Body Sense

www.massagetherapy.com—your resource for all things bodywork 11 MacInnis, CMT and owner of The Mommy Spa in Los Gatos, California, agrees. "Without proper training and certification," she says, "the result is often what I call expensive lotion application, and the lack of prenatal certification can be dangerous." According to MacInnis, working with a trained prenatal massage therapist is important for several reasons. First, she says, "Many spas offer pregnancy massage, but the therapists have not been trained in how to safely address the aches and pains associated with pregnancy. Secondly, "[The therapists] rarely work with a client in a side-lying position." And, third, "They may not have sufficient supports or techniques to safely address the pregnant client's needs." Most importantly, though, MacInnis says prenatal therapists are specifically trained to recognize any warning signs that might suggest a massage technique should not be used. WHAT TO EXPECT A proper prenatal massage appointment should include a detailed intake and health history form that alerts the therapist to any risk factors presenting with the pregnancy, or any issues that might call for special positioning on the massage table. In her own practice, MacInnis uses a clinical approach to pregnancy massage. "I feel communication with the client is very important," she says. "I ask the client about what they do with their body. Do they sit in front of a computer all day? Are they on their feet all day? Do they have a toddler at home that they are still carrying around?" Stress and fear can also manifest as discomfort in our physical body, and MacInnis says all of this information helps her know whether she needs to refer clients to other practitioners—as well as how to design a massage session that will best address their needs. During the massage, MacInnis asks her clients to let her know if they experience any discomfort or pain. "As a therapist," she says, "I can feel a tight muscle or connective tissue, but I cannot know what it feels like to the client. Pain does not always originate at the site, and this communication helps guide me to the cause and address it through massage or stretching—or even a change in behavior/posture." MacInnis says with pregnancy massage, clients get a full-body massage— just one side at a time. "Most prenatal massage is performed with the pregnant woman in the side-lying position and semi-reclined." Bolsters and pillows are often used to help clients find their most comfortable positioning. In MacInnis's practice, if the positioning of the baby does not allow the client to lie comfortably in a side-lying position, the client is then moved to a semi- reclined position (35– to 70–degree angle) with support under the knees. The frequency of pregnancy massage is determined on a case-by-case basis. Some women are miserable throughout the entire pregnancy, so they might want more frequent massages. Others might get a massage every 4–6 weeks at the beginning of pregnancy, and increase the frequency to once-a- week appointments toward the end. Athletes and women who work on their feet may set up weekly or biweekly appointments throughout the pregnancy. Massage Benefits by Trimester First Trimester • Relieve headaches • Help alleviate morning sickness • Reduce fatigue Second Trimester • Alleviate backaches • Relieve leg cramps Third Trimester • Reduce swelling/edema • Relieve pain from varicosities • Enhance sleep • Prepare pelvic muscles for birth process During the entire term of the pregnancy, massage can stimulate blood flow, which may assist in the prevention of anemia. It also helps alleviate leg cramps and muscle spasms. FINDING PRENATAL MASSAGE THERAPISTS There are several ways to find a certified prenatal massage therapist. Start with your massage therapist to see if they have this kind of training or know someone who does. Ask your obstetrician, midwife, doula, or prenatal yoga instructor for a referral. You can also go to massagetherapy.com to find therapists trained in this specialty. Lisa Bakewell is a full-time freelance writer, editor, perpetual learner, and lover of life in Chicagoland. Her areas of writing expertise span a multitude of topics that include health and wellness, travel, parenting, personal/company profiles, technology, and a plethora of "how-to" articles (her favorite!). She can be reached at lbakewell@att.net. Notes 1. Elaine Stillerman, Prenatal Massage: A Textbook of Pregnancy, Labor and Postpartum Bodywork (New York: Elsevier Health Sciences, 2007): 3–4. 2. Leslie, Stager, "Proceed with Caution: Foot/ Ankle Massage for Pregnant Clients," Massage & Bodywork (September/October 2009), accessed June 2019, www.abmp.com/textonlymags/ article.php?article=344. 3. WebMD, "Pregnancy Massage," accessed June 2019, www.webmd.com/baby/pregnancy-and- massage#1. 4. American Pregnancy Association, "Massage and Pregnancy—Prenatal Massage," accessed June 2019, www.americanpregnancy.org/pregnancy- health/prenatal-massage.

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