December 29, 2009

Preterm Labor and Massage

This was one request I had not run into before – a gentleman called to request I do a half-hour pregnancy massage for his wife, who was undergoing pre-term labor (33 weeks) contractions and was in the hospital.

I have been certified in pregnancy and post-partum massage for several years, but I must admit this request stumped me. In general, instructors tell therapists to steer clear of people having contractions and/or in the hospital. I told the gentleman about those guidelines, and he told me the doctor suggested a 30-minute pregnancy massage as both safe and helpful to his wife.

I empathize with the problem at hand – most likely stress and anxiety without organic dysfunction -- but I must say I decided to turn this down.I told the gentleman that I would not do the massage not because it could create a problem, but because I had no experience with this circumstance and was unsure. I suggested someone with more experience might have a different opinion.

One of the tipping points for me came after looking online at various massage and pregnancy sites for pregnant women and for therapists. About half the sites said go for it, and half said no way. I tried reaching my pregnancy massage instructor, a nationally known expert, to no avail. I assume with the holidays my instructor was on vacation or off teaching somewhere.

It seems to me that some therapists out there may have encountered experiences with pre-term labor massages and may have some advice for me on this subject. Is it safe for the pregnant person? Is it safe for the massage therapist? What are possible indications or contra-indications? Are there any studies?

These questions come up because I've found a wide divergence over the years between beliefs about pregnancy massage, practices and comfort levels amongst therapists.

An example: My pregnancy massage class was taught by a very well-respected instructor. It was attended by several massage therapists from the USA and European countries, as well as aestheticians practicing both skin care and massage.
During our class, the instructor talked about using pillows and body cushions, positioning for comfort, ground rules for communication, etc.

Then we got to the aromatherapy question. The folks trained in Europe were very concerned about using any essential oils, saying their training said that oils could create severe skin rashes. Lavender, our most common oil used for relaxation massages, was considered a powerful trigger for labor contractions and was absolutely banned from use in pregnant women.

Our instructor, who had performed thousands of pregnancy massages, said she has always used oil scented with lavender throughout the entire term and never had a problem with any client.

A rather awe-inspiring silence followed.

USA meets Europe isn't always a comfortable match. Our European therapists looked horrified and our USA folks were un-nerved. The massage lead for a spa broke the silence. If some folks were horrified, then some pregnant folks would be too, if they had been told aromatherapy could harm them or their baby. Best not to offer any aromatherapy in pregnancy massages at all, in order to practice defensively. Who would want a pregnant client to call back after a massage and claim they might be damaged by lavender scent?

Not a very scientific reason, but a practical one.

All this led to a much more fun discussion about foot reflex points and triggering contractions. Our Europe friends said the point on the little toe would help trigger contractions, so they should be avoided at all costs unless the woman was past due and trying to start contractions.

An expert reflexologist with USA/Chinese training in our class popped up with his two cents: The little toe point was more for pain relief than contractions, and was a great toe-hold for expectant fathers trying to help their spouses during labor.

To which our very experienced instructor added a little observation: If the little piggy point caused contractions, the line outside her office door would snake around the block with past-due women willing to try anything to get that baby out of there!

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