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INTRODUCTION
Much has been written and scientifically validated about the beneficial effects of massage on almost every major body system. It is also a well-documented fact that massage is a powerful tool in reducing stress and its deleterious effects.
The stress and anxiety a pregnant woman experiences will definitely work against her. Blood catecholamine1 levels increase and interfere with the work of oxytocin and other labor-promoting hormones. There is also an adverse effect on the developing fetus. In other words, whatever the expectant mother feels is directly passed on to her growing child.
Enter the oldest healing art: massage. During pregnancy, massage can safely, comfortably, and effectively relieve stress, whether it is physical, emotional, and/or psychological in origin. With so many women returning to more holistic health choices and birthing practices, the use of massage to treat the discomforts of pregnancy is a natural response. Massage is a potent way to take charge of your own pregnancy, to reclaim your birthright. Every time you experience a positive response to the treatments in this book, your success empowers you with more control, security, and confidence for an easier birth outcome.
Mother Massage has been written to involve both expectant parents. Fathers now share birth preparation classes, attend the births, and are more aggressively pursuing paternity rights and privileges in the workplace. By using the easy massage techniques in this book, he can also participate during the nine-month process and help support and ease the discomforts of his partner's pregnancy.
Each technique is no longer than ten or fifteen minutes in duration and is clearly illustrated for easy reference. The treatments reduce the effects of many of the most common problems a pregnant woman might incur and can be used as often as necessary.
The intimate nature of touch has the additional advantage of bringing two people closer together. At a time when emotions and sensitivities are already heightened, massage enhances interpersonal communication even further. A deeper involvement develops for the provider as he helps his partner enjoy this most exciting experience.
Infant massage is included as a natural progression to the pregnancy. This special treatment helps both child and parent form a unique bond of love, trust, and nurturing. It also offers the father an opportunity to express his tender feelings, no longer considered an exclusive maternal right.
All attempts have been made to clarify when each partner is being addressed. Mother Massage speaks to the expectant mother about the development of her pregnancy and self-massage techniques. The expectant father is addressed during most of the massage techniques of Chapter 2 (Chapter 3 is for both partners equally), labor, and postpartum massages.
My expectant clients respond to their pregnancies with the most interesting reactions. Some of them are astounded how their bodies know just what to do. Others have to be reassured that pregnancy is not a permanent condition and that their figures will return. Most of them agree, however, about how strong, ready, and prepared they feel as a result of the massages.
Use Mother Massage throughout your pregnancy and postpartum weeks. The chapter on full body massage can be used at any time after the pregnancy and for either partner. So I hope you enjoy this book and reap the benefits of massage for a long time!
Elaine Stillerman
New York City, 1991
Chapter 1
The Massage Techniques
Women in tribal societies resume normal activities almost immediately after birthing. To get back into shape quickly, these women employ a number of natural techniques, including massage, abdominal binding, herbal treatments, diet, and steaming of the perineal region. All of these methods help the new mother to regain her strength, heal faster, and ease her way in subsequent births.
Massage is a sensuous, relaxing, and loving treatment that has the added bonus of being especially good for you. It is one form of "medicine" most people delight in taking! Massage is a wonderful way to reduce stress and promote general well-being.
While you are pregnant, your body is undergoing stress-producing changes. Massage pleasantly and effectively eliminates many of the adverse effects of stress and the accompanying discomforts. Let’s look briefly at some of the physiological changes that occur during a massage and see how they benefit your health and the health of your developing baby:
• Massage will help prepare you for an easier delivery. Self-massage to the perineum (the area between the vagina and anus) promotes flexibility and elasticity. It might actually help you avoid an episiotomy.
• Massage stimulates glandular secretions, stabilizing your hormonal levels and making their side effects less severe.
• Massage to the legs can control varicose veins, and the draining effect of massage facilitates reduction of edema (swelling) of the extremities.
• An increase in general circulation offers a rise of blood to all areas of your body, including the placenta. This brings greater nutrition to the tissues of the body and enhances waste product removal.
• "Lazy" red blood cells lining the vessel walls are reintroduced into circulation, thus increasing the red blood cell count. This is of particular importance to those women with anemia. A rise in the red blood cell count also helps to eliminate fatigue, since more oxygen-carrying hemoglobin is released into the bloodstream.
• The lymphatic system circulates faster and more efficiently. The result is more energy and less fatigue.
• The strain on the muscles of the lower back, abdomen, and shoulders can be greatly reduced through massage. As your pregnancy advances to its final trimester, this relief will be most welcome.
• Muscle tone can increase with regular massage. Muscle spasms and knots are easily released, and muscles, ligaments, tendons, and joints enjoy greater flexibility. This is most advantageous during labor.
• Massage sedates the nervous system, producing much-needed rest and relaxation. In utero, your baby feels the same way. Frazzled nerves are lovingly soothed, and insomnia can be relieved.
Massage accompanies childbirth nearly everywhere in the tribal world. Noted anthropologist George Englemann, who studied tribal customs, wrote in 1884, "There is hardly a people, ancient or modern, that do not in some way resort to massage and expression in labor, even if it be a natural and easy one."1 The elder women of the Nama Hottentot tribe of South Africa massage the expectant mothers several times a week in preparation for childbirth. Pregnant women of Uganda receive treatment to make their bones supple for an easy delivery. Women of Kiribati (formerly the Gilbert Islands) receive "shampoos" by expert massage practitioners to train their muscles to bear contractions.
The massage techniques you will be using are derived from Swedish massage, Shiatsu acupressure, and foot reflexology. Mother Massage also includes herbal remedies, nutritional information, and exercises and postures as part of its holistic scope of pregnancy health care.
The Swedish strokes are effleurage, petrissage, friction, tapotement, and the nerve stroke.
EFFLEURAGE
Effleurage is the stroke you will begin and end each treatment with. This long, gliding movement introduces the massage and prepares the muscles for deeper work. The movement is primarily responsible for the increase in circulation of blood and lymph. It can eliminate fatigue from the body by improving waste removal and increase nutrition to those tissues being treated. You can easily see how important this stroke is to help the expectant woman overcome fatigue. Effleurage is also one of the most pleasurable and sensuous strokes. In the illustrations, effleurage is indicated with short, straight arrows.
PETRISSAGE
Petrissage is popularly referred to as kneading. It applies to any movement that moves muscles over bones and consists of kneading, pressing rolling, and squeezing. Petrissage is responsible for the increase in size and strength of a muscle. For mother's massage, you will use it to increase the tone of weakened and strained muscles. Petrissage, or circular kneading, is indicated with curved arrows.
FRICTION
Friction is generally used in therapeutic treatments to relieve muscle spasms and tension. It is either a circular movement applied to a joint to help restore range of motion and flexibility of the joint, or transversely across the belly of a muscle. The latter application breaks down muscle spasms and is of great importance in the treatment of sciatica.
TAPOTEMENT
Tapotement is also called percussion, and you perform it as if you were playing a drum with hands or fingertips rapidly following each other. It is a stimulatory stroke that can promote muscular contraction, increase the blood supply to a particular area, and enhance nerve response.
NERVE STROKE
The nerve stroke is a very light, gentle fingertip glide down any part of the body. Its purpose is to signal the end of a massage sequence and to sedate all the nerve endings that have been stimulated.
ACUPRESSURE
Acupressure is the basis of the Shiatsu technique. Pressing into a specific point along the energy meridian (channel) will help break up energy blocks, reduce muscular adhesions, increase circulation to a particular area, and produce a relaxed sense of well-being.
FOOT REFLEXOLOGY
This ancient healing art is applied to the feet. Each part of the body has a corresponding point on the foot. Pressing these points offers relief from the discomforts of pregnancy and promotes more energy and better health.
HERBAL REMEDIES
The teas and herbs mentioned in this book are predominantly emmenagogues--that is, they relate to the female reproductive system. They are nontoxic. Many recipes, such as for red raspberry leaf tea, can be taken daily to help tone and strengthen your uterus. The dosage and frequency are given for each recipe. One word of caution: Herbs and other natural remedies should never be taken at the same time as conventional prescribed medications and should not be randomly self-administered without the knowledge of your health care provider or physician.
NUTRITION
Good nutrition during pregnancy is a matter of knowing how much to eat and exactly which foods you need to support yourself and your healthy baby. Some discomforts of pregnancy can be caused by nutritional deficiencies such as anemia; whenever possible, you will be guided to specific foods that may resolve those problems. Appendix II lists USRDA during pregnancy and lactation to help you plan adequate meals for yourself and your family.
EXERCISES AND POSTURES
Many of the problems that arise during pregnancy are due to muscle strain, weakness, and poor posture. The simple exercises are included to help you relieve these aches and complaints. Proper exercise will increase your energy, strengthen the muscles most strained during pregnancy and labor, stimulate circulation, increase flexibility in the joints, and control swelling in the extremities.
One of the best overall workouts is swimming. It places no stress on the joints and is an efficient aerobic exercise and toner. Walking or cycling are also wonderful activities that are safe for pregnant women. Weight training is becoming popular to give added muscle tone and strength in preparation for childbirth. Many exercise classes are specially designed for pregnant women. These classes are very beneficial in controlling weight gain and maintaining muscle tone.
Exercise also has the advantage of providing the pregnant woman with a sense of control over her ever-changing body, and it boosts her ofttimes fragile self-image.
Consult with your physician or health care provider before beginning any program of exercise.
CONTRAINDICATIONS OF MASSAGE
There are times during your pregnancy when you should not receive a massage. These contraindications are:
• when you have morning sickness, nausea, or vomiting
• with any vaginal bleeding or discharge
• when you have a fever
• when you notice a decrease in fetal movement over a twenty-four-hour period
• when you have diarrhea
• if you experience pain in the abdomen or anywhere else in your body
• if you notice excessive swelling in your arms or legs
• do not massage directly on top of a bruise or skin irritation; this includes direct massage to keloid scars, those thick, red, ropy scars that might have resulted from a previous C-section or other surgical procedure
• do not massage immediately after eating; wait at least two hours
• if your doctor or health care provider disapproves for any other medical reason
SUPPLIES
You don't need a lot of equipment to make the massage a pleasurable experience. However, you will need:
• a warm room free from drafts, breezes, and noise
• some sort of cushioning for the floor, such as a sleeping bag, mat, or blanket
• sheets to protect the cushion and the furniture when you will be massaged in a seated position
• extra towels
• extra pillows; one will be for the massage provider
• massage oil; vegetable oil is fine--remember to put the oil in a plastic bottle to avoid breakage
• moisturizing creams or lotions for the face if preferred over oil
• clean hands and short fingernails
• music and candlelight to enhance the mood
1. Catecholamines are compounds responsible for the "fight or flight" response to stress.
1. Judith Goldsmith, Childbirth Wisdom (New York: Congdon & Weed, 1984), p. 39.
