First trimester of pregnancy

[Logan R]

Hi all,
Looking for advice on massage during the first trimester of pregnancy. I have a regular client who I massaged yesterday and she told me she is pregnant. I am a mobile massage therapist and I was at her home and set up so I did do a massage but did not massage the lower back, abdomen and just did gentle efflurage on the feet. She is a healthy young woman and is not experiencing any complications but is stressed because the pregnancy wasn't planned and she is obviously going to have to make big adjustments to her life. I understand full body massage iscontraindicated in the first trimester but have never found anything that really goes into the reasons for this. I have done a searchon previous threads on this topic but still none the wiser. I am going to advise her that she no longer have full body massage but I wanted to be able to explain why, does anyone have a reference for this kind of info? I would also like to know if any type of massage is completely ruled out in first trimester, I was thinking that it would be safe to do a facial and face massage combined with massage of hands and arms, what do you think? Would be very grateful for your thoughts and advice.

Biggles

 

[Calinda]

Hi there!

We were always told that massage is contraindicated in the first 3months as this is the time that miscarriages may happen as its so early (same reason they recommend you wait 3months to tell people you're pregnant), and if the client did have a miscarriage and they had recently hada massage you wouldn't want them to think that the massage had a negative effect on the pregnancy. I'm unaware of actual research that massage at this time causes anything like this but I think is just a safer bet to not massage in the first 3months. We were also told that after 3months the doctors permission is required, and then just be aware of certain 'points' to miss on the client.

Cat

 

[anuja]

ahhh massage and contraindications... especially with pregnancy.[/align][/align]i would say that its always best to not do if you dont feel it right or your client doesnt feel it right.[/align][/align]with pregnancy... yes, in training you are told to avoid the first 3 months... i used to think the woman would explode or something! basically, the only contraindiaction and reason for this is litigation. should the pregnancy miscarry after you have done a massage, you will be the first person to "blame", even though your massage couldnt have possibly caused the miscarriage.[/align][/align]think about it... mother nature made pregnancies extremely resiliant... one of the reasons why mammals have survived for so long. its very very hard to dislodge a viable pregnancy. having said that, one should use caution with any unstable or history of unstable pregnancy.[/align][/align]its also a good idea to have done advanced courses so as to fully understand the A & P of pregnancy. [/align][/align]as the pregnancy progresses, it may not be possible to have client on the couch in conventional massage positions.. so think about that too.[/align][/align][/align]

 

[Alex Fouleau]

Thanks Cat and Rosie for your replies they make a lot of sense. That 1st three months is obviously whena woman is more likely to miscarry and yep I sure wouldn't like to be blamed for causing that to happen. I have massaged a client through the 2nd and 3rd trimesters of pregnancy and she found it really beneficial plus reckons it minimised the stretch marks. I will definately consider doing some additional training in this area too and have checked out the well woman website mentioned in previous threadswhich looks pretty good. You can actually get a free place by setting up a course in your own area so I may well see if anyone near me is interested in doing this type of training too. So if anyone in Brighton or surrounding areas happens to read this PM me about it.
Biggles

 

[ESS3NC3 0F 3V1L]

Biggles - I am with Rosie - pregnancy is not in itself a condition of illness - rather of extreme wellness - and hence is not generally of itself a contraindication for massage at any stage in the pregnancy.

However there is the blame and litigation side of massage that usually makes the first trimester (when most miscarriages occur) a 'proceed with caution'and most importantly 'if in any doubt - dont' period. Hereis my rough and not exclusive list of added cautions in the first (and some in all three) trimesters - basically anything outside the normal blooming pregnancy that might increase the miscarriage risk - please add the ones I missed:-

1. History of miscarriage
2. Multiple pregnancy (twins or more)
3. An IVF or infertility treatment pregnancy (this is a very precious baby)
4. Family history or genetic counseling for possible abnormality
5. Any kinds of medical investigation of thebaby (amnio etc)
6. Any abnormal symptoms - raised BP / diabetes / abdominal pain / bleeding/ PKUetc
7. any abnormal history in first prior pregnancies
7. Any sense from the client or therapist that this does not feel like a good idea

I would also add that if a client is used to an activity pre-pregnancy (eg massage, exercise, yoga etc) then continuing them in a 'normal' pregnancy is usually fine - but starting different activities in the first trimester is generally not a great idea as the body is not used to it - and that they may need to be scaled back / adapted. On the massage front I would adapt/reduce depth / intensity / speed of massage.

Having said that massage can be really wonderful anytime in pregnancy and helps mum adapt to her changing body in a way she may not have the chance to by any other means. Talk to your client and reach consensus based on assessment - but even if all you both feel comfortable with is face and hands then this can be fabulous relaxation and help reduce the stress (and also I believe the miscarriage rate???) often associated with pregnancy.

If this is an area you want to get into - or feel more comfortable with - then training is a great idea - aspretty much allschools teaching basic massage, rightly in my opinion, are in the 'just dont do it' rather than even the 'if in doubt dont' camp. Trainingmay also help with insurance - not sure what yours covers?

If anyone can point to research on massage in early pregnancy (risks or not)I would love to see it

Hope that helps

InTouch

 

[Clrtr01lae6w]

Hi InTouch,
Thanks for your advice. I agree pregnancy pregnancy is a state of wellness not illness. It'sa shame, thereseems to beso much stuff around about what women should and shouldn't do during their pregnancy that it kind of makes it quite an anxiety provoking time. I have decided to air on the side of caution and chatted to my client about it tonight and we agreed that she will get back in touch in the 2nd trimester which actually is only a few weeks away for her anway.
Best wishes
Biggles

 

[umaryzyg]

Hi Biggles[/align][/align]Well I must say this is a new one on me, aromatherapy massage is contraindicated in the first trimester because of the possible effects of some of the essential oils, but not come across massage itself as being a problem.[/align][/align]If someone is having difficulties with their pregnancy then they will tell you during the consultation and you would act on what they tell you, otherwise massage away [/align]

 

[Mr. NYC has a hangover]

Hi Paul,
Thanks for your comments. Yeah it seems a bit crazy doesn't it, but most courses and info I have come across say do not massage in the first trimester but without really going into the reasons why. Based on the comments and PMs I have received from this thread I gather that it is about avoiding possible litigation during the first three months when a woman is most likely to have a miscarriage. I guess this could have a knock on effect with insurance.If the training you have done, and therefore massage you are covered for says dont, would this then mean you are not covered by insurance? I think I am in danger of overthinking about it now![&:] My plan is to get some training in this area and find out more about it.

 

[aliceperez77]

Hi everyone,

A large percentage of my client base are pregnant ladies, and (as long as your insurance is valid) you can treat them from day 1!! It is really worth doinga specialist course however as there are techniques that are more suitable for different points in the pregnancy - the 4 day course ran by Wellmother(.org) is a great example.

In the first trimester, avoid the abdomen for anything but holding / energy work. Similarly as the body's hormones are changing do not work as deeply on any area as you would do on a non-pregnant lady - this is not to say you can't use strong techniques but all of the body's tissues are softer and more flexible and it will take a lot less to both release tension and cause pain!

Hope that helps!

Jules

 

[pruin1]

Hi Jules,
Thanks for your post it is very re-assuring. My client has recently re-contacted me now that she is in the second trimester and I am giving her weekly massage. I have looked up courses on pregnancy massage and will very likely do one when I can get some cash together to spend on training.
Best wishes
Biggles

 

[jivsksgj]

Your welcome! Feel free to drop me a line if you have any questions - and have fun, its so rewarding doing pregancy treatments!


Jules x

 

[ohqfowwa]

hello,
according to ITEC, pregnancy is contraindicated in the first trimester but only on the abdomen. this is because massage here may cause disruption to the developing foetus. i have not heard of full body massage being totally contraindicated before, indeed when i was training one of my tutors fell pregnant and asked me to give her a back massage with firm pressure when in the first trimester.
the reasons pregnancy are most often contraindiacted are the one i mentioned above, fluctuating blood pressure concerns, risk of miscarrriage (tho this may have more to do with the clients past reproductive history and difficulty in carrying pregnancy to term), and the ever present threat of litigation.
if anyone has different information, please post it. this is by no means definitive.
I often treat clients in all stages of pregnancy.
the best thing to do for your client and yourself and unborn baby is to get them to provide you with written consent from their GP that massage is safe.
good luck! massage is brilliant for women in pregnancy, get the all clear and go for it. mum and baby will love it.

 

[T Bryant]

if you are massaging pregnant ladies and have not done a special course for this and added it to your insurance, please look at your original course syllabus (as it keeps changing) your insurance will only cover you for what you were taught and as this subject could be litegious you dont want to leave yourself open.

I personally have a large number of Pregnant clients and they benefit greatly from massage but I am well covered on the insurance front thankfully.
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