In fact, one of the spa’s literature specifically defines prenatal massage as light to medium in pressure more like a traditional Swedish massage (and oh my gosh, check out the prices!! I did not make that 80minute one up!):

Pre-Natal
Performed on specially designed cushions and pillows,
this light to medium-pressure massage alleviates many
of the discomforts associated with pregnancy.
50 minutes – $155 or 80 minutes – $230

Others I spoke with verbally confirmed the same.

This is actually one of the issues I discuss with new clients as they come in for their first massage. It is very common for women to have received a prenatal massage elsewhere and have not received enough pressure.

Most pregnant women I talk to think this practice is pure insanity. In fact, they end up scheduling prenatal massages precisely because they want pressure on their aching backs and hips.

What is this all about? Well partly it’s that you pay more for deep tissue work in a spa. Spa management sees it as a measurable element they can put a price tag on. But mostly it stems from a sense of pregnant women as fragile and a need to use massage as pampering, relaxing time (which some would see as distinct from therapeutic elements).

Well, not to worry when you come visit us here at Equilibrio! We love deep tissue massage, we don’t think all pregnant women are fragile and we customize each massage for the amount of pressure you need; this might be lighter touch or it may be deeper, more sustained pressure. Our clients find this customized approach a deeply relaxing and nurturing experience.

Deep tissue bodywork is safe throughout your pregnancy. A knowledgeable therapist will work with you to find the correct pressure that will alleviate your discomforts!

Please feel free to call or email if you have specific questions about your individual situation. You deserve a fantastic massage!

Today’s NYTimes Science section:

For Parents on NICU, Trauma May Last.

A new study published in the Journal of Infant Behavior and Development by researchers at the Touch Research Institute found that massage therapy has significant impacts on depressed pregnant women and their babies.

It is estimated between 10 to 25% of pregnant women experience prenatal depression. This then becomes a risk factor for many complications, including prematurity, low birth weight and intensive care at birth. The baby may exhibit effects much later on as mental, motor and emotional delays.

Antidepressants are not the treatment of choice as they do cross the placenta and have been found to have adverse effects on the fetus.

In this study, researchers recruited pregnant women in early second trimester who were experiencing depression. These women’s partners were given instruction in massage and massaged the women twice a week at home for 12 weeks. The results were fantastic. Compared with the control group, the massage group experienced decreased depression and low back pain, fewer prenatal complications including a 75% lower prematurity rate and 80% lower incidence of low birthweight.

Interestingly, they found that depression and cortisol levels were still decreased in the massage group postpartum. Though the massage “ended” at week 32, the physiological effects lasted throughout the pregnancy and into postpartum. Newborns of the massage group also had lower cortisol levels than the control group.

Field T, Diego M, Hernandez-Reif M, Deeds O, Figueiredo B. “Pregnancy massage reduces prematurity, low birthweight and postpartum depression.” Infant Behav Dev. 2009 Jul 29.

One of the most phone calls I get from new clients is, “I am 8 weeks pregnant and nobody will massage me. Please tell me you can help me! My back is killing me.”

There are lots of rumors out there that massage is to be avoided during the first trimester. And the policies of some therapists and day spas actually restrict massage to second and third trimester, some stating that it is unsafe, others unwilling to work with the uncertainty of first trimester when their therapists have minimal pregnancy training and limited experience working with pregnant women.

What is important here is that these are “policies” not “facts.” These therapists and establishments have restricted massage to second and third trimester women based on potential liability issues in an extremely litigious society, not on the safety of massage.

Massage by a properly trained therapist is safe for you and your developing baby throughout your entire pregnancy; a trained therapist is going to talk to you about your pregnancy, make any necessary modifications and refer you back to your midwife or OB if anything is uncertain. For a woman who is at particular high risk for miscarrying and/or has experienced previous miscarriages, she may want to be careful about adding lots of new activities during that first trimester, including massage. Others may want to add the relaxation and stress relieving benefits of massage to their routines. If you are considering massage during first trimester and are concerned about its safety during your specific situation, please consult your doctor.

The case for first trimester massage.

In my practice, I actually encourage women to get bodywork done during their first trimester.

While few first trimester women have the classic low back and pelvic pain characteristic of later pregnancy (once that belly really starts to show), many do experience a range of discomforts for which massage can be helpful. One of the earlier signs that indicates to a woman that she is indeed pregnant is enlarged, tender breasts. The increased weight in her chest puts a greater strain on her thoracic spine, shoulders and neck, yielding upper back and neck pain, as well as headaches.  A trained therapist can help relieve that strain and educate women on how to integrate that change into her posture so as to minimize additional strain.

First trimester can also be an extremely emotional time as women contemplate major life changes (which can be joyous, scary and stressful all at the same time, or even unwanted) all while riding major hormone surges. Massage (and yoga, and any mindful body practice) support women as they integrate these changes into their lives, and help minimize the physical impact of stress on the body. For moms who already have kids at home, their massage may be the only substantive “me time” they regularly have during this pregnancy.

Modifying massage for first trimester women.

As a massage therapist, I need to make fewer accommodations for a first trimester mom than later in pregnancy. I do however take several things into account. Is she showing yet? If not, can she still go face down on the table? Is she physically and emotionally comfortable doing that? How tender are her breasts? Does she need support to prevent pressure on her breasts? Is she dealing with severe nausea? I would take all of these things (plus many other details) into consideration when setting up a massage for a first trimester woman.

In general, if you are nervous about getting a massage, always ask your midwife or doctor about any concerns they might have and talk to a trained specialist. And, whether you are nervous or not, if you are experiencing a high risk pregnancy or experiencing complications, always get clearance from your provider and find a trained specialist who knows how to modify your massage for your body and your pregnancy!

We have a limited number of copies of the book left in our office (signed by the author). $16 (sales tax included). Meanwhile you can check out Reny’s website and blog for new stories.

The uterus is anchored into the pelvis but a series of ligaments (unless your Victorian doctor has diagnosed you with the dreaded floating uterus of hysteria!). These ligaments undergo tremendous stretching and strain as the pregnant uterus grows in size and becomes heavier. There are three major sets of ligaments — the round ligaments which attach to the pubis, the broad ligaments which attach to the inside of the sides of the pelvis, and the sacrouterine ligament which connects the uterus to the anterior surface of the sacrum. These ligaments can cause all sorts of discomforts for pregnant women. The round ligament actually has some contractile tissue and can go into spasm. As the heavy uterus begins to spill forward out of the pelvic bowl, the broad and sacrouterine ligaments tug at the already loosening pelvic bones and refer all sorts of pain to the low back and back of the pelvis.

When a woman lies on her side, the uterus will shift with gravity toward the surface she is lying on. This can add further strain or stretch to some ligaments, which in turn can in turn pull on the bones of the pelvis and cause discomfort and pain. Many women find support relief by tucking pillows under the uterus. By propping their belly up with pillows, they are able to keep the center of the uterus more in line with the midline of the body and eliminate possible strain.

In my own work with pregnant women, many are often surprised at the difference made by a supportive belly pillow. It not only minimizes strain to the uterine and pelvic ligaments, but it helps keep your back and pelvic bones aligned and lets you sleep in a more neutral alignment.

Yes, belly propping makes sense. But a specialized pillow?

Believe it or not, but there’s this study…Yep. Those Australians. In this study, researchers tested the effect of using a specific wedge-shaped pillow compared with a standard hospital pillow, used to support the abdomen of a pregnant woman while lying on her side, in preventing or alleviating backache and backache-related insomnia. Women used the specialized belly pillow one week and a standard hospital pillow for the their belly for one week. The weeks they used the belly pillow they reported lower scores for backache and reported better sleep (though actual sleep scores didn’t corroborate this). Though some women felt both pillows were helpful, more felt that the specialized pillow was superior. I.L. Thomas’, J. Nicklinz, H. Pollock’ and K. Faulkner. “Evaluation of a Maternity Cushion (Ozzlo Pillow) for Backache and Insomnia in Late Pregnancy.” Ausl NZ J Obster Gynaecol. 1989; 29: 133

Many of the pregnancy body pillows that are out there are intended to tuck under the belly and offer similar support. For those of you for whom that doesn’t cut it or you are not interested in purchasing a big body pillow (or taking up that much room in bed), there are several wedge-shaped pillows on the market.

The Boppy. This wedge by Boppy is quite popular. I have heard mixed reviews on it from clients, but many women find it indispensable. Usually priced $15 to $20.

Leachco’s Best Rest.
This 2-piece pillow offers support under the belly with support of the back. Helps keep you from rolling over on to your back. I think the two pieces separate to offer more specific support. Usually priced around $30.

Babies R Us Wedge. I have heard rumor of a relatively cheap pregnancy wedge pillow available at Babies R Us. My clients repeatedly lament this purchase — it’s a vinal covered wedge-shaped piece of foam, but it’s quite firm and most women complain it is too hard.

Spinal Care Pregnancy Wedge. This is the pillow I use with my pregnant clients. It’s a simple foam, shaped into that “eggcrate” design to distribute weight and heat. $24.95

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