Pregnancy, Labor, Postpartum Bodywork

Comment

Comment by Rebecca Overson on March 8, 2010 at 2:21pm

OK, friends, thought you might like this addition to the ongoing discussion about positioning, specifically with bodyCushions.

I sent the following email to Body Support Systems, the manufacturers of the bodyCushion:
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To: sales@bodysupport.com
Sent: Tuesday, March 02, 2010 9:54 AM
Subject: for Tom Owens - re: pregnancy positioning

"Hello BodySupport People,

I would love to get in touch with Tom Owens and discuss pregnancy positioning with bodyCushions. There is a TON of debate out there about the safety of prone positioning even on bodyCushions and I would LOVE to get to the bottom of it. Research, information, etc. is what I am looking for, not a sales pitch. I have been using bodyCushions for 15 years now and I love them... but as a prenatal massage specialist I must get some factual information in my hands.

If you could put me in touch with him and/or pass along any information you have, I'd greatly appreciate it.

Thanks so much -

Rebecca de Azevedo Overson LMT
Salt Lake City, Utah"

--------------------------------------

This was the reply I received from Tom Owens:

"Rebecca - Thanks for your inquiry... honestly, the only research regarding pregnancy is that the bodyCushion has been "field-tested" for more than 23 years with only "blissful" reports... and, by the way, the bC is most often construed to be a positioner only for pregnancy. As you see, Kara will forward you a very compelling letter I received some time ago.
Thanks for your advocacy... I'm sure every one of your clients appreciates you.
Tom"
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In the email forwarded from Kara, Tom referenced the following that I felt to be helpful:

"Also, I'll email Belly Bliss (editor's note: That's the name of my company - Belly Bliss Prenatal Massage in Salt Lake City - which is going to have a new name but that's a whole different story...) regarding basic anatomical considerations, such as:
On the bC (bodyCushion)
the patient's torso is elevated, therefore the hips are flexed, much as they are when the patient is on hands and knees, therefore reducing any imposition on the uterine ligaments. (Much as she is when engaged in a hands and knees exercise to reduce pelvic and low-back pressure).
The uterus is hammocked, not hanging. Her body is supported on the bony landmarks of her frame.
The patient is not lying on her fetus as she is with the Prego Pillow and the EarthLite thing-a-ma-jig...Of course you don't have a pregnant woman face down... Duhh... unless the above positioning considerations are taken into account.
I love her name, "Belly Bliss"... all due to the bC, I'm sure. :)
Again, careful considerations are in order, such as, if the fetus is presenting laterally, the bC is not going to suffice... nothing will. Pay attention to the patient... any discomfort, place her on her side on the bC.
This is not rocket science... it's basic common sense.
Have a great day!
Tom"
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I have also attached the letter from one of their clients who is a prenatal massage practitioner. She makes a very good case for prone positioning on the bodyCushions.

Also, I am going to shoot a video - an informational video for my website - that discusses this very issue - as a means of educating my clients about positioning so they can make an informed choice. I will let you all know when that is done so that you can view it or share it with others in case you find that helpful.

Kara (an employee of Body Support Inc.) informed me that for awhile they were getting a lot of flack from people saying it was dangerous for prone positioning, so to err on the side of caution they stopped recommending it; but then they received feedback from people who have used the cushion successfully and now they just recommend that people use the cushions according to their skill, comfort, and knowledge level.

By the way, Kara said that their Positioning for Pregnancy DVD is now available on YouTube via www.bodysupport.com; it's in about four different parts. Anyone can view it for free.

I hope this helps!!!

Rebecca Overson
Salt Lake City, Utah

Pregnancy Letter.pdf

Comment by Elaine Stillerman, LMT on February 21, 2010 at 2:56pm

In response to Heather Maynard's query about the safety and efficacy of (heated) castor oil packs during pregnancy, please refer to Dr. William A. McGarey's book,The oil that heals: a physician's successes with castor oil treatments, (A.R.E. Press, 1993). This book chronicles research done at the A.R.E. Clinic (Virginia Beach, VA) following the readings of Edgar Cayce. C-a-r-e-f-u-l use of castor is indicated in certain conditions. Heather, I suggest you call the A.R.E. for the book and more information.

Elaine Stillerman, LMT. author of Prenatal massage: a textbook of pregnancy, labor, and postparum bodywork, ((Mosby, 2008).

Comment by Rebecca Overson on February 9, 2010 at 9:32am

Thanks everyone for your helpful input!

As I mentioned previously, I have used bodyCushions with all my clients from 1995 forward, pregnant or not. So it was natural for me to reach for them when I became pregnant - it was the only way I could get comfortable. When I was pregnant with my first, I went to a massage school locally, to the student clinic, and asked if they had bodyCushions. The guy at the front desk - a student - said, "Sorry, you can't lie face down on bodyCushions. It will increase the pressure in your uterus and slow circulation to the baby." He didn't know that I was a massage therapist who has TAUGHT prenatal massage. I said, "Really. Are you a woman? Have you ever been pregnant?" (I wasn't very nice, but come ON, I was pregnant, achy, and grouchy... and I REALLY wanted to relax!) I insisted I would be fine and they reluctantly used the cushions. It was so frustrating. I never went back.

I then found a lovely day spa and the therapist used bodyCushions right up to the end of my pregnancy. It was perfect. In fact, it was in that environment of beauty and comfort that I decided I wanted to birth in a relaxing and supportive environment, and that's part of the reason I chose a home birth. She was a wonderful therapist.

Then, during my second pregnancy, I had a membership at Massage Envy, and when I was 14 weeks along they told me I could not use bodyCushions and that I must have massage only in a sidelying position. I was only 14 weeks!! Not even showing! I asked them why and they said because of their insurance policy, that it's dangerous to the uterus. I said, "Listen guys. I have bursitis in my right shoulder and I can't lay on my side all that well." They insisted. I thought it was interesting that they would compromise an already compromised shoulder to save my 14 week uterus. :) At that point I couldn't help but say, "Seriously guys, I have been a massage therapist since 1995. I teach prenatal massage. BodyCushions are fine for prone positioning." but of course, it's policy, so they refused. I respect that, but I also felt like banging my head against the wall. I had a mediocre massage that felt like a lot of work to me.
I cancelled my membership.

I also had times where a therapist (not knowing I was a therapist) was really hesitant to do foot massage, which I badly needed. He said it would put me in labor. Hogwash. (If a foot massage puts women in labor, do you have any idea how much money I would be making, inducing labor naturally???Ha!) ;)

I've been told I can't have deep glute work, deep low back work... it's ridiculous the myths that are out there among therapists.

I still think it's really sad that most schools offer only a crash course/intro to pregnancy massage - enough to scare students out of ever doing it. Perpetuates a lot of myths.

So again, as a customer, I had really crappy experiences, and after my children were born and I began to focus exclusively on pregnant clientele, I took it upon myself to make sure that my CUSTOMERS are SATISFIED and don't have to encounter lots of stress and misinformation just to get a massage! :)
This is where I agree wholeheartedly with Elaine that the best measure is the client's comfort. Sadly, that's something therapists might overlook because they are scared of doing something wrong.

Like I said before, sidelying has somehow become the consensus that it is best, but from a customer's perspective, I would argue that it is not as relaxing and not as comfortable. Whenever I do administer massage in the sidelying position, I do it with the bodyCushions because it doesn't put pressure on the shoulder. I have never been confident with regular sidelying position on a table with pillows everywhere. I think there are better ways.

I'm opening a pregnancy massage center here in Salt Lake City - it's my effort to provide the resource that I had such a hard time finding during my pregnancies - and I also intend to mentor and train new LMTs who need that hands-on experience to have the confidence to work on expectant and new moms. This is an area I am very committed to and passionate about.

Anyway.....

Thanks everyone for your input in this dialogue. I look forward to more supportive conversations with this group and would love to continue to network with all of you who are advancing the field of prenatal, labor, and postpartum massage.

Comment by Florence Renault on February 8, 2010 at 4:38pm

Rebecca, I encourage you to continue the discussion. I respect you for going into such a controversial area and if there are any of us who already know it all then why are we here? The downside of these social networks is that the written word can so easily be misinterpreted. I felt that I was blasted in another group for a comment I made, as well, and it's too bad that we can't all express ourselves without fear of someone's nasty reply simply because they disagree. We are all here to learn from one another and support one another, aren't we? So, back to the cushion! I used it with pregnant women years ago and had the same experience, they were so grateful. We do need to educate our clients and be aware ourselves. However, I also believe that the client also has to be responsible in taking care of herself - in other words, as in any massage session, let us know if something doesn't feel right, whether it's positioning, pressure, temperature, etc. OK, I hope that comes across as I meant it!!! I currently have a client who just announced her pregnancy so I thank all of you for educating me as it's been awhile - the majority of my clients are retired. I do have Carole's book but I also was wondering about the cushion since I had such success with it years ago.

Comment by Cherie Dreier on February 8, 2010 at 2:08pm

Rebecca, I am in total agreement with you. The decision should be mutual between the client and the therapist and I always try to do what my client requests as long as we both feel that it is safe. I believe that as long as it is comfortable for the mother to be, and you educate the client properly, go ahead and use the Body Cushions in the prone position. I'm sure that you also explain to the client that at any time during the massage, if they become uncomfortable, you can adjust the position accordingly.

I am assuming that Jennifer has some information that is making her comment on not using the prone position, but I am not hearing any factual support in regards to her belief. Unfortunately, it just sounds to me as if she is almost yelling at you and the way she is expressing herself is argumentative with no factual reasons behind it. I mean no disrespect to anyone here, but that is how I am reading it and I am betting I am not the only one with that feeling. I have read some previous posts that she has written and it appears that is how she comes off with others as well. Maybe she isn't intending to come off that way, but unfortunately, that's what some of us are "hearing". I do not want to open this up for more argument, and if she chooses to respond to this with some biting words she certainly has the right to do so, however, I will not be caught up in the argument, I just wanted to show my support to you. You, your client and their doctor can determine what is best on a case by case basis.

For the record, I do not use the Body Cushion system, and for the most part, massage in the sidelying position, however, I would be open to using the system and changing my methods.

Comment by Elaine Stillerman, LMT on February 8, 2010 at 1:55pm

I used the body support systems for my pregnant and non-pregnant clientele for many years before I ever spoke with their President, Tom Owens. He offers my students discounts on his products and provides a set to be raffled off in each of my classes.

I am approached by many companies and individuals to represent their products and I am quite selective when it comes to taking class time to speak of a helpful product. But none of this changes the fact: this is a safe, effective, and wonderful product.

Comment by Rebecca Overson on February 8, 2010 at 1:51pm

Hey Jennifer, listen... I could be wrong here, but I can't help but get the feeling that you are being argumentative and antagonistic in this discussion, when I am really just trying to get some information among intelligent professionals. Like I said, I could be totally reading into that wrong, but you haven't contributed anything to this conversation except interrogation. I don't need to answer to you nor does anyone else.

If you have some information to contribute, please contribute it. This isn't about who is right or who is wrong. I am trying to get some clarity here and see if anyone else has had similar experiences.

If you or anyone else for that matter thinks prone positioning on bodyCushions is awful and dangerous, I really do want to know why! and where you get the information from. And, I'd love to talk about how you solve the problem of a pregnant client REALLY wanting to lie on their tummies safely and how you tell them that they can not. I'm not being sarcastic here. I would really love to know.

Or maybe I should delete this whole conversation if it's going to be a source of STRESS for me or anyone else. I ask that you be helpful and move this conversation forward, or kindly refrain from participating.

Comment by Rebecca Overson on February 8, 2010 at 1:19pm

Thank you, Elaine, this has been my reasoning exactly - the client's comfort. Isn't massage supposed to be... comfortable? Isn't that the very thing pregnant clients are craving? I really resented being told by well-meaning massage therapists, during my pregnancies, that I didn't know what was best for my body :D

And I agree entirely, that anything besides the bodyCushions are not effective.

Jennifer, as I said previously, I tell my clients that some people have a concern that there is a risk. I don't know that there is a risk. Based on my own experience, I don't feel there is a risk when using bodyCushions properly. And this is why I asked - because most of the information out there leaves out bodyCushions (or at least does not address them specifically.)

I obviously don't want to do any harm to my clients.

I also don't want to tell my clients something is dangerous when it's not. (For example, I can't tell you how many times I have to educate people on the fact that massaging the feet won't put you in labor... )

Nor do I want to tell them that they can't receive massage in a position that is most comfortable for them, just because it's somebody's opinion.

I think we have to use our best judgment, the available information, and the wisdom that comes from experience, to provide the best treatment for our clients.

Elaine, do you ever find it's necessary to use a second wedge under the pelvis and chest pieces (in other words, doubling up on those wedges), to lift them a big higher, to accommodate a bigger belly? Or do you at that point just do sidelying?

Comment by Elaine Stillerman, LMT on February 8, 2010 at 12:37pm

This question comes up from time to time and I am always compelled to answer. The only correct answer is dictated by the client's comfort. If she is safely positioned on the cushions, their unique design supports the uterine ligaments and the gravid uterus, while preventing increased intrauterine pressure. But this can only be said for the body cushions and no other prone positioning product.

OK, so that begs the question: what is the proper placement? The client's ASIS's must lay in the middle of the square foam shape of the pelvic piece and the angled wedges must have the thicker ends facing each other, each flush with the chest and pelvic piece. (I demonstrate this in the DVD of my textbook.)

Her breasts are placed in the chest/breast recess (the optimum cushion is the 5" breast protector that has no recess, but is a complete cut out.)

The people at Body Cushion Systems worked long and hard in developing this magnificent product and it is IDEAL for pregnancy during each trimester when used correctly.

I only wish I had created them!
Elaine Stillerman, LMT

Comment by Rebecca Overson on February 8, 2010 at 11:56am

Jennifer, let me answer your question with a question :)

Does anyone out there actually KNOW that properly-supported, prone positioning on bodyCushions will actually a)increase intra-uterine pressure and b) put clients at a greater risk for uterine ligament strain?

Everyone seems to have well-formed opinions, but I have yet to see anything other than hearsay. Just trying to get to the bottom of the arguments. As I mentioned, I am not aware of any research in this area - specific to bodyCushions - but I would love to know if anything exists.

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