During pregnancy, a woman’s body experiences “changes in shape, composition , hormonal flow, fat and weight distribution and posture." The mother will also experience emotional, psychological, and possibly even spiritual changes, some of which can be very stressful. Massage therapy can help a pregnant woman cope with these changes over the course of her pregnancy.
Massage therapy can even be given during labor, to help the mother cope with the pain and stress. Relaxation skills taught to a mother during prenatal massage can help during labor, even if massage isn’t given. Postpartum massage can help the mother recover from birth physically and emotionally.
Prenatal massage also has the power to influence the growing baby, as your therapy affects the mother’s stress levels (and therefore hormonal balance), digestion, and circulation. You can also benefit the baby second-hand: a mother who enjoys and benefits from prenatal massage may be more likely to offer massage and healing touch to her own infant once he or she is born.
Many pregnant woman feel pressure to project an image of perfection to the world, especially when faced with media images of celebrity pregnancies. The stress of not being able to communicate her true feelings can have a negative affect on mother and fetus. sometimes, a massage therapy session is the only time a soon-to-be mother will feel truly supported in a non-judgmental fashion.
Body image is one of the issues facing women during pregnancy. Most women gain at least 28 pounds, which is healthy and normal. However, some women are uncomfortable with the weight gain. Misinformed partners who are afraid of being intimate of fear of harming the baby may also contribute to this.
Some women are also afraid that massage can lead to a miscarriage. Of course, massage is perfectly safe during pregnancy, but a sense of over protection can occur.
Benefits of prenatal massage include:
Hormone regulation: Studies done in the past 10 years have shown that hormone levels associated with relaxation and stress are significantly altered, leading to mood regulation and improved cardiovascular health, when massage therapy was introduced to women’s prenatal care.
Reduction of swelling: Edema, or swelling of the joints during pregnancy, is often caused by reduced circulation and increased pressure on the major blood vessels by the heavy uterus. Massage helps to stimulate soft tissue to reduce collection of fluids in swollen joints, which also improves the removal tissue waste, carried by the body’s lymph system.
Improvement of nerve pain: Sciatic nerve pain is experienced by many women in late pregnancy as the uterus rests on muscle of the pelvic floor and lower back. The pressure of the uterus spreads tension to the muscles of the upper and lower legs, causing them to swell and put pressure on nearby nerves.
Reduces stress: Stress can cause “increased maternal heart rate, blood pressure, vomiting, nausea and immune system dysfunction.
Improved respiration: Many pregnant women have trouble taking full breaths as the baby grows and puts pressure on the diaphragm and lungs. They also tend to lean backwards to compensate for the weight of their front, which can make breathing more difficult. Massage can help with structural alignment issues in the ribcage, improve “neck, abdomen, and chest mobility,” and correct restrictive postures, all of which will make breathing easier and more effective.
Improved digestive health: Pregnancy hormonal shifts can lead to indigestion, nausea, vomiting, and heartburn. Massage can increase the production of food absorption hormones, which can relieve some of the discomfort, and even improve infant nutritional absorption.
Urinary system improvement: Pregnant woman have to urinate more frequently, as the growing uterus puts pressure on the bladder.
Reduced aches and pains: A women’s body experiences drastic musculoskeletal shifts during pregnancy, as the body changes to accommodate the growing baby and to prepare for birth. Massage can relieve the pains associated with this shifts, including cramps, sciatica, back pain, muscle spasm, fibrosis, and other form of myofascial discomfort.
Helps to prepare for an easier delivery, particularly self-massage of the perineum. This facilitates stretching, which can help the mother avoid an episiotomy.
Varicose vein control.
Improved posture: Bodywork sessions are an opportunity to teach posture correction, relieving related musculoskeletal complaints such as low back pain, headaches, neck and shoulder pain, foot discomfort and sciatica.
Enchanced lactation: massage stimulates prolactin production
Increased immunity: touch enhances the immune system function by reducing stress.
Increased energy.
Increased ability to nurture others: massage provides an experience of nurturing, healing touch.
A few of the changes a pregnant women will experience include:
Loosening of the ligaments: One of the hormones released during pregnancy is called relaxin. Its job is to create a lengthening and softening of your ligaments to allow the pelvis to expand and open during birth. Massage relaxes your tight muscles, decreasing pain and discomfort.
Extreme fatigue: You get tired for a reason. You are carrying a lot of extra weight that requires more energy use. Massage gives you necessary time to rest and rejuvenate.
Shifting Proprioception: Especially in the last trimester, you may not be sure exactly how much space you occupy. Your sense of where your belly and the outside world meet may not be accurate. This is why some pregnant women become clumsy or ‘accident prone’. Massage therapy increases your body awareness and clarity of your position in space, and can thereby prevent injury.
Shift of the musculoskeletal system, including: anterior rotation of the pelvis, increased lumbar curvature, stretching of the abdominal muscles, posterior leaning of the ribcage, external rotation of the hip, changes in the elipsoas, hyper-extension of the knees to compensate for shifting center of gravity, collapsed arches, compression and strain of ligaments in the pelvis, and temporary scoliosis.
THE FIRST TRIMESTER: WEEK ONE THROUGH FOURTEEN
This is the most critical and unstable period of a woman’s pregnancy. 80% of miscarriage occur during the first trimester. Some women may have heard rumors that massage is unsafe during the first trimester. According to American Pregnancy Association, massage is safe at any point in any trimester. However, some therapist still refuse until the mother is through her 12 week, due to increased chance of miscarriage during the first trimester.
Changes in the mother: Hormonal changes in the mother can cause vomiting and nausea, exhaustion, and rapid mood swings.
SECOND TRIMESTER: WEEK FOURTEEN THROUGH 28
The second trimester is the point when most women begin to look visibly pregnant, especially if it is her first pregnancy. The risk of miscarriage drops dramatically. The mother may begin to feel fetal movements. Nausea from morning sickness will disappear for many women at this point. They will have more energy than they did in the first trimester. Some women call this the “golden period” of pregnancy- you are as comfortable as you will be during the pregnancy, and you look pregnant but haven’t gained all the weight you will during the whole pregnancy.
During the second trimester, you may experience the following changes:
Appetite may increase
The uterus has grown to the weight of the belly button, making the pregnancy visible.
The skin on the belly may itch as it grows and there may be pain down the sides of the body as the uterus stretches. The lower abdomen may ache as ligaments stretch to support the uterus.
The need to frequently urinate may decrease as the uterus grows out of the pelvic cavity, relieving pressure on the bladder.
A mother’s nose may become congested and she may experience nosebleeds. This is due to the increase in hormones (estrogen and progesterone) that affect the mucous membranes in the nose.
Varicose veins and hemorrhoids may appear.
The increasing weight gain may cause backaches.
Skin pigmentation may change on the face or abdomen due to the pregnancy hormones.
Heartburn, indigestion, and constipation may continue.
Carpal tunnel
Stretch marks
Leg cramps
Self care Recommendation:
Postural awareness
Abdominal, perineal, and back strengthening exercises
Belly rubs in late second trimester to connect with the baby.
THIRD (FINAL) TRIMESTER: WEEK 28 THROUGH DELIVERY
This is the time of the most obvious fetal growth, as evidenced by the mother ever-expanding belly and ever-increasing discomfort. Fetal movement may become visible to the people standing near the mother. The mother will continue to have increased energy when compared to the first trimester, but there are some obvious changes happening as the baby gains more and more weight.
During the third trimester, you may experience the following changes:
Shortness of breath due to the uterus pushing on the xiphoid process and the baby possibly pushing into the diaphragm
Back pain
Severe edema
Pelvic heaviness
Uterine ligamen spasms
Constipation, heartburn, and indigestion due to compression of the digestive system from the baby’s weight
Increased hair growth/nail growth
Stretch marks
Frequent urination after 36 weeks, after the baby drops into the pelvis and begins putting pressure on the bladder ( the dropping does allow the mother to breath more deeply, however)
Increased anemia, leading to dizziness
Restless sleep
Further loosening of the joints as hormones act to open the pelvis
Braxton-Hicks contractions, which are “practice” contractions that do not cause changes in the cervix, but can still be painful
Leaking colostrum from breasts
Sacroiliac pain and sciatica
Diastasis recti ( separation of left and right abdominal muscles) due to stretching of the belly
Increased dependence on others for assistance in things such as bending over, getting out of a chair, or driving
Self care Recommendation:
Postural awareness
Perineal massage method
Teach partner massage method before labor
Visualization and breathing to help relax with current discomfort
Massage all stressed muscle group
Perform frequent pelvic tilts, lengthening low back back
Some mothers go past their due date, which can cause them stress and anxiety, along with continued discomfort. Massage is an excellent way to soothe both mother and baby if the due date has come and gone.
Self care/ At home stretches
Knee-chest stretch: Lie on the floor or when your in bed ( if still comfortable) and bring both knees to the chest. Gently rock up and down on the spine, repeating until the muscle is relaxed.
Knee-chest twist: Lie on the floor or when your in bed ( if still comfortable) and bring both knees to the chest. Drop the bent knees to one side and turn your head in the opposite direction, raising the opposite arm. Breath, stay still for 30 seconds, then switch.
Self care for edema:
Lie on your side to reduce edema- it has the most efficient blood return
Elevate your hands/feet above the heart for 15 minutes
Avoid excessive sodium in the diet and drink as much water as possible
Ask your doctor about taking vitamin B6 and vitamin B complexes, which have shown to reduce water retention
Soak your hands or feet in half cup of epsom salt dissolved in two cups of water.
Wear loose clothing, especially those that aren’t restricting in the legs or groin
Rest on the forearm and knees, which relieves pressure from sitting and decreases blood pooling in the pelvis.
Self care for Leg cramps (Charley Horse):
Press a finger or thumb into the belly of the muscles while dorsiflexing the foot to relieve the cramp. You may want to increase the consumption of calcium-rich food, as a calcium deficiency can lead to cramping.
Do a few gentle calf exercises
Self care for Breast:
Wear supportive bra
Perform lymphatic drainage around the breast
Try reflexology for breast- press the top of the foot between the second and third toes and press the lymphatic point on the top of the foot between the big and second toes.
Allergies/Sinus Congestion Self care:
Perform facial massage techniques or have your partner do it at home
Perform self reflexology by holding the tops of each toes for 30 seconds. These correspond to the sinuses.
Visualization and Affirmations:
Think of a places that make you more relaxed or what environment you feel safest. Picture yourself there, in a warm, loving and safe place.
Affirmation during contractions: Moment by moment, one contraction at a time, I will find ways to ride the waves of contractions.
Self care Squatting exercise:
It helps stretch the adductor and perineum, which need to be flexible and expansive for birth
It strengthens the legs, feet, and ankles, and reduces leg cramps
It is contraindicated for clients with symphysis pubis.
BENEFITS OF MASSAGE DURING LABOR
Can increase oxygen levels, increases oxytocin which decreases anxiety and cortisol levels, has sedative effect that can help her deal with contractions
Speed up labor and can decrease the use of medications for bringing on labor, can be used to increase strength of contractions or their frequency
Improves mother’s comfort by relieving aches and cramps
Can increase a mother’s pain threshold and decrease the need for pain medication
Relieve the pain of back labor
Massage to the jaw can promote relaxation to the pelvis, increasing dilation
Can be used (with PCP’s guidance) to reposition a baby who is not head-down
Can increase a mother’s energy level and reduce anxiety and depression
STAGES OF LABOR
During stage one of labor, the cervix thins and dilates (which can also happen before labor starts). Contractions happens consistently. Once the cervix reaches seven centimeters dilated, transition begins and continues until she reaches ten centimeters dilated. During this stage some mothers will enjoy a full body massage. Most women carry tension in response to pain in the following: masseter and temporals, trapezius, levator scapulae, and other upper back muscles, hands and finger flexors, hamstrings and quadriceps, adductor longus, brives, and magnus, erector spinae, quadratus lumborum, and other lumbar muscles, levator ani, transverse perineal, gastrocnemius and toe flexor.
Stage two usually last one to three hours and involves pushing the baby down the birth canal and out of the vagina. Many mothers find this stage of labor exhilarating because they are relieved to actually be doing work. During this stage, you may want to perform effleurage on the abdomen from the top of the belly to the pelvis, mimicking the expelling of the uterine muscles. Squeeze the big toe and next toes on both feet during contractions, which indirectly relax the pelvic floor and inner thighs.
Stage three of labor involves some of the strongest uterine contractions which the body uses to expel the placenta. Immediately nursing can speed up these contraction. This stage usually from 10-30 minutes. Some women don’t even notice it happening.
BREATHING TECHNIQUES DURING LABOR:
Abdominal breathing: to help relax and surrender. Inhale through the nose, allowing the breath to slowly fill the belly and be released in a gently slow exhalation through an open mouth or pursed lips.
Whale breathing: for releasing frustration, nhale through the nose and exhale with a puff through the mouth, like a whale does when surfaces
Ujjayi Victorious breathing: this breath comes from yoga and can strengthen the nervous system when done for at least three minutes. Breath in through the nose so you can feel the breath on the back of the throat, which will make a louder breathing sound than normal breathing. Bring the chin forward and down so the breath massages the back of the throat. This breath starts in the abdomen and fills up the chest. Pause at the top of the inhalation, then exhale with control.
POSTPARTUM MASSAGE
This helps relieve the strains related to labor, nursing, and/or possibly surgery. Also help the mother to recover from birth physically and emotionally.
Precautions: Embolism, hemorrhage, surgical incisions, gestational blood pressure issues, separated symphysis pubis, leaking bodily fluids.
POST-CESAREAN MASSAGE
No abdominal massage without the permission of the doctor.
