Massage Monday: Pregnancy

In light of yesterday being Mother's Day, I thought I would cover the benefits of massage therapy for pregnant women. I will address some of the precautions that must be considered as well.  The program that I graduated from had a brief but informative section of class devoted to the proper techniques of massage with relation to pregnancy and what sorts of health conditions to be aware of. Some massage therapists enroll in a completely separate course that focuses entirely on pregnancy. I believe the course is a weekend long intensive hands on and book learning course.  Pregnant women are asked to come into the course in order to be "bodies" for the learning massage therapists. If you or someone you know is pregnant, massage could be an excellent way  to relieve some of the physical symptoms that may be experienced. If massage is the route you choose, feel free to ask your potential massage therapist whether or not he/she have taken the pregnancy course. If he/she has not, don't hesitate to ask for a referral to someone who does if that is what makes you most comfortable. Also, don't be offended if he/she refers you to one without you asking. The therapist may feel uncomfortable treating pregnancy as he/she may not have very much experience in this area. Often when a therapist refers a client it is because the therapist has the client's best interest at heart. So, how does massage help?
In the first trimester, a massage therapist will stay away from performing deep massage over the low back or near the abdomen. This is because first trimester pregnancies are so touch and go the therapist does not want to do anything that may compromise the pregnancy. That said, women who are in their first trimester can lie on their stomachs during the massage and light-VERY light-massage can be performed on the low back. Other than these two areas during the first trimester, massage can continue as usual. In the second and third trimesters deeper pressure can be applied to the low back and most women who are pregnant will probably need this work done. With the centre of gravity moving to where the baby is, the back and legs become over worked. Massage therapists should not perform any aggressive joint mobilisations during pregnancy due to the hormone relaxin being released, preparing the body for the baby's delivery.
Relaxin causes all of the muscles/ligaments/tendons to loosen or "relax" so that the body can change shape. This in itself is kind of amazing, but if joint mobilisations are performed during this time, joint capsuls-or where the joints fit together-can be over stretched or misshapen and the likelihood of these joints returning to normal is lowered. I personally would not send a client to a chiropractor during pregnancy, but that is my opinion and other professionals may disagree with me. My position is based on the explanation above. However, if an emergency occurred where only a chiropractor's work would be effective, then I would explain the situation to the client and let her make her own decision.  After pregnancy a visit to a chiropractor is probably needed, but the release of that hormone has decreased and the risk of creating loose fitting joints is decreased.
During the last trimester the positioning on the massage table may change in order to make the expectant mother as comfortable as possible. So, instead of lying on your tummy and being sore, the therapist can have you lie on your side propped up by a bunch of strategically placed pillows. If a client needs to lie on her back during the second and third trimesters, a pillow will be placed under the right side to prevent the baby from squishing an important artery. At first, this pillowing feels strange, but eventually it becomes more comfortable. In class we had to practice our positioning and also had to experience it so that we knew what we were putting our clients through. As said before though, if you are not comfortable, tell your therapist and he/she can reposition you. The massage is always about your comfort.
A few things to keep in mind when talking with your therapist about your pregnancy are:
-how far along are you (This information makes it possible for your therapist to treat you properly and safely).
-whether or not you have the onset of pregnancy induced high blood pressure (Massage increases circulation and so may increase high blood pressure if the proper techniques are not used. Massage can be modified for high blood pressure, so don't stop going if you develop high blood pressure).
-what positions are most comfortable for you (This will allow the massage therapist to ensure he/she puts you in a comfortable position, which is imperative for a successful massage).
-If you are not showing, make sure to tell your massage therapist. (Again this allows the therapist to make the necessary adjustments to ensure you have a healthy pregnancy. I.E. If your therapist is certified in Aroma Therapy and he/she usually administers a treatment with essential oils, it is important to tell him/her about your pregnancy as some essential oils can induce labor).
Massage can reduce stress and in turn that can  decrease high blood pressure, headaches and other physical manifestations of stress. As a pregnant woman, you will more than likely  be stressed. So don't forget to take a few minutes for yourself and relax. Massage will help with this.
A technique called "lymphatic drainage" can assist with water retention issues. The technique is incredibly light and is quite relaxing. The feather-light strokings moves the lymphatic fluid along and can help with some of that trapped fluid. This technique may increase your need to pee, so please don't feel embarrassed to tell your therapist that you have to go. He/she should stop the treatment as many times as you need so that you may relieve yourself.
Massage can also help with your low back pain. When your centre of gravity shifts with the growth of the baby, the backs of your legs-or your hamstrings-become over extended with the forward tilting of your pelvis. Your therapist should work on your low back, depending on which stage of pregnancy you are in, and then stimulate your hamstrings. This stimulation technique causes the hamstrings to contract and it should help them shorten a bit again. The therapist should address the fronts of your thighs-or your quads-as these will have done the opposite to your hamstrings and shortened. They need to be lengthened to relieve some of your low back pain. If you enjoy heat, then heat can be applied to your quads to assist them to  loosen up. A caution that must be taken into consideration though is that a deep heat is not placed over the abdomen-we don't want to cook the baby. Heat should not be placed   over the low back during the first trimester as this is a sensitive stage of pregnancy.
Massage is excellent for women who are pregnant. I know a lot of women who have received a great deal of relief from massage during pregnancy. There are definitely things to be taken into consideration when receiving massage therapy during pregnancy, but I illustrated these precautions so that you would understand better why massage therapists do the things he/she does when you are pregnant. I believe that people should have  power over his/her own bodies and knowledge is power. A lot of pregnant women have expressed to me that as soon as her "bump" starts showing her body no longer belongs to her as it is the baby's and complete strangers feel he/she have the right to "pet" it. Nobody knows your body better than you do, especially a pregnant body. The more information you have the better equipped you will be to make decisions about it. So, enjoy your pregnancy and remember to take time for yourself. :)