After graduating from massage school

[pippy:D]

I am currently a student at Tri State College and have about one year left. I had just found out that my cousin was pregnant a little over a month ago...i found out that massage is contraindicated for the first trimester of a pregnancy, but i was wondering if and what further education i needed to be able to help her once she gets out of her first trimester, and what techniques i can use to benifit her and the baby without hurting either of them and if i can even do massage on her without being educated in pre-nadle (spelling?) massage....any comments or suggestions are greatly appreciated

 

[Joey .]

Hi, MeganLB. I am sure you will find plenty of good information around this forum to help you on your massage therapy journey. Here are a few threads I found that you might find helpful, as you are learning and trying to decide your scope of practice with your cousin. As far as massage being contraindicated in the first trimester, there is plenty of debate and strong feelings around that topic. My recommendation is that you take an outside pregnancy massage class, or maybe ask an instructor at your school for an extra tutoring session, so that you understand the proper bolstering techniques and possible contraindications better.

massage in the first trimester

1st trimester potential client: Informing without scaring

pregnancy massage

Post-natal massage

I participated in the above thread, and here is some of the info I posted from a handout I received at a pregnancy massage workshop:

About side lying position:
This is an ideal position for pregnant women to receive massage. It is very safe and comfortable, and lying on the left side increases cardiac output by 22%. Many health care professionals advise pregnant women to lie only on the left side as a precaution to avoid Supine Hypotensive Syndrome; however, recent research shows that there is no other difference between left and right side lying positions. In fact, for postural reasons there is value in lying on both sides.

You can also put mother in a semi-reclined position, with the aid of wedges and pillows to bolster her up in a comfortable resting position. Don't forget to bolster under right hip, and some small pillows or bolsters for arms. Here is a recommended procedure:

Semi-reclined Position:
Use a salon back table, or large wedge pillow to position her torso at a 45 to 60 degree angle with the table and add pillows as necessary to maintain proper neutral alignment and fully support the head to the low back.

Place a wedge pillow (can use "baby wedge") under her right hip to shift the weight of the uterus and baby off the descending aorta and inferior vena cava, avoiding Supine Hypotensive Syndrome which decreases the mother's blood pressure and the fetal circulation and increases pressure on the mother's venous system.

Place pillows under both knees and under both arms.

When changing positions or getting off the table, help her sit up from this position or ask her to roll onto her side and use her arms to sit up, avoiding stress on her abdominal tissues.

Info for Baby, Mother, and Therapist through all phases of pregnancy:

First Trimester
from date of late menstrual period through 13th week

BABY

From fetilized egg to 3" long
Has complete skeleton (body, arms, legs, eyes, nails and ears)
Major organs forming by 6th week, developed by 12th week
13th week placenta issues hormones which maintain pregnancy
Responds to touch

MOTHER

Ultra-sensitivities
Aches and pains usually disappear because of hormone, relaxin
Risk of miscarriage is highest
Increase in blood plasma makes anemia possible

THERAPIST FOCUS

Swedish massage main modality
Abdominal work is contraindicated
Passive joint movement or rocking may increase nausea
Avoid reflex work around lateral malleoli and anterior tibialis
Prone or supine positioning still comfortable

Second Trimester
14 weeks to 28 weeks

BABY

Grows to 11-14 inches
Heartbeat audible, fetus movement felt by mother around 18 weeks
Responds to sound

MOTHER

Uterus reaches umbilicus
Structural problems can begin (low back stress, enlarged breasts, skin stretching, muscle and ligament cramps, varicose veins and hemorrhoids, uterine ligament twinges)
Anemia possible

THERAPIST FOCUS

Wedge right hip in supine postition so the uterus does not put pressure on the inferior vena cava
Deep tissue massage is OK (keep in mind toxins released in mother's body will probably reach baby)
Intent is to relieve stresses of pregnancy and prepare for birthing

Third Trimester
29 weeks to 40 weeks

BABY

Weight doubles in 7th month
All but lungs functional by 8th month


MOTHER

Uterus reaches bottom of rib cage
Pubic symphysis, sacroiliac joint discomforts
Edema, especially in ankles and legs
Uncomfortable in one position for lengthy time
Sleep can be uncomfortable, wakefulness in early A.M. hours

THERAPIST FOCUS

Side lying and semi-reclining best positions
All massage modalities can be appropriate with intent to relieve discomforts (also will relax sympathetic nervous system and prepare for birthing)
Soft ligaments can make some passive joint movements uncomfortable; check in with client as you do it
Relief of pelvic congestion, SI joint, and low back strain
Deep tissue work on adductors in preparation for delivery