The Basics:
Pregnancy does bring life changes with new sets of challenges, and massage therapy can help with that! It can reduce anxiety, stress, depression and pain, reduce tension and soreness in muscles, reduce swelling, improve sleep, and promote relaxation. Massage can provide many benefits to a woman’s pregnancy, as well as her postpartum healing and recovery.
Massage therapy & the first trimester
Morning sickness: A semi-reclined position can be used to help reduce nausea. Massage and acupressure for (P6) promote relaxation and can help reduce the negative impact of severe Nausea and Vomiting of Pregnancy (NVP). Techniques causing the mother to rock or shake during the massage are avoided because excessive body motion may worsen nausea. Sucking on peppermint or ginger candy may help reduce mild nausea. Using peppermint oil during the massage may help reduce mild nausea.
Fatigue: Techniques and pressure that promote relaxation are used to encourage rest.
Breast changes: Supportive cushions and positional modifications are available to provide more comfort. Wearing a bra for added comfort is optional, too.
Massage therapy & the second trimester
Prone “face down” position: Specific bolsters are provided for lying face down. At anytime during the massage, if the mother begins to feel the symptoms of supine hypotensive syndrome or the therapist recommends side-lying position, the mother will be transitioned to what’s most safe.
Supine hypotensive syndrome: A side-lying position or a left lateral tilt position reduces the symptoms of supine hypotensive syndrome.
Massage therapy & the third trimester
Relaxin: Relaxin starts effecting the connective tissue by the first trimester and continues to be produced throughout pregnancy. Some techniques may not be suitable for some pregnant mothers, so it is important the massage therapist always keep communication open and abides scope of practice.
Heartburn: Wait at least three hours and try not to eat a large meal before the massage appointment. A semi-reclined position can help alleviate heartburn.
Lower back pain: Massage therapy can help reduce back pain in pregnant women. During the massage, the lumbosacral and gluteal areas are emphasized to help reduce back pain. Before and after the massage session, education may be discussed about postural changes, ligament laxity, and uterine ligaments.
Frequent urination: Bathroom breaks do happen! A friendly reminder to use the restroom before the session will be given.
Varicose veins: Massage therapists should avoid the affected area while the mother is pregnant and for 10 weeks postpartum due to the increased risk of blood clots.
Stretch marks: Lighter-than-normal pressure may be used over stretch marks. Massage therapy will not reduce stretch marks.
Edema: When dealing with Edema, it’s imperative the therapist know when to exercise precaution and when massage therapy is contraindicated. Mild swelling of the lower extremities during pregnancy is normal. Due to the increase of interstitial fluid within the mother’s body, Swedish massage is recommended. Elevating the mother’s lower extremities can help to reduce swelling within her lower legs and feet.
**Massage therapy contraindications
Massage therapy & the fourth trimester
Vaginal birth: In- office massage can begin within a few days after a vaginal delivery. Extra support for the mother’s breasts and fundus are provided for comfort. Side-lying position is an option, too. Encouraging and teaching the mother to perform fundal massage can help the uterus return to normal size.
Cesarean birth: In- office massage can begin within a few days after a cesarean delivery once the mother is medically stable. Extra support for the mother’s breasts and fundus are provided for comfort. A side-lying position may be needed to avoid pressure on areas containing recent incisions and drain tubes. While the incision sight is healing, this area is to be avoided and should not be manipulated in any way. Once healed, massage of the scar tissue can begin. Avoid vigorous massage on the lower extremities for 12 weeks after surgery.
Breastfeeding: Water will be provided before and after the massage due to the increased demand of the mother’s fluid needs at this time. Depending on her comfort level, the mother may elect to wear her bra during the massage because her breasts may leak milk. Side-lying and proper bolstering are provided for swollen and/or tender breasts. During the massage, there is focused attention on the back, neck, shoulders, and arms, which may be tight from holding the baby during feedings. Before and after the massage, education on pectoral stretching and self-breast massage is offered to help relieve breast pain and improve newborn suckling.
Mastitis: Postpone the massage until the mother has been fever-free for over 24 hours without the use of any fever reducing drugs such as ibuprofen and acetaminophen. Absent a fever, massage can be performed while avoiding the pectoral region of the affected area. Positioning the mother for comfort as needed to avoid any pressure on her affected breast(s).
Prenatal and postpartum depression: The overall effect of the massage should be nurturing and relaxing. Massage therapy can decrease prenatal and postpartum depression by reducing stress and anxiety, lowering norepinephrine levels, increasing dopamine and serotonin levels, and lessening the pain and discomfort found in her body.