Offering prenatal massage is a fantastic way to help pregnant clients sleep better, reduce their stress levels, and relieve headaches. During pregnancy, women often suffer from symptoms related to hormonal changes, not to mention aches and pains from weight gain and anxiety due to major life changes and the upcoming birth of their child. Although regular massage and prenatal massage have many of the same goals, there are some significant differences that the prenatal massage therapist needs to be aware of.
One of the key differences is the positioning of the client. It is absolutely crucial that you learn to position pregnant clients using bolsters and pillows to make sure they are comfortable throughout their massage. You should also know about the special needs of pregnant women during each trimester. Here are some of the key things you need to know about working with pregnant clients.
Prenatal Clients May Need a Lot of Reassurance About Safety
Pregnant clients are often concerned about whether or not massage is safe during pregnancy. There are a lot of myths out there about prenatal massage, and pregnant clients often need a lot of reassurance. The truth is, massage therapy is completely safe, even during the first trimester, as long as it’s administered by a properly trained and licensed prenatal massage therapist.
During prenatal massage training, you will learn about sensitive pressure points that could stimulate muscles in the uterus and pelvis. These pressure points are located in the ankles and wrists. It may be best to avoid these pressure points during early pregnancy, especially in women who have increased risk of miscarriage or preterm labor. As a properly trained prenatal massage therapist, you will learn how to keep your client safe and comfortable, so there is no need for your client to feel unsafe during their session.
Studies show that the benefits of prenatal massage are numerous and far outweigh any risk. Explain to your client that they can expect less back pain, reduced stress and anxiety levels, improved mood, and better sleep after a prenatal massage. Massage even boosts the levels of feel-good hormones, like dopamine and serotonin. In fact, some studies show that women who receive regular prenatal massage throughout pregnancy required less pain medication during labor and delivery and even have fewer cesarean sections.
Positioning Your Pregnant Clients
You will need to make some significant modifications to your client’s positioning as her pregnancy progresses. As a prenatal massage therapist, your primary goal is to make sure the client and baby are safe and comfortable throughout the massage. Generally, you will want to have your client switch to a side-lying position by the time she is 13 weeks along in her pregnancy to prevent undue stress on the uterus, pelvis, and lumbar regions.
When a pregnant woman lays face down, it can compress the spine and worsen any back pain the client is already feeling. In addition, the prone position puts pressure on the sacroiliac joints and sacrouterine ligaments. A pregnant woman’s breasts also become enlarged as she progresses through pregnancy and lying on her side will prevent discomfort due to pressure on her chest area. Congestion can also be an issue for some women during pregnancy and laying face down with their head in the cradle could increase pressure to the sinuses.
Lying face up in the supine position carries its own set of risks during pregnancy because it causes the enlarged uterus to put pressure on the inferior vena cava. When this area is compressed for too long, the client’s blood pressure could actually decrease enough to have a negative impact on blood flow to the baby. For these reasons, most midwives and doctors recommend that prenatal clients lay on their left side whenever possible to minimize risk to mom and baby. Although lying on either the left or right side is ok, laying on the left side puts less pressure on the heart, so it is the best position for oxygen and blood flow to the fetus.
Using Bolsters, Cushions, and Pillows to Keep Your Client Safe and Comfortable
Keeping the prenatal client’s head and spine in good alignment is essential for her safety and comfort. Pillows, cushions, and bolsters are the best way to achieve proper cervical alignment. A small pillow or wedge should be placed under the client’s belly to provide support for the uterus and keep the uterine and lumbar regions from being strained.
In addition, another pillow should be placed under the waist of your client to provide additional support for the hips and waist. A third pillow can be tucked under her upper arm to provide support for the breasts while preventing her torso from rotating and putting strain on the back. Finally, place another longer pillow between the ankles, knees, and hips to keep the horizontal plane level and slightly flex the hip and knee.
A Note About Pregnancy Massage Tables
There are special massage tables that you can purchase for use with your prenatal massage clients. They require the client to lay over a hole where the belly can hang down freely. There are mixed opinions about these tables, and many prenatal massage therapists actually prefer the side-lying position using pillows for support, as we explained above.
One of the main reasons many experienced therapists don’t like to use a pregnancy massage table is that they have limits to how much they can be adjusted so your client will be lying over a hole that may be the wrong size for their stage of pregnancy. Although there’s no pressure on the belly with a special pregnancy massage table, there could be added strain on the lumbar region, as well as the uterine and sacral ligaments.
If you were to press down on the client’s back during the massage, you would increase this effect, possibly causing the exact opposite effect of what your client needs. The added pressure of the massage and the weight of the body will actually compress the uterus and abdomen. Using an extra-wide massage table and the side-lying position, along with pillows for support, is probably the safer and more comfortable option for your client.
The chances are good that you will end up working with pregnant clients at some point in your career. Receiving advanced training in pregnancy massage will help you to be more confident with your prenatal clients, as well as keep them safer and more comfortable throughout their massage therapy session. It also shows that you take your career seriously and it may qualify you for additional job opportunities.