How is massage for pregnancy different?
Prenatal massage sessions are designed in consultation with you – some women come in for a session that is much more focused on relaxation, others need really specific therapeutic work to address particular discomforts. Most women need a little of both. Your comfort and safety during the massage are always the most important elements of any session. Below are two of the major areas that distinguish pregnancy massage.
Positioning on the table: As the body changes shape and size during pregnancy, positioning options during massage (and sleep!) become increasingly limited. We work with our clients mostly in a side-lying position on the massage table.
To ensure your comfort, we use special, orthopedically-designed cushions to position you on your side and keep you well supported. Most women find this extremely comfortable and often pick up some creative pillow tips for use at home. (more on pillows below!)
Areas of Focus: In general a prenatal massage session is going to spend a lot of time working on a woman’s hips, back, shoulders and neck. These areas hold a lot of tension, and are often bearing the brunt of her changing shape and loosening ligaments. A full-body massage is fully appropriate for a healthy pregnancy, with some modifications as discussed with your therapist.
Please note that treatment from your massage therapist is intended as a supportive therapy complimenting the prenatal care of your midwife or physician, never as a replacement.
Why Massage During Pregnancy?
Pregnancy is a time of dramatic shifts in a woman's body. For many women pregnancy ushers in a series of physical discomforts, as well as stress and emotional changes, as she prepares for significant transformations with the addition of a child to her life. Almost every system in her body undergoes changes as she supports the growing fetus and makes room for its increasing size.
In a normal, healthy pregnancy, a woman can anticipate any of the following: as her uterus enlarges, the contents of her abdomen are rearranged and shifted; her joints are relaxed and loosened, often accompanied by pain and misalignment; her center of gravity changes and is compensated for by swaying the low back and shifting her walking pattern; her breathing patterns change as the growing fetus begins to limit abdominal breathing; her digestive system is ravaged as she battles nausea, pressure on her stomach, constipation and hemorrhoids. Many women experience bouts of fatigue, insomnia, swelling in their limbs, carpal tunnel syndrome and emotional swings.
Quite a lot of change over a short period of time! Pregnancy is often also a time of great emotional unfolding and a deeper development of a woman's body-mind relationship, as she grapples with all that is happening.
Massage can be a supportive therapy that assists women throughout these changes - relieving many of the new aches and pains and other physical discomforts of pregnancy, as well as helping them reduce the everyday tension and stress they are experiencing.
What are the benefits of prenatal massage?
Massage promotes overall wellness throughout the duration of pregnancy and in the postpartum period, with several benefits:
*Promotes relaxation and minimizes stress *Helps alleviate morning sickness *Reduces fatigue *Relieves headaches *Reduces edema and lowers blood pressure *Promotes constipation relief *Alleviates backaches *Relieves leg cramps *Enhances sleep *Helps reduce pregnancy induced carpal tunnel syndrome *Facilitates better breathing *Facilitates postpartum emotional, psychological and family adjustments *Contributes to postpartum rehabilitation of abdominals and promotes structural realignment
There is an increasing amount of research studying the benefits of massage for pregnant women. Women who receive regular massage throughout their pregnancy report fewer obstetric and postpartum complications, such as reduced prematurity rates, shorter and less painful labors, and fewer days in the hospital following labor and delivery. Massage has been shown to help reduce postpartum depression, and in studies, depressed adolescent mothers reported less anxiety and depression, which was indicated by decreased stress hormones in their blood.
How does pregnancy massage accommodate my pregnant belly?
We work with each individual woman to find a very comfortable and relaxing position on the table for your body. We will help adjust you on a table using pillows and special contoured body cushions to support you and your changing shape and size. Depending on how far along you are in your pregnancy, we will adapt your positioning on the table aiming to take the pressure off your low back and hips. We never work belly/face down on the table during any trimester, we will only use combinations of reclined, face-up positions and side-lying positions. We will discuss these, and find ways to optimize your comfort and use positions that promote the best oxygen/blood circulation for both you and your baby. The further along you are in your pregnancy, the side-lying position is the safest. Most women love these cushions and want to take them home with them!
In our practice, we do not use any special tables or pillows with “belly cut outs” to help you lie face down; while some women feel relief from these cushions, we are not so sure how ideal they are for receiving massage. It seems lying face down, no matter how well supported your belly is, creates too much strain on your low back and could increase intrauterine pressure, particularly once we begin applying pressure to your low back and hips during the massage. For many women, these special pregnancy pillows end up recreating some of the postural distortions that they are seeking relief from through massage.
Which techniques will be used?
Pregnancy massage is always gentle and nurturing. But that can also include appropriate deep tissue work on the back and hips. Depending on where you are in your pregnancy and how you are feeling, your therapist may use any of the following techniques:
*Breath work and body-awareness to help you adjust to your changing body
*Swedish massage, gentle stretching and limited deeper tissue work to help increase circulation and minimize developing varicosities, reduce stress and fatigue, reduce muscle cramping and spasms, and reduce fluid retention in feet and legs.
*Postural alignment techniques to help relieve the pain from strain in your hips and low back.
*Relaxation techniques to foster deeper relaxation and internal awareness.
We never do any deep abdominal work throughout the pregnancy, and avoid the abdomen all together during the first trimester. It is completely safe during this time, as your uterus is still the size of your fist and protected by the bony structure of the pelvis. However, due to the high incident of miscarriage in the first trimester, massage therapists avoid it because women tend to have some anxiety around their belly, and the objective of the massage is to reduce stress. Depending on the health of your pregnancy, we may decide to add light gliding strokes over your belly as the pregnancy progresses into the second and third trimesters. This promotes skin elasticity and circulation to the general area.
Are there any times when massage should be avoided during pregnancy?
Pregnancy causes significant systemic changes in the body, and for some women these physical changes can lead to prenatal complications, including placental abnormalities, intrauterine growth retardation, premature rupture of membranes, pregnancy induced hypertension, as well as gestational diabetes. While massage is not necessarily contraindicated for all of these conditions, you and your massage therapist may need to make several modifications to adapt to your current situation. In order to make sure we are accommodating you properly, we will take your medical history and ask for regular updates on your pregnancy and any new discomforts. If you have any of the conditions listed above, we may need to ask for a written release from your doctor or midwife before beginning or continuing massage treatments.
Can I receive massage during my first trimester?
Absolutely! There are lots of rumors out there that massage is to be avoided during the first trimester. And the policies of some therapists and day spas actually restrict massage to second and third trimester simply because of the high miscarriage risks of first trimester. This, however, is a restriction based on potential liability issues in an extremely litigious society, not on the safety of massage. Massage by a properly trained therapist poses absolutely no risk to you and your developing baby throughout your entire pregnancy. For a woman who is at particular high risk for miscarrying and/or has experienced previous miscarriages, she may want to be careful about adding lots of new activities including massage. Others may want to add the relaxation and stress relieving benefits of massage to their routines. If you are considering massage during first trimester and are concerned about its safety during your specific situation, please consult your doctor.
How late in my pregnancy can I receive massage?
Assuming the pregnancy is healthy, you can have massage up until you are ready to give birth – and hopefully you will even have support people in the birth who will give you any touch that you might need during the laboring process. In fact, some women even schedule a massage on their due date so they will have something to look forward to if labor hasn’t progressed at all.
How often should I receive massage while I am pregnant?
There is no standard answer for this question, as each woman and each pregnancy are different. Massage is intended as a support for you throughout and following your pregnancy, so you should aim to schedule appointments as you need them to help manage the stress and discomforts. If massage therapy is going to be an integral part of your prenatal care, you will probably benefit from sessions once or twice a month in the first trimester, and two to three times a month in the second and third, more frequently as you approach you due date. If you are experiencing intense discomforts, you may want to schedule more frequent or longer sessions.
Involving your Partner
Oftentimes we encourage women to bring their partner (or another support person) in for a special "partner massage" sessions. During this time, we can teach the partner several techniques to help alleviate some of the pregnant woman’s more nagging discomforts and tips on how to provide general loving support through touch. This not only gives the woman access to a little help at home between her massage appointments, but the partners are usually thrilled be able to be more proactively involved in the pregnant woman’s experience. The earlier in your pregnancy you can bring in your partner, the more time they have to provide this support for you. Oh yeah, and sometimes it’s good for your partner to get a massage too – they are usually under a lot of stress as well and can always use more help being as present as possible to support you throughout the pregnancy and birth, as well as the exhilarating and exhausting work of loving and caring for a newborn.