Supporting Pregnancy with Massage Therapy
Nurturing touch during pregnancy, labor, and the postpartum period is not a new concept. Cultural and anthropological studies reveal that massage and movement during the childbearing experience was and continues to be a prominent part of many cultures’ healthcare. 1 Studies indicate that most of the more peaceful cultures use touch prominently during pregnancy and early childhood. 2 Midwives, who for centuries have provided maternity care, have highly developed hands-on skills.
Current research on the benefits of touch is providing a contemporary basis for its reintroduction in many technological societies, including the United States. Scientists have found that rats restricted from cutaneous self stimulation had poorly developed placentas and 50% less mammary gland development. Their litters were often ill, stillborn, or died shortly after birth due to poor mothering skills. 3 Pregnant women massaged twice weekly for 5 weekly for 5 weeks experienced less anxiety, leg and back pain. They reported better sleep and improved moods, and their labors had fewer complications, including less premature births. 4Studies show that when women received nurturing touch during later pregnancy they touch their babies more frequently and lovingly. 5 During labor the presence of a doula, a woman providing physical and emotional support, including extensive touching and massage, reduces the length of labor and number of complications, interventions, medications, and Cesareans. 6
Why Pregnancy Massage Therapy?
Profound local and systemic changes in a woman’s physiology occur as a result of conception and the process of labor. Changes during pregnancy span the psychological, physiological, spiritual, and social realms, according to Carole Osborne, author of Pre- and Perinatal Massage Therapy and maternity massage therapy specialist since 1980. “Massage therapy can help a woman approach her due date with less anxiety, as well as less physical discomfort,” says Osborne.
A typical session performed by a therapist specializing in pre- and perinatal massage therapy, can address pregnancy’s various physical challenges: edema, postural changes, and pain in the lower back, pelvis, or hips. Swedish massage may facilitate gestation by supporting cardiac function, placental and mammary development, 7 and increasing cellular respiration. It also reduces edema and contributes to sympathetic nervous system sedation. 8 Deep tissue, trigger point, and both active and passive movements alleviate stress on weight-bearing joints and myofascial structures, especially the sacroiliac and lumbosacral joints, lumbar spine, hips, and pelvic musculature. 9 Structural balancing and postural reeducation reduce neck and back pain caused by improper posture and strain to the uterine ligaments. “Prenatal massage therapy also can facilitate ease of labor by preparing the muscles for release and support during childbirth,” according to Osborne.
“Beyond these physical effects, an effective prenatal massage therapy session provides emotional support,” says Osborne. In the safe care of a focused, nurturing therapist, many women unburden their worries, fears, and other anxieties about childbearing. She believes that bodywork helps the mother-to-be develop the sensory awareness necessary to birth more comfortably and actively. “Laboring women whose partners learned and provided basic massage strokes to their backs and legs had shorter, less complicated labors. 10 Imagine the benefits generated by the skilled hands of a trained touch specialist!”
The Postpartum Period
Beginning with the baby’s birth, a new mother must cope with more changes. She is typically only 10 to 12 pounds lighter, yet she is still maintaining her body with an anterior weight load posture. The massage practitioner can facilitate proprioceptive reprogramming to gently return the body to its pre-pregnancy state, to alleviate pain, and to bring about a renewed sense of body and self.
As a specialist in postpartum work, Osborne focuses on repositioning the pelvis and repatterning overall body use. Postpartum massage sessions can restore functional muscle use in the lumbar spine area, as well as strengthen and increase tonus in the abdominal musculature stretched and separated by pregnancy. Additionally, the overtaxed, hypotoned iliopsoas muscle functions can be improved. Upper back muscles which now support larger breasts and the carried infant’s weight need work to reduce strain, and to help maintain flexibility despite the physical stresses of infant feeding and care. For post-Cesarean mothers, specific therapeutic techniques also can reduce scar tissue formation 11 and facilitate the healing of the incision and related soft tissue areas, as well as support the somato-emotional integration of her childbearing experience.
Pre- & Perinatal Massage Therapy Education
To safely massage pregnant, laboring and postpartum women, Osborne feels that it is imperative that practitioners be knowledgeable about normal pre- and perinatal physiology, high risk factors, and complications of pregnancy. “Many of these conditions necessitate adaptations and consultation with physicians and/or midwives prior to sessions. Various techniques and methodologies must be modified or eliminated, depending on the individual and the trimester of pregnancy,” according to Osborne.
“Somatic practitioners will find reliable detailed, research based protocols and contraindications in Pre- and Perinatal Massage Therapy, and in my home study course based on that text,” says Osborne. For those seeking comprehensive hands-on training and certification as a maternity massage specialist, she recommends her 32 hour workshop.
“My Pre- & Perinatal Massage Therapy book and training programs developed from 27 years as a somatic practitioner and educator and 22 years of specialization in maternity and infant massage,” says Osborne. “Our students benefit from our continually expanding body of knowledge, research, clinical experience, and consultations with other perinatal health care providers.”
“Our instructors offer somatic therapists a safe and comprehensive approach to pregnancy, labor, and postpartum massage therapy. We also encourage an empathetic, non-judgmental attitude in supporting women’s ‘pregnant feelings’. These certification workshops include over 80 techniques specifically adapted for pre- and perinatal needs, and the practical marketing strategies, ethics, and skills to elicit collaboration with other perinatal specialists and to build a successful pre- and perinatal massage therapy practice.”
Application has been made to the Scottish Massage Therapy Association and the Guild of Complementary Practitioners for continuing professional development (CPD) points. Carole Osborne is approved by numerous American associations and agencies. She is approved by the National Certification Board for Therapeutic Massage and Bodywork as a continuing education provider (32 category A units: workshops include two ethics hours). Her workshops and staff are also approved by the Florida Board of Massage, California Board of Registered Nursing, and International Childbirth Educators Association; meet current American Massage Therapy Association continuing education standards; can be used for Associated Bodywork and Massage Professionals membership; and can be used for continuing education credit with Doulas of North America.
The Pre- & Perinatal Massage Therapy certification workshop is Carole’s expansion and refinement of the original Bodywork for the Childbearing Year® training which she co-created and taught from 1980-1996. Since 1980 she has trained over 4,000 massage and perinatal specialists throughout the United States, Canada, and Scotland. Her first textbook, Deep Tissue Sculpting, is an established professional text. Click here to order a book or to learn more about other workshops by Body Therapy Education.
Carole Osborne is the author of and Pre- and Perinatal Massage Therapy, and a contributor to the upcoming textbook Teaching Massage Therapy, as well as numerous other publications. She is the 2008 recipient of the AMTA Jerome Perlinski National Teacher of the Year Award. The work outlined in this article is adapted from portions of the author’s textbook Deep Tissue Sculpting.
Footnotes
- Goldsmith, Judith. Childbirth Wisdom. New York: Congdon and Weed, 1984.
- Prescott, James. “The Origins of Love & Violence and the Developing Human Brain.” Touch the Future, Long Beach, CA, Fall, 1995, pp. 9-15.
- Rosenblatt, J.S. and D.S. Lehrman. Maternal behavior of the laboratory rat. Maternal Behavior in Mammals, Wiley, New York, 1963, p. 14.
- Field, T.m M. Hernandez-Reif, S. Hart, H. Theakston, S. Schanberg, and C. Kuhn. Pregnant women benefit from massage therapy. J. Psychosomatic Obstetrics and Gynecology, 20(1), March, 1999, 31-8.
- Rubin, R. Maternal Touch. Nurs Outlook, 11/1963, ppp. 828-31
- Kennell, J.H., M.H. Klaus, S. McGrath, S. Robertson, C. Hinkley. Continuous emotional support during labor in a US hospital. J Am Med Assoc, 265, 1991, pp. 2197-2201
- Rosenblatt, J.S. and D.S. Lehrman. Maternal behavior of the laboratory rat. Maternal Behavior in Mammals, Wiley, New York, 1963, p. 14.
- Zanolla, R., Monzeglio, C., Balzarini, A., et al. “Evaluations of the results of three different methods of post-mastectomy lymphedema treatment.” J. Surg. Oncol. 26:1984, p. 210-13.
- Quebec Task Force on Spinal Disorders. 1987. Scientific approach to the assessment and management of activity-related spinal disorders. Spine, 12:, Supplement 1.
- Field, T., Hernandez-Reif, M., Taylor, S. , Quintino, O. Touch Research Institute, University of Miami School of Medicine and Iris Burman, Educating hands School of Massage Therapy. Journal of Psychosomatic Obstetrics and Gynecology, (in press 1998).
- Hufnagel, V., M.D. “Medical basis for using massage after surgery.” Massage Magazine #17, Dec-Jan/1988-89, p. 21.