pregnant client

[ouektuxmiwziwzend]

Hi I haven't used this forum for a while ... it's all changed!!! Anyway I am looking for a bit of help please. I have been massaging now for a years but have only just come across my first pregnant client. I've been massaging her for over a year and now she is four months pregnant - she last came to me just before she knew she was pregnant. She's booked in in two weeks time and I am just wondering the best way of going about massaging her.

I'm okay about lying her on her side to do her back but what about the rest ... should I have her semi reclined when she is on her back? I presume I do shoulders as she is lying on her side. Any good pointers would be welcome. Thanks

 

[Mursal M]

Hi

You can work one side of the body whilst she is on one side and then the other side when she turns over

Have plenty of cushions cushioning her stomach, between her knees etc.

There are a couple of points which are a total no no in the shoulder area as they will cause spontaneous abortion/labour.

It might be worth maybe doing a pregnancy massage course if she is going to be a regular.

You also need to find out that she does not have symphasis pubis disease which means that you must not move her legs around especially opening them as this will cause great pain to your client.

I hope this helps

 

[Inferno Tomato]

"There are a couple of points which are a total no no in the shoulder area as they will cause spontaneous abortion/labour."

Where? Is this related to reflexology? Acupressure? Massage therapy? Please give more information.

 

[Linz]

Hm that is a new one "There are a couple of points which are a total no no in the shoulder area as they will cause spontaneous abortion/labour."

I am very surprised my pregnant patients haven't all had miscarriages over the years as they all get full body massages and that includes a very thorough neck/shoulder and back massage

 

[cnejiuexiwxixfeom]

So Paul how do you go about massaging them then? Do you just have them lying on their backs to do the shoulder/arms, legs etc and then move them on to their sides for the back?

I've never heard of not being able to touch a pregnant ladies shoulders - this doesn't even apply in reflexology where there are some points that you should leave out.

Thanks again

 

[Cyn]

Hi bexx

When they get too big to lay on their expanding fronts, it is easier to sit them on a chair backwards and get them to lean forward and rest their arms onto the treatment couch, you can also do it with them lying on their sides as has already been said, but you cant get the same amount of pressure on that way

 

[hello.]

when I did my japanese facial massage course it was based on meridians and there are a couple points along the shoulders not to work when the client is pregnant - one of which is the governing vessel mp for the reasons rahnee has already said

this is also covered in some indian head massage courses

 

[Wesley Johnsen]

Hi ya

There is a point on the top of both of the shoulders known as Gallbladder 21 (Look it up in any good acupressure/shiatsu book). Pressing really hard especially with your elbow can cause miscarriage, according to Chinese Medicine. GB21 helps the Chi (Qi) to descend.

Just in case, work the top of the shoulders softly.

Cheers

Dave

 

[Marnie]

Mmmm, me too!
I have a kneel and perch on seat (from a catalogue shop in their office chair section - supposed to be good for posture when you're on the computer - never liked it for that but it's come in handy for massaging ) and have clients sat on this resting forwards onto a pile of pillows on the table - to do their backs. Then get them to climb onto the couch - back rest elevated so they're not too flat + rolls under knees. I bend their leg up a little to massage the back of each leg whilst I'm doing the fronts. The rest of the massage is near enough the same as normal. Love doing tummies - still enjoy the thrill of being kicked by that new little person (and that's after examining 100s of tummies as a midwife).

 

[am k]

There is two things you can do, the first is use the chair for seated massage, the next, have the client sitting on a stool, leaning forwards onto a pillow, and have her/his lower half covered to keep warm.

 

[MARIE LOVES SCOTT]

Thanks for the replies ... I think I will start off with her sitting and leaning against the couch to do her back, shoulders, arms and maybe her face as in IHM and then ask her to get onto the couch to do her legs (bend them thanks Vetiveria) and then onto her sides for the back. Thanks ever so much most helpful

 

[Yacajoo]

I think it is extremely difficult to stimulate an acupuncture point using massage unless you really get stuck into it with your elbow (as Reiki Pixie says), and you've got to be REALLY good to get a point with an elbow. (the other big no-no acupuncture point is on the outside of the nail of the little toe, but that doesn't get mentioned often). There are 21 forbidden points of pregnancy for acupunture (google that, lots of info) I was taught stimulating the triple heater on the head was a no no during pregnancy, but people are busily doing IHM on pregnant clients and working their shoulders.

Having said that, most pregnancy massage textbooks say keep away from GB21, and the reflexology uterine point. I err on the side of caution with contraindications for pregnancy massage - you never know when someone will be a bit legal trigger happy, or have someone close to them that is legal trigger happy. I won't take on a new client in the first trimester for that reason - existing clients I will continue to work on, I just say no big changes in the first trimester, so if they usually have a massage, massage is OK, if they don't they can wait until 2nd trimester. I may not agree with the text books, BUT that is what would be used in a court of law, so I follow the recommendations in the text books. Until there are more textbooks that say poppycock! to the usually recommendations in the pregnancy massage textbooks, I will follow the average pregnancy massage textbooks, no uterine reflexology, no GB21.

It's all another example of why training is important.

And put a wedge under the right hip when reclining, even if the knees are up, to aleviate presure on the vena calva

 

[Sk8rgirl]

So has anyone got any hard evidence to these so called contraindications, or is just like Reiki and broken bones and pacemakers etc.

There is a growing case for not treating people with all sorts of conditions and in all sorts of instances, however there is very little hard evidence to back up most of the so called contraindications.

There was a time when therapists were taught the possible pitfalls of this or that treatment applied in certain circumstances, they were expected to use caution and common sense to apply them at their discretion which IMO is the way it should be. One patient might not receive a particular treatment but the next one in the same circumstances will quite rightly receive it.

I personally feel we therapists need to be careful with this, for if the insurance companies take on board these cautionary contraindications as absolute contraindications then we will not be able to treat people for all sorts of things that we successfully treat them for now.

A normal healthy pregnancy is not a disease or illness and as far as massage is concerned has no contraindications. Massage is the natural choice for most people undergoing pregnancy to help them come to terms with the many changes that are taking place in their bodies, all that is required is a little common sense when applying the various techniques we use.

 

[aztec]

Well said Paul!

This thread seems to be "talking in tongues" by which I mean that what started as a massage question has spawned reiki, reflexology etc. responses. These may be entirely appropriate and indeed necessary in response to a question from someone performing those therapies, however, our colleague here, is (I assume) providing a massage service.

Interesting thoughts nevertheless.


Simon

 

[izetxuvpitfidlema]

Whic brings me nicely onto my thought about these acupressure/reflexology points.
IF something goes tragically wrong, and IF you end up in court. then what an expert in the field, let alone an expert in different fields thinks is irrelevant. What matters is what a panel of your peers (ie, typical, average massage therapists) thinks is appropriate. I wouldn't expect a massage therapist to even know about reflexology or acupressure points; nor would a court. If it becomes the norm to include these things as your responsibility to know, then it'll cause major upsets, and will certainly need to be taught as a matter of course, and then delayed until anyone practicing before that decision was made, had retired.

PS, you've got to be going some, AND exptremely unlucky to stimulate those points by accident adn without specifically targetting them.

 

[Blackheart62310]

My website gets at least one hit a day from a google search long the lines of 'foot massage while pregnant', that is at least 365 people per year click on my little website to find the answer to that question, which means a lot more people than that search for something along those lines. I get at least one email a month from someone saying 'I had a massage, I am pregnant, will my baby be ok?' People are searching along those lines because it has filtered out into the general public that foot massage during pregnancy is a concern, I'm not making them type in the search phrase, they are doing it of their own accord. They are not peers, they are the general public. (very different legal system if a panel of your peers is all you have to worry about, I was under the impression that expert witnesses that support the plaintifs case get called in) If the general public is so concerned about foot massage during pregnancy, imagine what a field day an expert witness would have with all the text books like Mother Massage by Elaine Stillerman, Pre- and Perinatal Massage Therapy by Carole Osborne-Sheets and Massage During Pregnancy by Bette Waters all mentioning keep away from reflexology uterus point during massage and various combinations of acupuncture points! SP6 gets mentioned more than GB21. These are MASSAGE text books, not reflexology , acupressure or acupuncture books. I don't think massaging the reflexology uterine point or GB21 or SP6 will cause a miscarriage, if it did there would be no unwanted pregnancies, everyone would know 'just push this spot for 10 seconds and you won't be pregnant', but while the general public think that pregnancy massage can be a risk, and textbooks give very clear indications about what should not be massaged during pregnancy massage, I will work on the conservative side of what can be done during pregnancy massage. Courts don't look favourably on 'I didn't know' as an excuse.

If you're not worried about the possible legal ramifications of a miscarriage being blamed on a massage therapist (after all she was smoking, binge drinking, spending time in a sauna, had an underactive thyroid, high stress levels, all possible miscarriage contributors) there is no need to worry about the standard recommendations. But when someone looks for blame they look for the first possibility of what was done to them, not what they did to themselves, to blame when something goes wrong. That massage could be it. If legal action was taken it may get thrown out, but it's incredibly stressful while it looms over your head.

They change first aid training pretty regularly according to the latest research of what should and should not be done, they don't wait until everyone has retired before changing it.

 

[Genesis A]

Hi ya all

Cola is right about SP6 over GB21, and not forgetting LI4. But where is the evidence? It comes from thousands of years of observation. But would that hold in a court of law? Unless you really "dug in hard" with your thumbs into these points and prehaps ankle area foot reflexes, would it really cause uterine contractions? Why use such pressures in the first first place?

I will treat personally most people with most ailments, because of experience and commonsense. Contraindications are debatable. Each case is so different and I know so many therapists who treatment contraindication lists as gospel. If you take it too far you would never treat anyone. From a teaching point of view, contraindication lists are useful to allow the student to reflective upon their actions and to be safe.

I agree pregnancy is natural and not a medical problem, unless there is a medical problem.

If I treat a pregnant lady, I'm always cautious, but not too fluffy bunny about it. If complementary and alternative medicine is going to be taken serious it has it be effective, otherwise its fluffy relaxation or pampering (which of course has its place).

While I typing, I like to use Thai Yoga Massage in the side position on a comfortable futon mat for a pregnant clients.

Best Wishes

Reiki Pixie