For 1000’s of years, touch has been used to improve and enhance a woman’s experience of her pregnancy and birth. Ongoing research supports the claims of psychological and physiological benefits of massage and touch specifically during the perinatal cycle. Some cited benefits include: improved physiological function; improved posture and emotional wellbeing; musculoskeletal pain reduction; enhanced lactation and increased prolactin production; decreased intra-uterine stress; increased ability to nurture others.
While the benefits are many, myths of dangers still circulate, resulting in fearful pregnant women and insecure massage therapists who are concerned that touch may trigger a miscarriage. With this in mind, some sources recommend avoiding massage in the first trimester when most pregnancy losses occur. Others contraindicate touch to particular areas of the body, such as the belly, legs, or ankles, with hopes of avoiding the stimulation of contractions. In general, these ideas are not accurate.
The first trimester is indeed a time of great physiological and emotional changes––all the more reason for a woman to receive nurturing touch, helping her integrate those changes. While miscarriage is extremely common, it generally occurs because the fetus is non-viable; massage has never been clearly implicated legally or scientifically as a cause.
Additionally, gentle touch to the pregnant abdomen does not hurt baby or mother. While one may choose not to offer belly rubs in the first trimester in order to avoid associations between the massage and a miscarriage, the touch itself is not dangerous. During the first trimester, the uterus is low in the pelvis and not palpable without applying deep abdominal pressure––a practice which is contraindicated for massage therapists during pregnancy. Instead, nurturing touch to the abdomen, especially in the 2nd an 3rd trimesters, can be extremely relaxing for the mother.
Certain acupressure points in the lower leg, feet, hands and shoulders, are generally contraindicated for acupressure or acupuncture, but they are not “magic buttons” that cause contractions when touched! General Swedish massage to these areas is not contraindicated, as it does not stimulate the points similarly to acupressure. If it were so simple for touch to stimulate labor or contractions to begin women would happily avoid all medically induced labors and abortions!
There are many inaccurate beliefs about perinatal massage, but there are also real and important precautions during pregnancy, labor and the postpartum period. Massage therapists intending to work with this clientele need to cultivate an in-depth knowledge of the physiological changes during this time, along with the skill to implement adaptations relative to minor risks, and the ability to recognize some symptoms of high-risk situations. Practices of primary concern include using positioning variations on the massage table that provide safety while reducing risk of nausea, heartburn, increased lumbar lordosis, and uterine pressure on the inferior vena cava and aorta, as well as paying heed to the higher risk of blood clots during pregnancy and postpartum.
As perinatal massage education increases, fears and myths about its dangers can decrease. Therapists who learn accurate and appropriate cautions and contraindications, can help dispel myths and assuage unwarranted fears. Armed with knowledge and gifted with the ability to offer safe, caring touch, the massage therapist can help pregnant women reduce anxiety, and increase their pleasurable experiences of their pregnancy. Details about risks, benefits, and methods of safely working with pregnant woman can be learned in specialty pregnancy massage classes, such as the series offered this June at DSM. Excerpted and adapted with permission from Lippincott, Williams and Wilkins: Nurturing Massage for Pregnancy: A Practical Guide to Bodywork for the Perinatal Cycle, by Leslie Stager, RN, LMT, 2009. See calendar for dates of Leslie’s workshops at DSM.