Benefits of Massage During Pregnancy
- Relieves muscle spasms, cramps associated with the stress of extra weight bearing and physical changes that occur during pregnancy.
- Reduces stress and teaches the mother to relax.
- Relaxation is one of the keys to labor and delivery.
- Gestation processed enhanced through increasing blood circulation, lymph circulation, reducing edema, increasing cellular respiration.
- Provides emotional support and physical nurturing; this may be passed on to the baby
- Assists in reducing the stress in the weight bearing joints and musculoskeletal structures.
- Helps maximize breathing capacity which is needed during labor and delivery.
High Risk Pregnancies Do not proceed without written release of physician.
- Diabetic Mother
- Cardiac Disorders- heart disease
- Chronic Hypertension
- Previous Problem in Pregnancy – previous miscarriage
- Mothers under 20 or over 35
- Asthmatic Mother
- Suspected RH Negative Mother or other genetic problems
- Drug addictions or exposure to drugs
- Previous multiple births
Proceed With Caution (Physician’s Release Advised)
- Incompetent cervix
- Complications due to DES used during pregnancy
- Lung or live disorder
- Severe anemia
- Convulsive disorders
- Abnormal Fetal Heartbeat
- Decrease or absence of fetal movement
- Interuterine growth retardation
- Lupus Erythematosus
- Poor lifestyle habits (drug abuse, poor nutrition, smoking, alcohol consumption)
- Low weight gain
- No prenatal care
Warning Signs of High Risk Factors
- Possible Miscarriage – bloody discharge, continual abdominal pains, sudden gush of water or leakage of amniotic fluid
- Urinary Tract Infections – very frequent urination with burning, low back pain increase in thirst and decrease in urination, chills and fever with 100 degree temperature or higher
- Pre-eclampsia – (toxemia of pregnancy – if neglected or not treated properly may develop true eclampsia) Sudden rapid weight gain, systemic edema, increased blood pressure (hypertension), protein in urine, increased headaches
- Eclampsia (Toxemia) Emergency situation-refer to physician immediately- Develops in 1 out of 200 patients with pre-eclampsia; persistent severe headaches; persistent severe back pain unrelieved by change of position; severe nausea/vomiting; systemic edema; pitted edema, increased blood pressure; visual disturbances; convulsions.
- Gestational Diabetes – excessive hunger and thirst; increased urination in 2nd trimester; sugar in urine, no non-pregnant diabetes
- Other conditions – thrombophlebitis; systemic infections; skin irritations; varicose veins; kidney disease; heart disease; cancer; acute injuries such as burns, bleeding, fractures
Contraindications for Massage
- Abdominal massage totally contraindicated for 1st trimester and limited to effleurage for remainder
- Gymnastics/ ROM – do not do movements when nausea present; or when symphysis pubis separates ( 2nd trimester)
- Pressure point around ankles and Achilles tendon should be avoided; pressure point between thumb and finger should be avoided
- Swedish stokes that affect circulation should not be used in the 3rd trimester if the client has a heart condition
- Tapotement contraindicated on the legs because of the increased danger of blood clots during pregnancy
Be conservative and consult the physician with any questions. Obtain release to work on client.
Physiological Changes of Pregnancy and Bodywork Suggestions
|Area of change||Changes||suggestions for massage/bodywork|
|Gastrointestinal and Urinary||
Trimester Information for Massage Practitioners
First: 14 weeks from the 1st day of last period
Baby: from egg to 3 ” long, fully developed body, arms, legs, nails, ears
Mother: uterus grows; heartbeat heard at day 26; increase in nausea and vomiting possible; at 10 weeks relaxin begins affecting joints – minimal structural changes occur; fatigue; increased blood volume and increased heart rate; metabolic changes; increase in frequency of urination; constipation; anemia; headaches and dizziness possibly due to hormonal changes.
Massage: Risk of miscarriage the highest; no abdominal massage; do massage to assist circulation; no reflex massage; no passive ROM if nauseated
Treatment plan: focus on postural alignment; pelvic, diaphragm, rib cage, low back.
teach relaxation techniques and deep breathing exercises, kegel exercises, pelvic clock exercises
Second: 14-28 weeks
Baby: grows to 11″ and 1 1/2 lbs. fingerprints, eyebrows and eyelashes form; 16 weeks sensitive to light; 24 weeks hearing develops; 29 weeks opens eyes and looks to light source.
Mother: Structural changes: stress on low back upper back, pectorals; rib cage flares out at base and elevates; diaphragm elevates at rib attachments; breathing is mostly costal; abdominal breathing difficult; linea alba separates; center of gravity changes to adapt to extra weight held in front.
Varicose veins and muscle cramping occur. Skin stretches. Breasts swollen and tender.
Massage: Decreased risk of miscarriage; deep tissue ok on areas of chronic stress; joints less stable due to relaxin especially SI joint, symphysis pubis and hips.
Treatment plan: Focus on increasing breathing capacity, releasing abdominal attachments at lower rib cage; releasing intercostals. Watch for sciatica, low back and upper back problems related with changes in center of gravity. Continue to teach relaxation and connection to breathing. Open up pelvic floor by working on adductors, hamstrings and rotators later in this stage
Third: 28-40 weeks
Baby: 14-16 ” and 2 1/2 -3 lbs: at start; grows to 5-9 lbs. and 20″ in length; 29 weeks lungs developed; 32 weeks brain development, eyes track movement, sleep patterns develop.
Mother: Shortness of breath, difficulty breathing as uterus grows to rib cage; diaphragm rises 1 1/2 ” upward; Difficult to move and walk; hemorrhoids, varicose veins, heartburn, hiatal hernias, frequent urination, constipation, trouble sleeping, edema in ankles and legs, carpal tunnel, stress to heart
Massage: same as in 2nd trimester
Treatment plan: Decrease stress to postural muscles – adductors, legs, hips, low back. Decrease edema. Increase relaxation.
Pregnancy Massage Articles Online
- Massagenerd.com – Pregnancy Massage Section
- The Evolution of an MT From Office to Birthing Room By Caitlin Philips : Massage and Bodywork Magazine
- Miracle of Motherhood By Erik Dalton : Massage and Bodywork Magazine
- Pregnancy Massage Touch for the Mom-To-Be By Shirley Vanderbilt Massage and Bodywork Magazine
- High-Risk Pregnancy By Kate Jordan, NCTMB Massage Today
- Pregnancy Leg Massage By Elaine Stillerman, LMT Massage Today
- Maintaining Core Integrity During Pregnancy and Postpartum Recovery By Elaine Stillerman, LMT Massage Today
- Pelvic Pain in Pregnancy By Kate Jordan, NCTMB Massage Today
- Prenatal Massage During the First Trimester By Elaine Stillerman, LMT
- The Truth About Pitocin By Elaine Stillerman, LMT
- To C or not to C? That Is the Question By Elaine Stillerman, LMT
- Maintaining Core Integrity During Pregnancy and Postpartum Recovery By Elaine Stillerman, LMT
- Keeping Cool Through Pregnancy By Elaine Stillerman, LMT
- Help Your Client Achieve a Natural Labor: Four Simple Tips for Pain Relief By Michelle C. Larson, MAc, BA, LMT
- Touching the Unborn How Energy Therapy Can Be Applied In Utero By Karrie Osborn Massage and Bodywork
- Holistic Maternity Care Integrating Shiatsu and Massage By Suzanne Yates
- Prenatal Massage During the First Trimester By Elaine Stillerman, LMT
- Laboring Naturally Lifespan By Karrie Osborn Massage and Bodywork Magazine
Pregnancy Massage Training/Classes/ Books
- www.bodytherapyassociates.com – Comprehensive educational opportunities with Carole Osborne-Sheets
- Kate Jordan Seminars – Bodywork for the Childbearing Years