2013 – Pregnancy Massage

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Nurturing the Changing Body By Erika Kruger. No patient illustrates the process of individualising a therapeutic massage treatment better than a pregnant woman. Whatever devices and techniques you so successfully used with a previous patient or even with the same patient on a previous occasion, the body you encounter this time, presents a brand new challenge. Pregnancy is a time of changes as the patient’s entire body adapts to accommodate the life growing inside and to prepare for the birth of the baby. It also implies changes in the mother’s personal and professional life. And change, however, exciting, can be stressful, leading to physical and emotional discomfort. What doesn’t change is the basic skills of therapeutic massage when treating a patient during pregnancy. The difference lies in the way the treatment is done to accommodate the different developmental stages of the pregnancy and in the way the patient experiences the treatment. It remains the responsibility of the health professional to learn as much as possible about the patient’s situation and her special needs. Therapeutic massage during pregnancy is often the woman’s first encounter with this therapy. It might be the first time that she has found time to nurture herself and the baby or often midwives and doctors refer mothers-to-be for therapeutic massage for relaxation and to relieve lower back pain and sciatica. MULTIPLE BENEFITS Research studies have shown there are multiple benefits of therapeutic massage during pregnancy. The obvious ones are relief of physical tension and discomfort in the weight-bearing joints, the back and the neck. Therapeutic massage loosens tight muscles, increases flexibility making it easier for the body to adjust to the additional weight, reduces excess fluid retention and prepare muscles for labour. A study conducted in 1999 by Tiffany Field and a team from the Touch Research Institute in Miami, USA, and published in the Journal of Psychosomatic Obstetrics and Gynaecology, indicated decreased anxiety and stress hormones during pregnancy. Therapeutic massage can also ease constipation and heartburn as a dominant parasympathetic state stimulates intestinal movement and it can slow the progress of varicose veins as it improves blood circulation. FIRST TRIMESTER Pregnancy is divided into three phases each characterised by distinctive emotional and physical changes. Although some schools of thought recommend avoiding massage during the first three months of pregnancy, therapeutic massage can be beneficial throughout pregnancy. Often woman only discover that they are pregnant when the foetus is already a few weeks old. During the first three months the woman’s body adjust to incredible hormonal changes, which are likely to cause mood swings. Many mothers-to-be complain of morning sickness or nausea, the result of the body’s physical adjustment to the growing baby and therapeutic massage...

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2013 – Pregnancy – A time of many changes

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Carolyn Hoffman shares her experience in the field of pregnancy massage. People always ask me how this came to be my initial area of special interest. I think it began when I was pregnant myself, and had weekly massages (for R10 per hour!). Not only did I find it very therapeutic, for the aches and pains associated with pregnancy, but also for a sense of being better connected with my body and the rapid changes it was undergoing. I am not saying that I had the conscious thought that one day I would like to do this myself. In fact, I had not even done my initial training as a massage therapist, yet, but I have no doubt that this very positive experience influenced my choice of a case study whilst I was doing my massage training in New Mexico, USA the following year. I had enjoyed studying pregnancy massage as one of our more specific types of massage, and it just happened that my teacher was pregnant when the time came to choose our case studies. The feedback I got from her was invaluable, and I decided, then, to do an advanced course after I graduated. This I did in Texas , in 1991. Having now massaged hundreds of pregnant women over the past 16 years, I still find this work very rewarding and challenging. Role of the massage therapist in pregnancy massage Therapeutic massage therapists need to remember that we are part of a larger support team, which may include a husband or partner, gynaecologist, midwife, and others. It is important to know who your patient is seeing and keep in touch with other health professionals so that an integrated approach can be used. Women often have all kinds of concerns ranging from their own health to their baby’s health. They worry about relationships finances and other things. It is our role to provide a caring, safe place, to listen with empathy and to refer on if appropriate. Especially at this vulnerable time we must be aware of not becoming our patients’ psychologists or social workers. I define the massage I do as a massage that alleviates the aches and pains associated with pregnancy. I focus on those muscle groups that take particular strain during pregnancy: the lower back, buttocks, upper back and neck. After 16 years in this field I am convinced that upper back and neck pain is reported as often as lower back – just as morning sickness often manifests later in the day, so too, the myth that lower back pain accounts for 90% of a pregnant woman’s discomfort. The shift in centre of gravity, and the increased size of the breasts causes...

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2013 – Massage in Africa: Midwives and massage – Integrating the art of touch and maternity care in Africa

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Still today, traditional healers and midwives skilfully integrate the ancient healing arts of massage and midwifery, as they have for thousands of years. By Erika Kruger Modern day midwife, Kara Maja Spencer, describes prenatal massage and compassionate touch during the childbearing year as more than a primitive practice or luxurious pampering; it is an essential and vital part of holistic maternity care 1. “Before Western medical practices displaced traditional midwifery, the touch and massage of a midwife or birth attendant was the central component of prenatal care around the world. In the absence of obstetrical tools and gadgets a midwife had her eyes, ears, and hands to diagnose and assist pregnant women. Honed by constant practice the midwife’s senses of observation and intuition through touch were finely tuned. Today, traditional healers and midwives skilfully integrate the ancient healing arts of massage and midwifery, as they have for thousands of years.2 THE ROLE OF MIDWIVES A qualitative investigation of traditional midwives in Botswana has profiled her as a woman who is socially and culturally integrated into the local community; represents a highly valuable source of information on cultural conceptions of crucial importance to childbearing Batswana women; demonstrates the value of a close personal relationship and communication with the delivering woman; realizes the limitations of her own capacity in birthing situations; and maintains close links with and makes referrals to the local hospital where indicated 3. The prototypical traditional midwife who was the focus of this study was a 48-year-old Batswana woman who had attended over 350 births since 1971. Among her roles were pregnancy diagnosis, assessment of nutritional intake, counselling regarding the side effects of pregnancy massage of the abdomen, delivery, assessment of the newborn, cord care and cultural rituals. After delivery the traditional midwife makes home visits to follow up on vulnerable populations and encourage use of family planning to space births. MASSAGE IN PREGNANCY Massage plays an important role in preparing Nigerian mothers for childbirth.  The traditional birth attendant (TBA) in , as in other parts of Africa , often does not have formal schooling and acquires her skill and knowledge from either a relation or friend by means of an informal apprenticeship 4. In contrast, the midwife has a formal, basic and professional education and can only practice independently after passing the prescribed national examination and being registered by the Nigerian Nursing and Midwifery Council. The midwife is responsible for the care of the woman during the antepartum, intrapartum and postpartum period. From the 3rd month of pregnancy onward the midwife will carry out regular abdominal massage and palpation. This technique is used to loosen the nerves and relax the muscles, facilitating an easy pregnancy and delivery as well...

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