Prenatal Massage
Prenatal massage is the massage of pregnant women (prenatal) and women after giving birth (postpartum). It addresses the special needs of pregnant women such as discomforts in the low back, feet and legs.
• TECHNIQUE: Light effleurage over clients skin. Therapist can have the client on their back at an elevated 45º position, or side lie for the majority of the massage on the left side. The massage therapist will not have the mother lay on her right side for a prolonged period of time, because this can put pressure on the mothers inferior vena cava and cause circulatory stress to the mother and infant.
• BENEFIT: Promoting endocrine chances that promote rest and relaxation. Providing nurturing touch, which enhances bonding between mother and child. Promoting circulatory and lymphatic system efficiency, which supports both the mothers system and the babys gestation. Reducing the musculoskeletal strain associated with the structural and physiological changes in pregnancy, as well as care of an infant.
There are a lot of factors to consider for both the pregnant mother and the massage therapist. In order to determine if massage is appropriate it is important that the client is regularly seeing a physician, or midwife for prenatal/postpartum care. It is also important for the massage therapist to know if the client is having any complication or been at high risk in this or a previous pregnancy. If the client has had complications or
been at high risk the massage therapist will need written permission from the physician or midwife to continue with the massage. It is also important to know how far along the mother is in her pregnancy. This helps the massage therapist to know how to appropriately position the client.
Positioning is crucial in pregnancy and postpartum massage for the mothers and babies safety and comfort. Childbearing women have joint laxity due to hormonal changes beginning early in the pregnancy and remaining into the postpartum period. A regular massage table with soft padding and a collection of different sized pillows can provide adequate support and comfort for pregnant and postpartum women.
The following outlines recommend client positioning:
1st Trimester Client Positioning:
As a personal preference, I will not massage mothers when they are in their 1st trimester.
2nd Trimester Client Positioning:
• supine position (face up) with pregnancy wedge pillow under right hip until approximately twenty-two (22) weeks and switching to semi-reclined after approximately twenty-two (22) weeks with the torso elevated 45-75º to avoid supine hypotensive syndrome (weight of the uterus on the inferior vena cava decreases maternal blood pressure and fetal blood circulation)
• side position with support under uterus
• seated position avoiding abdominal pressure
* As each pregnancy is unique, use conservative client positioning to insure client comfort and safety. Examples of conservative client position include but are not limited to using semi-reclined position or side position prior to 22 weeks with multiple gestations and large for gestation (LGA) babies.
3rd Trimester Client Positioning:
• semi-reclined position with torso elevated 45-75º to avoid supine hypotensive syndrome (weight of the uterus on the inferior vena cava decreases maternal blood pressure and fetal blood circulation)
• side position with support under uterus
• seated position avoiding abdominal pressure.
Due to the amount of Relaxin produced during pregnancy, any stretching will be done with caution. The Relaxin softens connective tissue especially pelvis, abdominal fascia, ligaments, and joints.
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Works Cited
Braun, Mary Beth., and Stephanie J. Simonson. Introduction to Massage Therapy. Philadelphia: Lippincott Williams & Wilkins, 2005. Print.
Knaster, Mirka. Discovering the Body's Wisdom. Bantam 1996
Pregnancy and Postpartum Massage Therapy Essentials Course Materials, 2006. New York: Cortiva Institute.