Massage During and After PregnancyKarina L. Fabian
Massage. Even the word sounds relaxing, bringing to mind scented oils, quiet music, soft lighting, and a firm touch kneading the tension out of the body as the stress melts out of your system. Massage therapy does more than relax, however. It loosens tight muscles, increases blood flow, and helps flush out toxins. It revitalizes the mind and body, improves posture, and facilitates a feeling of well-being.
“Massages are good anytime, but especially when you’re pregnant,” says Cherie Roff, mother of three. Roff, who had difficult pregnancies, says massage therapy helped her to sleep and move better. “I hurt all over because my muscles stretched [with the pregnancy], and I was having trouble walking because the baby was riding so low.”
Additionally, massage therapy during labor can ease a woman’s stress and keep her connected with her body and baby, often with dramatic results. After delivery and postpartum, massage can help a mother re-establish good posture, work out kinks caused by the many activities of motherhood, and better cope with the challenges of child-rearing.
The goal of prenatal massage therapy is to promote overall health and prepare a pregnant woman physically and psychologically for labor. “Our intent is not to fix anything, because the body continues to change, so we try to instill a mind-body connection,” says Laura Miller, a massage therapist who specializes in pregnancy and labor massage.
Miller says prenatal massage concentrates on easing poor postural habits and the stresses they put on the body. A woman’s posture is constantly challenged in pregnancy. She must adapt not only to the evolving size of her belly and breasts, but also to the hormonal changes that loosen her ligaments and allow her bones to move. This puts special strain on the pelvic muscles, a common cause for lower back pain, especially in the third trimester. “The pelvis rotates forward slightly due to the weight of the baby and stress on the pelvic girdle,” says Miller.
A good therapist will spot this and can stretch the muscles and work the pelvic area to relieve the pressure. She may also recommend exercises such as pelvic tilts to keep the pelvis in place.
In addition to gentle stretching, says Miller, prenatal massage includes long, integrating strokes to work the tension out of the muscles and improve circulation. Increasing the blood flow is especially helpful for the pregnant woman who does not get much exercise or motion, says Laura Favin, a prenatal massage therapist and national spokesperson for the American Massage Therapy Association. “It brings nutrition to the body and the fetus, and it flushes out toxins that are in the muscles back into the circulatory system.” Because of this, massage has been shown to help alleviate the symptoms of edema and carpal tunnel syndrome.
Prenatal massage releases more than physical toxins, however. Often in this quiet, restful time, emotional concerns will surface.
“Women will deal with emotional issues sometimes on the massage table that they didn’t realize were present until I start working on them,” says Miller. She adds that massage therapists don’t instruct or guide when these issues arise; they are simply “present” to the client, listening if she needs to talk, continuing the massage in silence, if she prefers.
Miller has seen many issues surface during her eight years as a therapist—many revolve around the pregnancy itself, particularly apprehension in first-time mothers. “After working with a woman for a month, I can see the transition as she begins to gain confidence in her body and to realize she can depend on it to do what it was designed to do.” Massage, Miller asserts, aids in maintaining that mind-body connection. “The women I work with on a regular basis have shorter labors and do better in labor and delivery because they do have such a connection with their bodies,” she says.
Prenatal massage benefits the baby, too. Miller says babies often move in response to her touch. She says she had one client whose husband could only feel the baby move just after a session.
There are times when prenatal massage can pose danger to the baby. Women in high-risk pregnancies or who have nausea or vomiting, fever, or discharge of any sort should check with the doctor before getting a massage. They should also check if they have abdominal pain or swelling beyond the usual edema. Additionally, Miller recommends waiting until after the first trimester to begin massage therapy. While massage is not dangerous, this is the time of highest risk for miscarriage, and Miller says she would not want a woman to feel massage had endangered the child.
After that time, Miller recommends monthly through the second trimester, then bi-monthly, then weekly, pretty much paralleling prenatal visits to the doctor or midwife. “The third trimester burden really takes its toll on a woman’s body, and that’s when she needs the work (massage),” says Miller.
Massage During Labor
A goal of prenatal massage is to prepare a woman for labor and childbirth. “We treat a woman like she’s an athlete in training,” Miller says, and part of training is coaching. Many prenatal massage therapists are available to clients as doulas. Those that aren’t are often willing to teach the woman’s labor partner positioning strategies and massage techniques that help ease the strain of labor. There are tricks of the trade, such as trigger points that can induce contractions in some women or ice massage, which are shown to decrease labor pain in some women.
Regular massage sessions can also help a woman learn to relax stressed muscles during labor simply because she’ll have had the experience of knowing how the muscles feel when relaxed.
After childbirth, a mother’s body is faced with new challenges. From carrying babies to changing diapers, breastfeeding to bathing, these activities stress the backs of even the most posture-conscious women. In addition, soreness from delivery, engorgement or sore nipples, and general fatigue can cause a mother to unconsciously slouch, putting additional strain on muscles.
Postpartum massage concentrates on alleviating the strain and regaining health. Miller explains that it includes stretching the back, lengthening the muscles, and balancing pelvic rotation. In addition, deep work and trigger-point therapy help release strain built up over the months of pregnancy.
Posture, of course, determines how well a mother’s body takes the strain. “(Massage therapy) helps you to regain a powerful posture. We lose it when we’re pregnant; we fight to maintain a posture that is erect as best we can and end up getting into compensatory patterns that are not good. I try to teach a woman how she should correct those postural imbalances,” says Miller.
Miller says the postpartum time presents a wonderful opportunity for women. “Doctors usually say the postpartum period is six weeks, when the uterus shrinks back to its normal size, which is true. However, the ligaments in your body take two years to cinch back down into place. A woman has a wonderful open window to get herself into a better place muscularly than she was in before she was pregnant. It’s a chance to work with your body and become stronger for it.”
Massage therapy can help a woman strengthen herself emotionally, too. Massage decreases stress hormones and promotes endorphins—especially beneficial to new moms coping with the radical physical and psychological change from pregnant woman to new mother.
“It’s just my observation, but I’ve seen women with postpartum depression really pull out of it quicker with massage,” Miller says. She also notes that women who have had massage throughout pregnancy seem not to have as many “new-mother” issues. “Having been touched and nurtured during pregnancy really facilitates that same transition between mother and child.”
Certainly, mothers benefit from nurturing experience after their child is born, too. At a time when everything in a woman’s life—from her schedule to her body—is centered around her baby, massage gives her an opportunity to concentrate on her own needs.
“The most powerful aspect of massage is that it’s a time to just feel and learn where her own boundaries are, and that’s especially important when a child is living off her own body,” says Favin. Massage, she adds, gives a woman a chance to reconnect with herself.
And if nothing else, massage can provide a woman with a much-deserved break—a chance to relax and let herself be pampered.
Choosing a Massage Therapist
Consider the following when selecting a massage therapist during pregnancy:
- Qualification: Is the therapist trained in prenatal massage? Certain positions and techniques are not recommended during pregnancy because they may endanger baby or mother. A national certification is preferable, since state standards vary.
- Affiliation with a national or international organization: This shows interest and involvement in continuing education. Organizations to look for are the Associated Bodywork and Massage Professionals (ABMP) or the International Massage Association.
- Personal comfort: Look for a therapist who is sensitive to your needs and condition. Often women are more comfortable with female therapists at this time.
- Experience as a labor assistant: If you might like to have your therapist with you during labor, ask if she offers doula services or is willing to teach your labor partner.
- Attitude about pregnancy and newborns: Find a therapist who either agrees with or is accepting of your birthing philosophy and who is comfortable with babies (in case you want to bring your newborn to appointments). If you plan on breastfeeding, ask your therapist how she’d handle a nursing baby. For example, is it all right if he nurses while she continues the massage?
You can find a massage therapist by asking your doctor or midwife, asking other women, or contacting the national organizations mentioned for a list of therapists in your area.