The Art of Prenatal Massage
by Kelly Lott, RMT

As you moms-to-be know, most pregnant women feel discomfort and added stress on their bodies at various points in their pregnancies. That may be why more and more pregnant women are discovering and benefiting from the art of prenatal massage.

What is prenatal massage?
Massage during pregnancy is therapeutic bodywork which focuses on the special needs of the mother-to-be as her body goes through the dramatic changes of the childbirth experience. It is a fast-growing field in the United States that has attracted the interest of labor and delivery nurses, nurse-midwives, childbirth educators and obstetricians. Massage therapy enhances the function of muscles and joints, improves circulation and general body tone, and relieves mental and physical fatigue.

The popularity of prenatal massage is the result of a trend toward a higher level of wellness, especially during pregnancy. Many women are postponing childbirth until they have achieved other goals, such as careers and relationships. Because of this, pregnancy is anticipated and enjoyed to its fullest for the wondrous experience it is. Today's pregnant women – along with other health care consumers – are looking for alternative approaches to support traditional health services.

Benefits of prenatal massage include: emotional support and nurturing touch; relaxation and decreased insomnia; stress relief on weight-bearing joints, such as ankles, lower back and pelvis; neck and back pain relief caused by muscle imbalance and weakness; assistance in maintaining proper posture; preparing the muscles used during childbirth; reduced swelling in hands and feet; lessened sciatic pain; fewer calf cramps; headache and sinus congestion relief.

Pregnancy massage can be done in different ways. Pregnant women may lie on their sides to be massaged, and they can actually lie on their bellies, since a specifically designed pillow has made it possible for expectant moms, no matter how far along they are, to lie flat on their stomachs. It accomplishes this with a deep center cutout in the pillow, so that bellies are accommodated and moms-to-be are relaxed and comfortable. After the first 22 weeks of pregnancy, lying flat on your back can cause pressure on deep blood vessels, due to the growing baby, thereby reducing circulation to you and your baby. To avoid this problem, pillows can be used to ensure that you are lying down and looking at the wall rather than the ceiling. Body pillows are especially effective for the side-lying position.

Benefits of prenatal massage
In addition to the fact that massage during pregnancy just plain feels good, there are many other benefits for the mom-to-be and her baby, too. A study conducted by Dr. Tiffany Field at the University of Miami School of Medicine showed that massage actually reduces stress hormones in the body. Touch is vital to the mother's physical and emotional well-being as she adapts to her new body image. Regardless of individual circumstances, a pregnant woman's body is challenged, changed and stressed in many ways. Massage gives special attention to the mother-to-be, which in turn nurtures the new life that grows within her.

Is prenatal massage for you?
Massage during pregnancy is usually safe for most mothers. Your massage therapist will want to know if you are having any problems or complications with your pregnancy before you begin. If you are, then your therapist will require approval from your primary health care provider before proceeding with any bodywork. The following are circumstances in which massage should not be performed:

• heavy discharge (watery or bloody);
• diabetes;
• contagious illness;
• fever;
• vomiting;
• unusual pain;
• pre-eclampsia;
• high blood pressure;
• morning sickness;
• abdominal pain;
• diarrhea;
• any malignant condition.

Areas of the body that should not be massaged include:

• skin rashes, open sores, bruises;
• inflammation;
• raised or distended varicose veins;
• local infection sites.

In addition to these areas, one other precaution needs to be mentioned: Direct and sustained pressure should not be applied to the area between the ankle bone and heel. This area is considered by many massage therapists and reflexologists to relate with the uterus and vagina, and it is thought that heavy pressure to this area could promote early labor. Assuming there are no other precautions or considerations, it should be all right to massage the rest of the feet.

Massage pointers
Because of the tremendous physical and hormonal changes that occur in the expectant mother, I do not recommend any massage during the first trimester. In my opinion, this is the time for the mother to get comfortable with being pregnant. The second and third trimesters are wonderful times to begin prenatal massage.

I do not recommend massaging so deeply that pain is ever felt. The most effective guide for determining proper pressure is open communication between the mom and whoever is massaging her. An unscented lotion is best to use as a lubricant, since many pregnant women have an aversion to strong odors. The person giving the massage should have short, trim and smooth nails, and should avoid wearing any watches, rings or other jewelry that might cut skin or make noise to distract from the experience. The massage should be done in a quiet area away from phones, traffic, children, pets, etc. Soft and soothing music can add to the relaxation and comfort of the mom-to-be. The room should be well ventilated -- having a fan circulating the air is a good idea.

The person giving the massage should have short, trim and smooth nails, and should avoid wearing any watches, rings or other jewelry that might cut skin or make noise to distract from the experience.

Massage can be performed anywhere from 10 minutes to one hour, depending on how much time you have and how much discomfort you are experiencing. Once a week during the second trimester is great, and twice a week or more, during the third trimester is wonderful. In my practice and in my teaching, I have found that my pregnant clients appreciate their massage therapy appointments because they know relief is at hand. They look forward to their weekly appointments to ease recurring problems, such as sciatica, leg cramps, and back and round ligament pain. I hope pregnancy massage eases any discomfort you may be feeling, too.

About the Author: Kelly Lott is a Registered Massage Therapist, Certified Massage Therapist, Certified Massage Therapy Instructor, Certified Pregnancy Massage Therapist, and Certified Infant Massage Instructor in Texas, and is also one of Pregnancy Today's Expert Panelists. She has been in practice since 1990. She is an advocate of involving birth partners in massage, and teaches massage techniques to birth partners so they may use them before and during labor. She can be reached toll-free at 1-888-274-9904.