Pregnancy Massage

Carole Osborne

Nurturing touch during pregnancy, labor, and the postpartum period is not a new concept. Cultural and anthropological studies reveal that massage and movement during the childbearing experience was and continues to be a prominent part of many cultures’ healthcare.1 Studies indicate that most of the more peaceful cultures use touch prominently during pregnancy and early childhood.2 Midwives, who for centuries have provided maternity care, have highly developed hands-on skills.

Current research on the benefits of touch is providing a contemporary basis for its reintroduction in many technological societies, including the United States. Scientists have found that rats restricted from cutaneous self-stimulation had poorly developed placentas and 50% less mammary gland development. Their litters were often ill, stillborn, or died shortly after birth due to poor mothering skills.3 Pregnant women massaged twice weekly for 5 weeks experienced less anxiety, leg and back pain. They reported better sleep and improved moods, and their labors had fewer complications, including less premature births.4 Studies show that when women received nurturing touch during later pregnancy they touch their babies more frequently and lovingly.5 During labor the presence of a doula, a woman providing physical and emotional support, including extensive touching and massage, reduces the length of labor and number of complications, interventions, medications, and Cesareans.6

Why Prenatal Massage Therapy?
Profound local and systemic changes in a woman’s physiology occur as a result of conception and the process of labor. Changes during pregnancy span the psychological, physiological, spiritual, and social realms. Massage therapy may help a woman approach her due date with less anxiety, as well as less physical discomfort.7

A typical session performed by a therapist specializing in pre- and perinatal massage therapy can address pregnancy’s various physical challenges: postural changes, pain in the lower back, pelvis, or hips, and edema. Touch during pregnancy may facilitate gestation by supporting cardiac function, placental and mammary development, and increasing cellular respiration.8 It also may reduce depression and stress by contributing to sympathetic nervous system sedation. 9 Deep tissue, trigger point, and both active and passive movements alleviate stress on weight-bearing joints and myofascial structures, especially the sacroiliac and lumbosacral joints, lumbar spine, hips, and pelvic musculature.10 Structural balancing and postural reeducation reduce neck and back pain caused by improper posture and strain to the uterine ligaments. Prenatal massage therapy also may facilitate ease of labor by preparing the muscles for release and support during childbirth.11

Beyond these physical effects, an effective prenatal massage therapy session provides emotional support. In the safe care of a focused, nurturing therapist, many women unburden their worries, fears, and other anxieties about childbearing. Bodywork may help the mother-to-be develop the sensory awareness necessary to birth more comfortably and actively. Laboring women whose partners learned and provided basic massage strokes to their backs and legs had shorter, less complicated labors. 87% of these massaged women were more satisfied with their partners’ support during labor.12 Imagine the benefits generated by the skilled hands of a trained touch specialist!

The Postpartum Period
Beginning with the baby’s birth, a new mother must cope with more changes. She is typically only 10 to 12 pounds lighter, yet she is still maintaining her body with an anterior weight load posture. Additional musculoskeletal stresses occur during the many hours of feeding, carrying and other newborn care. The massage practitioner may facilitate proprioceptive reprogramming to gently return the body to its pre-pregnancy state, to alleviate pain, and to bring about a renewed sense of body and self.13

Postpartum sessions often focus on relaxation, physiological recovery and pain relief. Longer- term care may normalize pelvic position and re-pattern overall body use. Postpartum massage sessions may restore functional muscle use in the lumbar spine area14, as well as strengthen and increase tonus in the abdominal musculature stretched and separated by pregnancy. Additionally, the overtaxed, hypotoned iliopsoas muscle functions can be improved. Upper back muscles which now support larger breasts and the carried infant’s weight need attention to reduce strain, and to help maintain flexibility despite the physical stresses of infant feeding and care.

For post-Cesarean mothers, specific therapeutic techniques also can reduce scar tissue formation and facilitate the healing of the incision and related soft tissue areas, as well as support the somato-emotional integration of her childbearing experience.15

Qualified Pre- & Perinatal Massage Therapists
While approximately three quarters of pregnancies proceed normally and are uncomplicated by medical conditions16, it is still advisable for massage therapists to be knowledgeable about pre- and perinatal physiology, high risk factors, and complications of pregnancy. Even without problems developing, physiological changes necessitate modifications to or elimination of various techniques and methodologies, depending on the individual and the trimester of pregnancy. When medical conditions develop, additional adaptations and consultation with physicians and/or midwives prior to sessions is prudent. Additional specific specialized training in prenatal and perinatal massage therapy helps to qualify massage therapists to safely and effectively meet women’s many and complex needs.

Somatic practitioners will find reliable, detailed, research- based protocols and contraindications in the second edition of Pre- and Perinatal Massage Therapy, and in other media and training programs created by this author. For those seeking comprehensive hands-on training and certification as a maternity massage specialist, practitioners should consider enrolling in the upcoming 32-hour technique certification workshop.

This book and training program have developed from over 37 years as a somatic practitioner and educator and 30 years of specialization in maternity and infant massage. Students benefit from a continually expanding body of knowledge, research, clinical experience, and consultations with other perinatal health care providers.

The highly qualified instructors of Pre- and Perinatal Massage Therapy offer a safe and comprehensive approach to pregnancy, labor, and postpartum massage therapy. They also encourage an empathetic, non-judgmental attitude in supporting women’s ‘pregnant feelings’. These certification workshops include over 80 techniques specifically adapted for pre- and perinatal needs, and the practical marketing strategies, ethics, and skills to elicit collaboration with other perinatal specialists and to build a successful pre- and perinatal massage therapy practice.

These courses are approved by the National Certification Board for Therapeutic Massage and Bodywork (32 continuing education credits). Each workshops and staff is also approved by the Florida Board of Massage (and other local state boards as required) and the California Board of Registered Nursing; meet current American Massage Therapy Association continuing education standards; can be used for Associated Bodywork and Massage Professionals membership; and can be used for continuing education credit with Doulas of North America.

Skilled, nurturing touch is good for moms and their babies, and for the family of humanity. As complementary healthcare research expands, more data validate improved outcomes from maternity massage therapy. With over 4 million American women pregnant annually, this is a viable and satisfying niche market for therapeutic massage and bodywork practitioners to pursue.

Carole Osborne has been a somatic practitioner since 1974, specializing in maternity care since 1980. In addition to private practice, she has worked in osteopathic, psychological, and women’s medical settings. She is author of Deep Tissue Sculpting, Pre- and Perinatal Massage Therapy, 2nd edition and is a widely sought-after continuing education provider. In 2008, the AMTA Council of Schools presented Carole with the National Teacher of the Year Award, a high point of her 37 years as a somatic arts and sciences educator. She is also a contributor to Teaching Massage and many massage therapy publications.

To order a book or to learn more about our June 2014 workshop, contact the local sponsor, Downeast School of Massage at 207-832-5531 or online at Call Carole at Body Therapy Education – (800) 586-8322 or (858) 633-3033.
Facebook page: Carole Osborne’s Prenatal and Deep Tissue Massage Training

1 Goldsmith, J. Childbirth Wisdom. New York: Congdon and Weed, 1984.

2 Prescott, J. Prevention or Therapy and the Politics of Trust: Inspiring a New Human Agenda. Psychotherapy and Politics International 2005;3:194-221. DOI:10,1002/ppi.6. Accessed 2/6/2009.
3 Rosenblatt, J.S. and D.S. Lehrman. Maternal behavior of the laboratory rat. Maternal Behavior in Mammals, Wiley, New York, 1963, p. 14.

4 Field, T., M. Hernandez-Reif, S. Hart, et al. Pregnant women benefit from massage therapy. J. Psychosomatic Obstetrics and Gynecology, 20(1), March, 1999, 31-38.

5 Rubin, R. Maternal Touch. Nurs Outlook, 11/1963, 828-31

6 Klaus, K, Kennell, J., Klaus, P. The Doula Book: How a Trained Labor Companion Can Help You Have a Shorter, Easier, and Healthier Birth. New York: DeCapo Press, 2002.

7 Field T. Diego MA, Hernandez-Reid M, et al. Massage therapy effects on depressed pregnant women. J Psychos Obstet Gynecol 2004;25:115-122.

8 Roth LL, Rosenblatt JS. Mammary glands of pregnant rats: development stimulated by licking. Science 1996; 264:1403-1404.

9 Field, 2004.

10 Pryde M. Effectiveness of massage therapy for subacute low-back pain. A randomized controlled trial. Can Med Assoc J 2000;162(13):1815-1820.

11 Bodner-Adler B, Bodner K, Mayerhofer, K. Perineal massage during pregnancy in primiparous women. Int J Gynecol Obstet 2002.

12 Chang M, Wang S, Chen C. Effects of massage on pain and anxiety during labour: a randomized controlled trial in Taiwan. J Adv Nurs, 2002 Apr; 38 (1):68-73.

13 Pirie A and Herman H. How to Raise Children Without Breaking Your Back. Second edition. W. Somerville, MA: Ibis Publications, 2003.

14 Quebec Task Force on Spinal Disorders. Scientific approach to the assessment and management of activity-related spinal disorders. Spine, 12:Supplement 1, 1987.

15 Andrade C-K and Clifford P. Outcome-Based Massage: From Evidence to Practice. Second Edition. Baltimore: Lippincott, Williams and Wilkins, 2008.

16 Ricci S. Essentials of Maternity, Newborn and Women’s Health Nursing. 2nd Ed. Baltimore: Lippincott Williams & Wilkins, 2009.

What is Kinesiology?

What is Kinesiology?
By Nancy Dail

Recently, Laura Allen asked “What is your favorite Kinesiology book?” From the bulk of the answers to her question, it was clear that many in our industry do not really know the definition of Kinesiology. To further confuse the issue, modalities have been labeled as “Applied Kinesiology” and later “Touch for Health” interchanged the terms kinesiology as a title. Massage curriculum has not always included kinesiology as a part of massage therapy education. Many believe that kinesiology and myology (the study of muscles) carry the same definition.

In 1964, Dr. George Goodheart developed “Applied Kinesiology” using manual resisted muscle testing with compression and circular friction to the origins and insertions of muscles. He incorporated the knowledge and use of meridians to his modality. Years later Dr. John Thie developed “Touch for Health” using Goodheart’s principles. These are useful modalities, not the study of Kinesiology.

Anatomy is simply learning the structure of the human body. It is all inclusive; one learns cells, nerves, bones, muscles, blood vessels, skin, etc. Physiology is the how the body functions. The function of the cells, nerves, bones, muscles, etc. Anatomy and Physiology have long been a part of massage curriculum; it is a basis for learning. When one locates the bones, finds the boney landmarks, and palpates the muscles, one is learning the anatomy of the structure and the location of the muscles. This should be, and for the most is, part of the training for any manual therapies.

Kinesiology is the study of muscles in motion. Not only does one study the location, attachments, actions, and innervations of the muscles, one also studies the principles and laws of motion, how bones act as levers, the angle of pull, balance, roles of muscles, proprioceptors, and how all this affects action. It includes the range of motion of a joint and how muscles can move actively, passively, and what happens with manual resistance and in stretch. With this knowledge, then the practitioner can evaluate the actions of the client, history, injuries, posture, and develop a treatment protocol that will be individually appropriate for that client. It is a course that can build on the foundation of Anatomy and Physiology. It is regularly studied and part of the curriculum for physical therapists and athletic trainers. It should be a part of each massage therapist’s training.

Orthopedic massage, developed by Whitney Lowe, takes the knowledge of kinesiology and asks the practitioner to apply four components: “orthopedic assessment, matching the physiology of the tissue injury with the physiological effects of treatment, treatment adaptability and rehabilitation protocol.”(see footnote below) This takes evaluation to another level using multiple modalities. It utilizes many aspects of kinesiology as a knowledge base.

In our professional field, we have long had problems defining ourselves, techniques, modalities, developing standards and generally agreeing on curriculum. This autonomy makes us unique in health professional fields, but also can be a determent to our development and integration. I have long felt that science is the foundation of your art. Kinesiology is a part or should be a part of that science.

Nancy W. Dail, BA, LMT, NCTMB has been a professional practicing massage therapist and a member of the AMTA since 1974. She is the founder and director of the Downeast School of Massage in Waldoboro, Maine (USA) (1980). A leader in her field, Nancy presents workshops internationally, is certified in Orthopedic and Sports Massage, and has developed the working philosophy of Dimensional Massage Therapy as lead author in Kinesiology for Manual Therapies published by McGraw-Hill. Her BA in Health, Arts, and Science from Goddard College helps her balance her administrative duties as Director with teaching Dimensional Massage, Advanced Skills, Kinesiology, Ethics and related subjects at DSM.

Quote above on the four components for orthopedic massage from: Orthopedic Massage Theory and Technique by Whitney Lowe Chapter 1 page 5. Elsevier Science, 2003.

A Labor of Love 2014

A Labor of Love
By Nancy Dail

Thirty-four years ago we started our school around our kitchen table. It was a labor of love to develop an art and science that has transformed into the residence of our 8,000 square foot building. As an independent massage school owner, we are now a minority. Now the market is shared with community colleges, trade and technical schools, beauty schools, and corporations with multiple campuses. Many independent schools have sold to the larger corporate businesses. Education and its venue have changed. Technology allows online courses to be the normal avenue to project information. Massage therapy classes have a practical component that has to be experienced in the class room. Technology can not replace the experience of touch – receiving and giving. Independent massage schools still provide that type of education.

In some ways the comfort zone of the kitchen table education is the experience of the independent school owner. One-on-one teaching is not unheard of and the individual is not a number but a name in the class room. Massage Therapy education is not just about the ability to provide services for the public. It is taking the sense of touch and developing an understanding of why we need to experience close human contact. It is about learning the benefits of touch and massage for each age group in almost any circumstance from birth to old age. It is about intent and realizing the potential for accelerating healing energies.

When I think about all the safe touch that our graduates have provided over the last 34 years, it warms my heart and continues to promote our mission here at the Downeast School of Massage: to train individuals in the art and science of therapeutic massage for and entry-level professional career, for continuing education and for personal growth. The personal growth part is not what adults usually sign up for. It comes irregardless of plans but as a part of the process of becoming a massage therapist and in-class-room course work.

Self-care is not part of the education of all health professional fields. As care givers, health professionals are often taught to expend their energies at the expense of self and not reserve stores to replenish healthy stock. This leads to unhealthy practices and eventual burnout in the form of depression, disease, or even injury. Massage therapy can not afford to not teach self-care as the therapist will otherwise not last in the profession. The independent school owner embraces this need as the focus of the school is about the student and his/her success.

The Downeast School of Massage starts its January classes the end of this month. It is not too late to enroll and become part of the rewarding career field of Massage Therapy. This career needs individuals to perpetuate growth and provide services to people of all ages. Massage Therapy is not an obscure profession anymore but an accepted part of health care. Our complete integration is upcoming and part of the near future. After being a massage therapist for 40 years I choose to be part of the future of this great career field and will continue to provide safe touch for my clients and touch education for my students. Join us in this adventure!

Nancy W. Dail, BA, LMT, NCTMB has been a professional practicing massage therapist and a member of the AMTA since 1974. She is the founder and director of the Downeast School of Massage in Waldoboro, Maine (USA) (1980). A leader in her field, Nancy presents workshops internationally, is certified in Orthopedic and Sports Massage, and has developed the working philosophy of Dimensional Massage Therapy as lead author in Kinesiology for Manual Therapies published by McGraw-Hill. Her BA in Health, Arts, and Science from Goddard College helps her balance her administrative duties as Director with teaching Dimensional Massage, Advanced Skills, Kinesiology, Ethics and related subjects at DSM.