Prenatal Massage and Pre-Treatment Evaluations
Massage Today. By Elaine Stillerman, LMT. Photo: Stephanie Berghaeuser. In addition to learning what to do to support your pregnant/postpartum clients and relieve their common discomforts, part of the prenatal professional training must include how to recognize when a massage should not be provided. And part of the dialogue that you have to establish with your clients is that when you feel a massage should be postponed until after they have been checked by their care providers, you mean it and stand behind your decision. It is not easy to tell a deserving client that her much-coveted massage is not going to happen, but if your pretreatment evaluations are positive, that is the only safe and responsible choice you can make.
But upon what standards or guidelines do you base your decision? The answer comes from understanding prenatal and postpartum anatomy and physiology. By the end of the pregnancy, most women have an increase of up to 40 percent more interstitial fluid. This excess fluid generally pools in her extremities, especially the legs and feet. In most cases, this “gravity” edema can be treated effectively with manual lymphatic drainage (MLD) and elevation of her legs. And although the swelling can be extensive due to poor posture, poor diet, excessive sodium in the foods she eats, standing a great deal during the day, weather conditions, and restrictive clothing to name a few contributing factors, it poses no health risk. Appropriate massage (MLD) will reduce the swelling by enhancing lymph absorption.