Over the last three decades, thousands of licensed massage therapists have trained to become maternity-massage therapy specialists, but nurturing touch during pregnancy, labor and the postpartum period isn’t a modern concept.
For many centuries, midwives have used their highly developed hands-on skills in supporting gestation and birth. Massage and movement during the childbearing experience was and continues to be a prominent part of many cultures’ maternity care.1 Most of the world’s more peaceful cultures use touch prominently during pregnancy and early childhood.2
When childbearing became increasingly medicalized over the last 150 or so years in Western countries, technology ascended over touch in caring for expectant and laboring women.3 In addition, prior to the 1980s, most massage therapy educators considered pregnancy a contraindicated condition for receiving massage. Around then, several pioneering massage and bodywork therapists, including me, became intrigued by its potential value to women and their families. Independently and collaboratively we explored, researched, and assembled contemporary foundations for the safe and effective practice of maternity-massage therapy.
Research Overview
This foundation includes a growing research basis for the inclusion of maternity-massage therapy as an adjunct to obstetrical and midwifery perinatal health care. In animal research, scientists have found lack of cutaneous stimulation had far-reaching effects. Pregnant rats restricted from licking their abdomens and teats had poorly developed placentas and 50 percent less mammary-gland development. Their litters were often ill, stillborn, or died shortly after birth, in part due to poor mothering skills.4
In contrast, human studies on women whose care included more touch enjoyed benefits for themselves, their infants and their families. Several small but promising studies compared massaged women with those who had an equal amount of relaxation therapy. The pregnant women, when massaged twice weekly for five weeks, experienced less anxiety and decreased leg and back pain. They reported better sleep and improved moods, and their labors had fewer complications, including less premature births.5 Depressed second trimester women had similar reductions in pain and complications when they received massage therapy rather than relaxation sessions or normal prenatal care.6 Many nursing studies show that, when women receive nurturing touch during later pregnancy, they touch their babies more frequently and lovingly.7
In other studies, when the touched half of 90 laboring women were contacted reassuringly for just 5 to 10 seconds whenever they expressed anxiety, their blood pressure and number of anxious expressions significantly decreased.8 Women whose partners massaged their head, back, hands, and feet for 20 minutes hourly of five hours of labor, had less pain and anxiety and improved mood.9 During labor, the presence of a doula, a woman providing physical and emotional support, including extensive touching and massage, may significantly reduce the length of labor and number of complications, interventions, medications, and Cesarean births.10 When massage therapists work with laboring women, they often report similar positive outcomes.
Education Overview
Look for a maternity-massage therapist with comprehensive maternity knowledge at the core of her/his practices. After a few prenatal or postpartum sessions, most therapists find their basic massage training insufficient to safely meet the complex physiological, musculoskeletal, and emotional concerns of the childbearing year.
Available perinatal continuing education training ranges from courses of several hours to modular programs totaling as many as 125 or 200 hours. Many employers require around 30 hours of maternity-massage therapy instruction. Most therapists find well-executed hands-on courses of this length to be appropriate learning experiences for their needs. Although online learning may be convenient, the obvious shortcoming of no hands-on oversight may make these courses less complete.
Effective curricula include: normal pre- and perinatal physiology and progression, high risk factors, and medical complications of pregnancy; research-based protocols for how to adapt massage therapy or eliminate various massage therapy techniques and methodologies, depending on the individual, her health issues, and trimester of pregnancy; how to effectively address common and specific prenatal, labor and postpartum needs; how to consult with physicians or midwives when conditions warrant.
Some courses include required evaluations for course completion and certification. (Note: there are no independent, non-commercial certifying agencies for maternity-massage therapists, and most states have no specified requirements to practice maternity-massage therapy.) Many therapists and their clients particularly appreciate an approach to maternity massage that is steeped in a deep trust for the normalcy and joy of pregnancy, along with a respect for its many challenges and possible medical risks.
Look for a therapist who was successful in a course developed by a respected expert in this specialization and taught by experienced, career instructors. Ask therapists you are considering booking with about the curricula, completion requirements, and learning strategies of the course they studied in. Some courses are more exploratory of one’s own childbirth experiences; others are more or less technical and clinical in their approach.
As one client recently said to me, “Now more than ever, I realize I should pay extra attention to whom I allow to work on my body. It’s evident that, even for a monthly massage, I want to know that that person is the best to touch my own body, not to mention to lay hand on my pregnant wife or ailing family member. I want a true therapist that has a real professional dedication and evolving continuing education as it applies to their field or particular specialties.”
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References
- Childbirth Wisdom. New York: Congdon and Weed. 1984.
- Prescott JW. 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. http://www.violence.de/prescott/politics-trust.pdf. Accessed 2/6/2009
- Cassidy T. Birth: The Surprising History of How We Are Born. New York: Atlantic Monthly Press, 2006.
- Rosendblatt J and Lehman D. Maternal behavior of the laboratory rat. Maternal Behavior in Mammals. Wiley, New York, 1963, p. 14.
- Field T, Hernandez-Reif S, Hart H, et al. Pregnant women benefit from massage therapy. J Psychosomatic Obstetrics and Gynecology, 20 (1), March, 1999, 31-8.
- Field T, Diego MA, Hernandez-Reif M, et al. Massage therapy effects on depressed pregnant women. Journal of Psychosometric Obstetrics and Gynecology 2004; 25:115–122.
- Rubin R. Maternal Touch. Nursing Outlook, 11/1963, p. 828-31.
- Sommer P. Obstetrical patients’ anxiety during transition of labor and the nursing intervention of touch [doctoral dissertation]. Texas Women’s University, Dallas, Texas, 1979.
- Field T, Hernandez-Reif M, Taylor S, et al. Labor pain is reduced by massage therapy. J Psychosom Obstet Gynecol 1997; 18:286-91.
- Klaus M, 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.
