isn't Perfect. New York: Dutton, 1991.

Samuels, Mike, and Nancy Samuels. The New Well Pregnancy Book. New York: Fireside, 1996.

Yates, John, PhD. A Physician's Guide to Therapeutic Massage: Its Physiological Effects and Their Application to Treatment. Vancouver, BC: Massage Therapists' Association of British Columbia, 1999.

ORGANIZATIONS

National Association of Pregnancy Massage Therapy. (888) 451-4945.

Carole Osborne-Sheets