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Pregnancy Massage

Types of prenatal massage therapy

A typical maternity massage therapy session can address pregnancy's various physical challenges: edema, gastrointestinal discomforts, postural changes, and pain in the lower back, pelvis, or hips. Swedish massage may facilitate gestation by supporting cardiac function, placental and mammary development, [10] and increasing cellular respiration. It also reduces edema and contributes to sympathetic nervous system sedation. [11] Deep tissue, trigger point, and both active and passive movements alleviate stress on weight-bearing joints and myofascial structures, especially the sacroiliac and lumbosacral joints, lumbar spine, hips, and pelvic and spinal musculature. [12] Structural balancing and postural reeducation reduce neck and back pain caused by improper posture and strain to the uterine ligaments. Prenatal massage therapy also can facilitate ease of labor by preparing the muscles for release and support during childbirth.

Beyond these physical effects, an effective prenatal massage therapy session provides emotional support. In the safe care of a focused, nurturing therapist, many women unburden their worries, fears, and other anxieties about childbearing. Individualized hands-on time with a somatic practitioner presents a unique and potent experience of support and relaxation for pregnant women. In contrast to the effects of stress, support and relaxation activate the parasympathetic branch of the autonomic nervous system, increasing steroid production. This helps create balance in the body and encourages a healthy, smoothly functioning state, characterized by steady blood pressure, pulse, and respiratory rate; regular blood flow to uterus, placenta, and fetus; healthy immune system functioning, emotional states, and response to stressful stimuli; and reduced fear and anxiety.[13]

An overview of research indicates that support can counteract the negative effects of stress. Women in these studies who also had strong support systems had one-third the complications of those who experienced similar stresses without a support system.[14] A massage practitioner provides soothing, nurturing touch combined with focused, individualized attention to the pregnant woman's physical and emotional concerns. This regular, caring contact can be a vital component of an expectant woman's support system, especially when family and friends are not providing such support.

Practitioners with complementary skills and training in communication and emotional processing can offer attentive, nonjudgmental listening. This presents additional opportunities for helping women to understand and assimilate the strong emotional states that some women experience during pregnancy. Practitioners can also educate women in body-use that assists in managing and reducing stress. They sometimes provide well-researched referrals to other professionals who deal with more complex pre- and perinatal health and psychological issues.

In many cases bodywork helps the mother-to-be develop the sensory awareness necessary to birth more comfortably and actively. Massage therapy can be profoundly relaxing, and it can provide an experience of "letting go" and focusing inwardly. It can create the same positive physiologic states and increased alpha brain wave activity as meditation. Variations in pressure, rhythm, and positioning flood the sensory nerve pathways with input that can increase body awareness and override signals of pain and stress.[15] Laboring women whose partners learned and provided basic massage strokes to their backs and legs had shorter, less complicated labors.[16] Imagine the benefits generated by the skilled hands of a trained touch specialist!

The Postpartum Period

Beginning with the baby's birth, a new mother must cope with more changes. She is typically only 10 to 12 pounds lighter, yet she often still maintains her body in an anterior weight load posture. The massage practitioner can facilitate proprioceptive reprogramming to gently return the body to its pre-pregnancy state, to alleviate pain, and to bring about a renewed sense of body and self.

As a specialist in postpartum work, practitioners can focus on repositioning the pelvis and repatterning overall body use. Postpartum massage sessions can restore functional muscle use in the lumbar spine area, as well as strengthen and increase tonus in the abdominal musculature stretched and separated by pregnancy. Additionally, the overtaxed, hypotoned iliopsoas muscles' functions can be improved. Upper back muscles, which now support larger breasts and the carried infant's weight, need work to reduce strain, and to help maintain flexibility despite the physical stresses of infant feeding and care. For post-Cesarean mothers, specific therapeutic techniques also can reduce scar tissue formation[17] and facilitate the healing of the incision and related soft tissue areas, as well as support the somato-emotional integration of her childbearing experience.

Pre- & Perinatal Massage Therapy Education

To safely massage pregnant, laboring and postpartum women, it is imperative that practitioners be knowledgeable about normal pre- and perinatal physiology, high risk factors, and complications of pregnancy. Every pregnancy necessitates a variety of adaptations to aspects of routine massage practices. Various techniques and methodologies must be modified or eliminated, depending on the individual and the trimester of pregnancy. Consultation with physicians and/or midwives concerning prospective and on-going massage therapy is often beneficial, and it becomes a necessity when maternal or fetal progression deviates from normal expectations.

Pre- and Perinatal Massage Therapy, available from Biotone, offers detailed, research- based protocols, contraindications, and guidance. Practitioners with clients having low-risk, uncomplicated pregnancies may find this information adequate for their needs. For those wanting to specialize in working with all types of pregnancies, comprehensive hands-on training, beyond what is usually included in basic massage therapy programs, is highly recommended. Certification in a maternity massage specialist course, generally around 32 hours, is available as continuing education workshops. When working with other than normal, low risk pregnancies, this level of training becomes imperative. (See author's website: www.bodytherapyassociates.com for information and scheduled certification courses.)