A Question For Prenatal MTs

[pear2apple]

Hi, I'm new I introduced myself, Chris, but if you haven't seen it, I graduated from an Ohio program and took the licensing board exam in December and will find out my results mid-January. I've been thinking and researching what I want to specialize in. While in school I gave a pregnant woman a massage. It was ok, I had about 10mins to prep for it (the woman showed up and HELLO she's pregnant- never told the school beforehand) so I didn't have a lot of info, and from what I've read, some of it was wrong anyway!

So, I'm kinda interested in pursuing a certification in Pregnancy Massage. Claire Marie Miller who does the Nurturing the Mother class is coming to my school in March for a 2-day seminar. I'm considering signing up. But I don't really know what I am getting into. I talked to the Dean at my school who does Pregnancy massage and tried to setup a time to come into her office to witness what takes place in a typical session, but it never panned out. So I'm not sure I know what to expect.

Of course, I'm not licensed yet so I'm waiting until I get the go-ahead from the Medical Board before signing up, but I'd like some info beforehand as well. Can anyone who specializing in Prenatal Massage give me some information? Maybe what you do in a typical day? What type of massage do you give? My teacher told me they could lie on their back while inclined with pillows if the mother wasn't too far along. She also told me the mother could lie on both her right and left sides during the massage. No one ever told me not to massage the inner thigh (granted it makes sense now, but I hadn't thought of it). Then another teacher told me the right side lying is dangerous because of some blood vessels. And the whole idea of the belly hole in the table or special pillows/bolsters so the mother can lie on her stomach totally freaks me out!

So if you have any links or info personally, I would completely appreciate it so I have more info before I start my career! Thanks!

[Addison_X]

Pregnancy massage is just Swedish massage with more equipment.

You'll hear a lot of silliness from people about what "not to do" to a pregnant woman; most of it is hearsay and not based in any real scientific evidence. They can lay on either side of their body, you can massage their inner thighs [assuming they're in a position for you to reach them], they can lay in a modified supine at any time given an appropriate bolster or table that will create an incline; in my opinion pillows aren't going to cut it for that though. However it is not recommended by most people that you use the tables with the holes in them; no two bellies are the same so it's hard to get the appropriate support for their belly, and generally they're a lot more pain than they're worth [for you and the client]. I've also heard from some MTs that you cannot do massage during the first trimester and/or third trimester for various reasons; which is also nonsense. There is really no time that you cannot massage a pregnant woman.

In general it's worth investing time and/or money into. You're at some point going to have to massage a pregnant woman, so you want to be good at it and well informed. I took my certification through Massage Doula [http://www.massagedoula.com/]; they provided good information and a good routine to perform as well as being an online course, which was convenient for me.

[pyronymph]

Not sure what you're doing, buy my pg massage isn't just swedish with more tools...

I do A LOT of stretching with my preggo clients. Sidelying on both sides with pillows/bolsters to support. I do avoid the acupressure points on the ankles and hands that are said to cause uterine contractions -- just as a precaution, I don't need to help along anyone who has the idea of giving birth on my table

I don't have a lot of clients who come in their 1st trimester -- many women are too cautious at this time due to their personal risk of miscarriage, it's not something that I warn them of. A lot of woman won't even tell people that they are pg until the 2nd trimester, for superstitious/peace of mind issues.

Definitely stay away from the pregnancy holed tables. Though I do want to get a Body Cushion -- those are crazy comfortable!!

[pear2apple]

I have no idea what a Body Cushion is....you mean a long body pillow? That is comfortable.

What kind of stretches would you do with a pregnant client? I still feel awkward doing stretches to just anyone else. I know I just need more practice. Before I went to massage school, I'd only ever received 3 professional massages and none of them involved stretching. I always thought it was weird, but now I notice almost every MT DOES do stretches.

I've talked to a Reflexologist and also Pregnancy MTs and they've both told me the foot points for uterus doesn't actually cause you to go into labor if your body wasn't already going to do it then or soon after. Its not like you push a button and out pops a baby. Of course, they also said for peace of mind to the mother, not to work extra on that area (unless asked) or avoid all together if the mother asks.

@Addison
Thanks for the link, I'll check it out!

[Addison_X]

Not sure what you're doing, buy my pg massage isn't just swedish with more tools... I do A LOT of stretching with my preggo clients.

I perform general stretching and ROM techniques as well where it's needed; however I consider those techniques a part of Swedish massage. It isn't like I'm doing active isolated stretching or PNF ROM techniques. I'm sorry if my over-simplification offended you, but yes, I consider pregnancy massage an extension of Swedish.

I have no idea what a Body Cushion is....you mean a long body pillow? That is comfortable.

It's a cushion set designed to place your body in an aligned position; either side-lying, prone, or both. They're pricey, but nice. http://bodysupport.com/

I've talked to a Reflexologist and also Pregnancy MTs and they've both told me the foot points for uterus doesn't actually cause you to go into labor if your body wasn't already going to do it then or soon after. Its not like you push a button and out pops a baby. Of course, they also said for peace of mind to the mother, not to work extra on that area (unless asked) or avoid all together if the mother asks.

You don't necessarily have to avoid giving general techniques over the area, just acupressure on the specific point.

[Taoist]

This actually brings up some questions I've had about prenatal massage, brought about by students at the school I work at being literally terrified of prenatal massages in clinic. The school just hired a new prenatal instructor, and I finally asked one of the students what the deal was and he said "there are just so many places we're supposed to avoid, I don't remember them all and there's so much risk of something happening, and I don't want anyone to go into labor during a massage!"

Say whaaaaat?

Apparently these "danger zones" included not only acu-points in the feet and ankles, but all up the legs and back, and included most of the upper shoulders. What is there left to massage? Another problem that happened to another student who was doing a prenatal massage: about halfway through the session, her client tells her to stop and ended the massage because she wanted more pressure on her legs but the student had been told not to do any more than feather-light pressure on the legs. The client was just too frustrated to continue and had even started getting a little emotional.
Hmmm.. I'm not sure what to make about it all.

Anyway, I agree that massaging the feet and shoulders and giving more medium pressure on the legs isn't going to make anyone go into labor if it's not time for the client's body to go into labor. Again, as long as working those acu-points isn't your focus, you can still give a really great prenatal massage without skipping over anything. I also agree about the cut-out tables. They make me nervous.

[Addison_X]

Some of the rationale behind the "danger areas" seem intelligent at first glance. Like when people tell you not to lay them on their right side because it will compress the vena cava. Makes sense right? Vena cava runs down the right side, it's a major blood route, don't lay them there. But in reality, these women are probably spending time sleeping on their right side without it causing complication, so spending an hour on our table isn't going to either. Like Jason said in the other thread, these women are a lot more resilient than we give them credit for.

Personally, between this post and the other thread you made, the Instructor sounds like a quack. If the students are coming away from the class afraid to touch a pregnant woman, they're not receiving adequate instruction.

[JaeMarie]

Just my quick .02 on avoiding specific acupressure points...

In my prenatal class, the instructor made it simple. She pointed out that if it were so easy to send a woman into labor by pushing a couple points, that labor would never have to be induced in hospitals - a nurse or doc could just hit a couple "buttons" and the ball would be rolling.

If you're wondering if the class will be a good investment or not, consider this. Will you be working on females? Will they be of childbearing ages? If you answer yes to either one of those, chances are, sooner or later you'll run into a pregnant client. Would you rather refer them, or roll right into a new phase of their life right with them?

Pregnancy isn't a pathology, and pregnancy massage isn't rocket science. It's mostly being aware of the changes going on within the woman's body, and learning how to make adjustments to accommodate those changes for their comfort and well being.

[pear2apple]

Thanks everyone for their posts.

Apparently these "danger zones" included not only acu-points in the feet and ankles, but all up the legs and back, and included most of the upper shoulders. What is there left to massage? Another problem that happened to another student who was doing a prenatal massage: about halfway through the session, her client tells her to stop and ended the massage because she wanted more pressure on her legs but the student had been told not to do any more than feather-light pressure on the legs. The client was just too frustrated to continue and had even started getting a little emotional.
Hmmm.. I'm not sure what to make about it all.

I was told in school, by my Anatomy teacher who is an LMT and an RN, that you don't lay them on their right side or massage the inner thigh. We didn't actually learn anything extra but Swedish massage in school....would have been nice to learn some special techniques though. But at my school you needed to pay for that with seminars...anyway, I don't want to get into a tangent about that stuff. Point I'm making is that, the one and only prenatal massage I gave in clinic, the woman complained that it was 'too light' even though beforehand I told her it wouldn't be deep pressure. Yet she still complained on my evaluation that I should have used heavier pressure on her low back....uh no thanks.

Anyway, I can see how students are terrified of pregnancy massage, its never talked about in school and we only had 2 pregnant women over a 9 month period for clinic.

In my prenatal class, the instructor made it simple. She pointed out that if it were so easy to send a woman into labor by pushing a couple points, that labor would never have to be induced in hospitals - a nurse or doc could just hit a couple "buttons" and the ball would be rolling.

If you're wondering if the class will be a good investment or not, consider this. Will you be working on females? Will they be of childbearing ages? If you answer yes to either one of those, chances are, sooner or later you'll run into a pregnant client. Would you rather refer them, or roll right into a new phase of their life right with them?

Pregnancy isn't a pathology, and pregnancy massage isn't rocket science. It's mostly being aware of the changes going on within the woman's body, and learning how to make adjustments to accommodate those changes for their comfort and well being.

Thank you! Good points

[Blue]

We had a pregnant student in class, so everyone got experience massaging a pregnant woman through the months. As Jae Marie said, if there was some magic points that would cause a woman to go into labor, inductions would never be needed. There would also be no abortion clinics anywhere, if a massage could cause a miscarriage.

We were taught the "standard" massage contraindications, and then we went through and looked for any research to back those up. We couldn't find any - ever! Specific women with complications will be told to only lie on their left sides. We couldn't find a single OB/GYN who had a problem with their patients getting massages throughout the pregnancy. They encourage women to stay active and continue on with all their regular activities as long as it is comfortable to do so.

It is best to learn about the changes a woman's body experiences in pregnancy and to learn how each specific client is doing with her pregnancy, but all the silly little rules and spots to never touch (or even to only do very light pressure) are based in fear and not understanding the human body. As massage therapists, we should be constantly learning more about the body, and able to apply that knowledge - and often decide to learn more - with each client we see.

A woman not in labor is highly unlikely to suddenly deliver on your massage table without warning because you touched the wrong spot.

[pyronymph]

I guess I need to clarify my response. I don't think that I'm going to cause a miscarriage or start labor. I avoid the acupressure points in case the body has already started the process (which can happen without the woman's knowledge -- not everyone is super in touch with their body to notice the minute changes at the beginning of the birthing process).

As to the first trimester -- I didn't say that I don't/won't give a massage at this time. I see no problem with it and don't believe that it will trigger a miscarriage. I was stating that most of the women who come in specifically for pg massage are past that point, either because of their own fears of miscarriage or not knowing that they're pregnant until after that point.

Sorry for any confusion.

[MassageIsMedicine]

My 2 cents...
From the point of view of a L.M.T. who is 5 months preggors and receiving weekly 90 minute massages.

I have had absolutely no problems receiving massage during my entire pregnancy. I talked with my OB and she had no problems with me getting massage during all 3 trimesters. I lay on both sides with no pain and receive massage on all parts of the body that a regular swedish massage entails. Pillows are used for my head, one to hug and one between my kness and ankles when on my side and it is the most comfortable position in the world. It's exactly how I sleep as well. I wish the taboo of massaging preg. women during 1st trimester would disappear for good. It was so beneficial to me in dealing with the fatigue and back pain. I was working full time, 21 clients per week, now down to 16 clients a week and without my weekly massages I'm not sure how I have make it! Also, now that I know what it feels like to receive while preg. I give much better prenatal massages. My advice is every pregnant woman should get regular prenatel massages!

[Taoist]

My 2 cents...
From the point of view of a L.M.T. who is 5 months preggors and receiving weekly 90 minute massages.

I have had absolutely no problems receiving massage during my entire pregnancy. I talked with my OB and she had no problems with me getting massage during all 3 trimesters. I lay on both sides with no pain and receive massage on all parts of the body that a regular swedish massage entails. Pillows are used for my head, one to hug and one between my kness and ankles when on my side and it is the most comfortable position in the world. It's exactly how I sleep as well. I wish the taboo of massaging preg. women during 1st trimester would disappear for good. It was so beneficial to me in dealing with the fatigue and back pain. I was working full time, 21 clients per week, now down to 16 clients a week and without my weekly massages I'm not sure how I have make it! Also, now that I know what it feels like to receive while preg. I give much better prenatal massages. My advice is every pregnant woman should get regular prenatel massages!

Thanks for your input!

[LadyNiko]

MassageInMedicine - I think I love you.

Your answer about how you were positioned during your prenatal massages is exactly the answer I was looking for today.

I had a new client call me out the blue today & state that she's 34 weeks pregnant and wants to lay on her stomach!

Uhm, no! She didn't take the answer that I was taught it's a bad idea to put a pregnant woman on her stomach after the first trimester.