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In this Post: Many massage therapists are intimidated by prenatal and postpartum massage, but they shouldn’t be. Pregnant women, and women who have just had babies need our nurturing touch! Learn common myths associated with this type of massage, to help you massage with more confidence and ease!
Pregnancy is not easy and can take its toll physically, as well as mentally and emotionally. As beautiful and amazing as childbirth is, ten months is a long time to share space with an ever-growing babe (or multiple babes)!
When I was pregnant, I was a stressed out, miserable mess. Morning sickness in the beginning, expanding hips that wouldn’t allow me to walk the dog, and above average emotional stress about whether I had purchased enough baby hangers.
Being stressed out about baby hangers seems a little silly, but pregnancy does strange, unexplainable things to the psyche!
Exercising regularly and eating a balanced diet are obvious ways to combat fatigue and maintain a healthy mindset. But what about the aches and pains that constantly change throughout pregnancy and after delivery?
In addition to stretching regularly and staying hydrated, prenatal massage can be a game changer both physically and mentally. Hormonal changes not only affect one psychologically but also physically.
A Few Of The Pregnancy Hormones And How They Affect The Body
Before you dive into prenatal massage, it would behoove you to learn about the changes women experience during pregnancy. Learning about these changes will help you serve your clients in a more educated, comprehensive way!
Produced in early pregnancy by an ovarian cyst called the corpus luteum, at ten weeks the placenta takes over the production of progesterone.
Progesterone relaxes the smooth muscles in the body, including the muscle wall of the uterus. It also causes relaxation of blood vessels throughout the body.
The effects one may feel from this hormone include; lower than normal blood pressure, dizziness, gastrointestinal problems such as acid reflux, burping, vomiting, gas, and constipation. This hormone can also lead to hair growth in strange places!
Initially produced by the corpus luteum until the placenta takes over production.
Estrogen triggers the growth of many organs and biological systems in the fetus and is a key player in the development process. In addition to the development of the fetus, estrogen also enlarges milk ducts in the breasts. This prepares them for milk production and enhances the uterus, allowing it to respond to other hormones such as oxytocin.
The effects associated with this hormone include increased appetite, nausea, spider veins, and changes in skin.
Relaxin is the pregnancy hormone which the placenta produces to soften the cervix and tissues of the birth canal in preparation for childbirth (hence the name).
In addition to softening your reproductive system, this hormone also loosens muscles, joints, and ligaments throughout the entire body. This can put women at a higher risk of sprains and strains during their pregnancy as well as reduce their stability and balance. Looser ligaments can also mean the widening of feet and the flattening of arches, which can cause some serious aches and pains and also may affect posture.
Emotional Challenges During Pregnancy And Postpartum
In addition to hormones affecting one physically, they can also cause mental and emotional changes. Some common side effects include moodiness and irritability, trouble sleeping, and forgetfulness. Fluctuating hormones can also attribute to crying spells and fatigue.
Hormones aside, bringing new life into the world can be a daunting thought. Many fears such as finances, work, relationship with one’s spouse, and the unknown of motherhood can cause a great deal of stress.
Motherhood, unfortunately, doesn’t come with a manual and the thought of not having all the answers and not knowing exactly how to care for this new human can be very stressful, (these thoughts don’t exactly help the sleeplessness caused by hormone changes!)
Another source of anxiety for many pregnant women is their changing body. Weight gain, stretch marks, varicose veins and not knowing if their body will ever return to normal after birth can be very concerning for many expecting mothers and can be a source of added anxiety and stress.
Postpartum is an especially vulnerable time for new mothers. Depression is more common after giving birth. Due to a sharp drop in estrogen and progesterone after birth up to 80% of women experience the “baby blues,” symptoms include problems sleeping, feeling sad and overwhelmed and frequent crying. Luckily, baby blues symptoms will usually subside within two weeks of giving birth.
Benefits of Prenatal and Postpartum Massage
Prenatal, postnatal, or perinatal massage can be a great way to prevent and treat many of the physical difficulties of pregnancy as well as help ease mental and emotional stresses. What a beautiful position we as massage therapists are in to help alleviate some of these burdens.
Many studies indicate that prenatal massage can reduce symptoms of depression and anxiety, relieve joint pain and muscle aches, and improve labor and newborn health.
Hormone regulation through massage is also a great benefit. In the past ten years, studies have shown that hormone levels associated with stress and relaxation can be significantly altered with prenatal massage. The Touch Research Institute, an institute funded for years by Johnson and Johnson, confirmed in a study in 1999 that massage during pregnancy produces higher levels of dopamine and serotonin and lower levels of cortisol and norepinephrine. This can improve not only mood but also overall cardiovascular health.
Implementing massage into ones prenatal care can also benefit baby during birth, fewer complications such as low birth weight are associated with the regulation of said hormones. Labor may also be easier for mom as massage can have a sedating effect on the nervous system, promoting stress relief and relaxation.
Speaking of relaxation, massage can significantly improve sleep, which can be hard to come by throughout an expecting mother’s entire pregnancy.
There are also many physical benefits associated with prenatal massage.
During pregnancy, blood volume increases by up to 60%. Massage promotes healthy blood circulation throughout the body, can reduce the swelling of joints, increase blood flow to the mother’s heart as well as to the placenta and uterus, and help maintain healthy blood pressure. Increased blood circulation also stimulates the lymph system, increasing the removal of toxins and increasing overall immunity. Healthy circulation also delivers more oxygen and nutrients to the mother and the growing fetus.
It is also valid to note that because of this increased blood flow pregnant women tend to run hot. You may want to skip the hot stones, space heaters, and table warmers when working with expectant mothers.
Sciatic nerve pain is a common side effect of pregnancy, as the fetus and uterus get larger they apply more pressure on the muscles of the pelvic floors as well as the lower back causing pressure and swelling of the nerves in the area. Releasing tension of the muscles through massage can reduce the pressure on the inflamed nerves resulting in a significant reduction in nerve pain.
In addition, prenatal massage can help remedy many other common pregnancy discomforts such as headaches, leg cramps, tension and knots, shortness of breath, acid reflux and heartburn, swelling, constipation, nasal congestion, lower back pain, varicose veins, and joint pain.
After doubling the amount of body fluids during pregnancy, the body must find balance. Massage can help with this as it assists in lymphatic drainage. The removal of excess fluids — assisting the body to shift excess water to the correct places.
Improved breastfeeding is another great benefit; massage increases prolactin levels (lactation hormone) and relaxes the body, which also helps milk production. Let the milk start flowing!
Dispelling the Myths
Therapeutic Massage Does Not Cause Miscarriage.
75% of miscarriages occur during the 1st two weeks of pregnancy when many women don’t even realize they are pregnant.
Check out these statistics for more eye-opening statistics about what does increase the risk of miscarriage. You might be surprised that things like the amount of butter that is consumed carries high risk.
One thing that you will find when you visit the above sites is that massage is not listed as a cause, but… Feeling stressed out carries a 200% higher chance of miscarriage. Think we as therapists might be able to help here? I think so!
“If fetal demise was as simple as getting a massage, or pressing some acupressure or reflexology points, it is doubtful that the abortion industry would exist… Despite a valiant search, we were unable to find any studies from any source that linked massage as a cause of miscarriage, or any studies in which the participants receiving massage had a worse outcome than participants not receiving massage.” – Judith Koch founder of the Institute of Somatic Therapy
Reflexology And Acupressure
Intention is a powerful force with profound impacts. Forced and sustained pressure and attention to exact points with the intention of inducing energy flow is contraindicated during pregnancy. But, this does not mean that you must avoid touching certain areas of the body altogether.
For example, point-like Spleen 6 (SP6) and Large Intestine 4 (LI4) shouldn’t be held for long periods. However, you can still massage these areas. Massage and acupressure or reflexology are very different techniques than a simple relaxing massage. They have very different intentions. If you are working with care, respect, and positive intentions, you can safely massage over points that are thought to induce labor. All too often, contraindications for acupressure are misconstrued as contraindications for massage in general. Let’s dispell this myth!
Suzanne Enzer, who wrote, “The Maternity Reflexology Manual” asserts that reflexology cannot cause the recipient’s body to do anything unnatural. She believes only if a woman is ready to go into labor will reflexology have any impact. Reflexology on its own cannot induce labor.
I am a firm believer that massage is beneficial for women in all stages of their pregnancy. It seems that all too often therapists shy away from doing this type of work because they lack knowledge and confidence. They fear that they will somehow cause problems. And while there is no evidence to be found that massage has a negative affect for pregnant women, there are still a few safety considerations.
- The risk of blood clots is greater during pregnancy, therefore use less pressure on the legs.
- High-Risk Pregnancies – when a doctor has restricted massage, don’t do massage!
- Certain positions – Supine is contraindicated because the weight of the baby and other uterine contents can press directly on the aorta and inferior vena cava, which decreases blood flow. If you happen to massage your client supine, make sure to check in frequently. Work in short 3-5 minute bursts. Immediately flip them to their left side if they start to show any signs of dizziness, nausea, or unease. Instead of working in the supine position work side-lying or semi-reclined.
When To Get A Written Medical Release
- HELLP syndrome
- Severe chronic hypertension
- Moderate to severe gestational hypertension
- Placenta previa
- History of partial placenta abruption in this or former pregnancies
- Symptoms of bleeding
- Preterm labor in this or previous pregnancies.
- History of miscarriage
- Blot clots, thrombophlebitis, DVT, history of DVT or embolism
- Clients restricted to bed rest
- Clients with conditions managed in the hospital
- Avoid deep abdominal massage – primarily to prevent any question or association of massage with miscarriage in you or your client’s mind.
- Avoid using certain essential oils, lavender, rose, rosemary, geranium, and chamomile, to name just a few.
- Breast massage during high-risk pregnancies, because it could cause uterine stimulation.
- Avoid rocking, rotations of range of motion stretches, or Trager bodywork as they could cause nausea.
- Avoid electric blankets and heating pads. Pregnant women tend to run hot, and because of EMF exposure. Which is bad for both mom and fetus.
- Do not overstretch joints as hypermobility occurs during pregnancy.
- Avoid deep work when edema is present.
The main thing I hope to convey to you today is to not be so scared of prenatal massage. Pregnant women need relaxing touch! Their bodies crave it, maybe even more so than any other time in their lives. If you approach this type of work with a nurturing, do no harm attitude, you have the potential to significantly reduce the physical and emotional toll pregnancy can create. Massage Therapists, get out there and help some mamas!
- Boulder College of Massage Therapy Graduate
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