Research Highlights
Of the Evidence Basis of Our Books & Courses
Pregnancy massage reduces prematurity, low birth weight and postpartum depression.
Field, T., Diego, M., Hernandez-Reif, M., Deeds, O. & Figueiredo, B. (2009). Infant Behavior & Development, 32, 454-460.
One hundred and twelve pregnant women who were diagnosed depressed were randomly assigned to a group who received group Interpersonal Psychotherapy or to a group who received both group Interpersonal Psychotherapy and massage therapy. The data suggested that the group who received psychotherapy plus massage attended more sessions on average, and a greater percentage of that group completed the 6-week program. The group who received both therapies also showed a greater decrease in depression, depressed affect and somatic-vegetative symptom scores on the Center for Epidemiological Studies-Depression Scale, a greater decrease in anxiety scale scores and a greater decrease in cortisol levels. The group therapy process appeared to be effective for both groups as suggested by the increased expression of both positive and negative affect and relatedness during the group therapy sessions.
A Meta-Analysis of Massage Therapy Research
Moyer C, Rounds J, and Hannum J. American Psychological Association Psychological Bulletin, 2004, Vol. 130, #1, pp. 3-18.
Massage therapy (MT,) is an ancient form of treatment that is now gaining popularity as part of the complementary and alternative medical therapy movement. A meta-analysis was conducted of studies that used random assignment to test the effectiveness of MT. Mean effect sizes were calculated from 37 studies for 9 dependent variables. Single applications of MT reduced state anxiety, blood pressure, and heart rate but not negative mood, immediate assessment of pain, and cortisol level. Multiple applications reduced delayed assessment of pain. Reductions of trait anxiety and depression were MT’s largest effects, with a course of treatment providing benefits similar in magnitude to those of psychotherapy. No moderators were statistically significant, though continued testing is needed. The limitations of a medical model of MT are discussed, and it is proposed that new MT theories and research use a psychotherapy perspective.
Pelvic Girdle Pain and Lumbar Pain in Pregnancy: A Cohort Study of the Consequences in Terms of Health and Functioning.
Gutke A, Ostgaard H, Oberg B. Spine. Volume 31(%), 1 March 2006. E149-155.
Study design: A cohort study in pregnancy.
Objectives: To differentiate between pregnancy-related pelvic girdle pain (PPGP0 and lumbar pain, and to study the prevalence of each syndrome and its consequences in terms of pain, functioning, and health.
Summary of Background Data: When studying prevalence, etiology, and consequences, differentiation between PPGP and lumbar pain is important, and, to our knowledge, its consequences for functioning and health during pregnancy have not previously been studied.
Methods: All women answered questionnaires (demographic data, EuroQal). Women with lumbopelvic pain completed the Oswestery Disability Index, pain intensity measures, in addition to undergoing a mechanical assessment of the lumbar spine, pain provocation tests, and active straight leg raising test.
Results: Of 313 women, 194 had lumbopelvic pain. The PPGP subgroup comprised 54% of those women with lumbopelvic pain, lumbar pain 17%, and combined PPGP and lumbar pain 29%. Women having both PPGP and lumbar pain reported the highest consequences in terms of health and functioning.
Conclusions: Pain intensity, disability, and health measurements differentiate subgroups of lumbopelvic pain in pregnancy.
Complementary therapies as adjuncts in the treatment of postpartum depression
Weler K and Beal M. Journal of Midwifery & Women’s Health. Vol 49, Issue 2, March-April 2004, pp. 96-104.
Postpartum depression affects an estimated 13% of women who have recently given birth. This article discusses several alternative or complementary therapies that may serve as adjuncts in the treatment of postpartum depression. The intent is to help practitioners better understand the treatments that are available that their clients may be using. Complementary modalities discussed include herbal medicine, dietary supplements, massage, aromatherapy, and acupuncture. Evidence supporting the use of these modalities is reviewed where available, and a list of resources is given in the appendix.
Pregnant women benefit from massage therapy.
Field, T., Hernandez-Reif, M., Hart, S., Theakston, H., Schanberg, S., Kuhn, C. & Burman, I. (1999). Journal of Psychosomatic Obstetrics & Gynecology, 20, 31-38.
Twenty-six pregnant women were assigned to a massage therapy or a relaxation therapy group for 5 weeks. Both groups reported feeling less anxious after the first session and less leg pain after the first and last session. Only the massage therapy group, however, reported reduced anxiety, improved mood, better sleep and less back pain by the last day of the study.
Father massaging and relaxing their pregnant wives lowered anxiety and facilitated marital adjustment.
Latifses, V., Bendell Estroff, D., Field, T., & Bush, J. (2005). Journal of Bodywork and Movement Therapies, 9, 277-82.
Fathers learned to massage their pregnant wives conducted progressive muscle relaxation. Massage therapy lowered the fathers’ anxiety and improved marital adjustment.
Benefits of combining massage therapy with group interpersonal psychotherapy in prenatally depressed women.
Field, T., Deed, O., Diego, M., Gualer, A., Sullivan, S., Wilson, D. & Nearing, G. (2009). Journal of Bodywork and Movement Therapies, 13, 297-303.
One hundred and twelve pregnant women who were diagnosed depressed were randomly assigned to a group who received group Interpersonal Psychotherapy or to a group who received both group Interpersonal Psychotherapy and massage therapy. The data suggested that the group who received psychotherapy plus massage attended more sessions on average, and a greater percentage of that group completed the 6-week program. The group who received both therapies also showed a greater decrease in depression, depressed affect and somatic-vegetative symptom scores on the Center for Epidemiological Studies-Depression Scal, a greater decrease in anxiety scale scores and a greater decrease in cortisol levels. The group therapy process appeared to be effective for both groups as suggested by the increased expression of both positive and negative affect and relatedness during the group therapy sessions.
Pregnancy and labor massage therapy
Field, T. (2010).. Expert Review of Obstetrics and Gynecology, 5, 177-181.
Women who received massage therapy reported decreased depression, anxiety, and leg and back pain. Cortisol levels decreased and, in turn, excessive fetal activity decreased, and the rate of prematurity was lower in the massage group. In a study of labor pain, women who received massage therapy experienced significantly less pain, and their labors were on average 3 h shorter with less need for medication. An underlying mechanism we have been exploring is that these effects are mediated by increased vagal activity.
http://www6.miami.edu/touch-research/Research.html Accessed January 14, 2011
Effects of massage on pain and anxiety during labour: a randomized controlled trial in Taiwan
Chang, M, Wang,S, and Chen, C. Journal of Advanced Nursing, 38 (1), p. 68-73, 2002.
Background. Labour pain is a challenging issue for nurses designing intervention protocols. Massage is an ancient technique that has been widely employed during labour, however, relatively little study has been undertaken examining the effects of massage on women in labour.
Methods. A randomized controlled study was conducted between September 1999 and January 2000. Sixty primiparous women expected to have a normal childbirth at a regional hospital in southern Taiwan were randomly assigned to either the experimental (n.30) or the control (n.30) group. The experimental group received massage intervention whereas the control group did not. The nurse-rated present behavioural intensity (PBI) was used as a measure of labour pain. Anxiety was measured with the visual analogue scale for anxiety (VASA). The intensity of pain and anxiety between the two groups was compared in the latent phase (cervix dilated 3–4 cm), active phase (5–7 cm) and transitional phase (8–10 cm).
Results. In both groups, there was a relatively steady increase in pain intensity and anxiety level as labour progressed. A t-test demonstrated that the experimental group had significantly lower pain reactions in the latent, active and transitional phases. Anxiety levels were only significantly different between the two groups in the latent phase. Twenty-six of the 30 (87%) experimental group subjects reported that massage was helpful, providing pain relief and psychological support during labour.
Conclusions. Findings suggest that massage is a cost-effective nursing intervention that can decrease pain and anxiety during labour, and partners’ participation in massage can positively influence the quality of women’s birth experiences.
Massage therapy effects on depressed pregnant women.
Field, T, Hernandez-Reif, M, et al. Journal of Psychosomatic Obstetrics and Gynecology, 25:115–122 June 2004
Eighty-four depressed pregnant women were recruited during the second trimester of pregnancy and randomly assigned to a massage therapy group, a progressive muscle relaxation group or a control group that received standard prenatal care alone. These groups were compared to each other and to a non-depressed group at the end of pregnancy. The massage therapy group reported reduced anxiety, improved mood, better sleep, and less back pain by the last day of the study. In addition, urinary stress hormone levels (norepinephrine) decreased for the massage therapy group and the women had fewer complications during labor and their infants had fewer postnatal complications (e.g., less prematurity).
Touch in labor: A comparison of cultures and eras
Hedstrom, L.W., N. Newton. Birth, 9/1986, 13/3, pp. 181-86
Discusses the purposes of touch in past and current peasant cultures as applied to pregnancy. These include: to lend support to the woman’s position, to stimulate contractions and to relieve pain. Argues that large areas of the woman’s body are supported or given different types of massage to accomplish this. In the US, by contrast, labor is stimulated and pain is relieved by pharmaceuticals. Touch is applied to much smaller areas of the woman’s body and is usually limited to hand holding. The purpose of touch in labor in the US is more to communicate caring and reassurance.
Labor Pain
Field, T., Hernandez-Reif, M., Taylor, S., Quintino, O., & Burman, I.
Journal of Psychosomatic Obstetrics and Gynecology (1997) 18:286-29
Labor pain is reduced by massage therapy.
Twenty-eight women were recruited from prenatal classes and randomly assigned to receive massage in addition to coaching in breathing from their partners during labor, or to receive coaching in breathing alone (a technique learned during prenatal classes).
The massaged mothers reported a decrease in depressed mood, anxiety and more positive affect following the first massage during labor. In addition, the massaged mothers had significantly shorter labor, a shorter hospital stay and less postpartum depression.
Update on NonpharmacologicApproaches to Relieve Labor Pain and Prevent Suffering
Simkin, P and Bolding, A. Journal of Midwifery and Womens Health ;49:489–504, 2004.
The control of labor pain and prevention of suffering are major concerns of clinicians and their clients. Nonpharmacologic approaches toward these goals are consistent with midwifery management and the choices of many women. We undertook a literature search of scientific articles cataloged in CINAHL, PUBMED, the Cochrane Library, and AMED databases relating to the effectiveness of 13 nonpharmacologic methods used to relieve pain and reduce suffering in labor. Suffering, which is different from pain, is not an outcome that is usually measured after childbirth. We assumed that suffering is unlikely if indicators of satisfaction were positive after childbirth. Adequate evidence of benefit in reducing pain exists for continuous labor support, baths, intradermal water blocks, and maternal movement and positioning. Acupuncture, massage, transcutaneous electrical nerve stimulation, and hypnosis are promising, but they require further study. The effectiveness of childbirth education, relaxation and breathing, heat and cold, acupressure, hypnosis, aromatherapy, music, and audio analgesia are either inadequately studied or findings are too variable to draw conclusions on effectiveness. All the methods studied had evidence of widespread satisfaction among a majority of users.