Pregnancy, Labor, Postpartum Bodywork

Comment

Comment by Rebecca Overson on February 8, 2010 at 10:50am

Hi Jennifer,

Great questions.

I'm not sure I can answer the "What in Carol's argument can you refute" question without re-creating her 2-page view on it - which I can do - just not at this very moment. I do know that she never specifically mentions bodyCushions, so I'm not sure if she is making reference to them.

Elaine Stillerman uses them - at least she talks about them in her book and demonstrates prone positioning on them, and I haven't been able to find anything that says NO, you should not use them after a certain point (unless other conditions are present, but for now, I'm just talking about normal, low risk pregnancies.)

I am of course influenced by my own positive experiences with the bodyCushion while pregnant, which was the ONLY way I could get low back relief.

However, with my clients...

Generally what I do is I show women the bodyCushions prior to their session.

(And to clarify, I only use bodyCushions. I don't think the PregoPillow is good (it appears to place all the pressure on the belly), I do not advocate tables with cutouts either.)

I show them how they work, how they are adjustable, and I also have multiple wedges (extenders) that I can use. (I have three sets of cushions, so I 'm not limited to only using the pieces that come with one set. I can use multiple "adjusters" - the wedges and rectangles - if need be.) I show them that it supports their skeleton, and that the pelvic piece supports their pelvis without pressure on the belly. I explain to them that some people have a concern that laying - even supported in this position - will increase intra-uterine pressure or create strain on the uterine ligaments. Generally they will know if something is wrong because they won't be comfortable. Physiologically or intuitively. (I also have the bodyCushion breast protector piece for postpartum women or for women whose breasts are very large or tender). I discuss with them the benefits of lying face down - that it feels more like a "real" massage - what they might be used to receiving while not pregnant, etc. That they can feel like their back is getting what it needs, and decompressing, etc. I talk about other "cons" of prone positioning, like stuffy sinuses, etc.

I also inform them that we can put them in a sidelying position, using the bodyCushions and additional pillows, and it is very, very comfortable. I tell them that the general consensus is that this is the "best" position for pregnant clients, but the downside is that it may not have the same flow that they are used to when receiving massage. (from a consumer perspective, it's the position I hear the most complaints about when women have gone elsewhere for prenatal massage.)

So the bottom line is, I do a very thorough job of explaining all the options, the risks and benefits of both, and I let them choose. I tell them that their safety and comfort are both very important and why, but the bottom line is that I let them choose.

Once I get them on the table, I check the positioning of the cushions. I tell them that they should not feel like they are laying on their baby, or that their belly is squished, or uncomfortable in any way at all. I slide my hand between the table and their belly to make sure it's in a good position - supported but not squished nor dangling. I add additional extenders if need be, to raise the pelvis and chest up higher if need be. I reiterate that they need to communicate to me if they are uncomfortable at all at any time - if they feel like they can't breathe, if they feel anxious, anything - and I can shift them.

The majority of the low back work that I do on them is from the side and I don't do any straight-down compression into the sacrum while in this position. Carol mentioned that prone positioning can be fine until you add pressure while doing low back work.

I have never had any complaints, and in fact, my clients love that they can feel so comfortable and supported face down. They look forward to it. They ask if they can take the cushions home!

I have shown the setup to my midwives, who think it is lovely. I asked them about increased intra-uterine pressure or ligament issues and they felt that it was only a problem with tables where the belly is dangling, unsupported, or when women are lying flat on their bellies, which is never comfortable in the first place.

I have clients that are doctors and nurses, who are expecting, and they love the setup and see no problem with it. Chiropractors love it too.

Now of course, I also have a thorough intake form. I get physician release forms for my clients with any risks. I am happy to communicate with their physician for any concerns. I require that my clients return their intake form by email at least 24 hours in advance of their session so that I have time to review it for any precautions. If they have any uterus/placenta issues that might be aggravated by prone positioning, I simply don't lay them prone.

I just believe that they should be able to make an educated choice for themselves. If given the choice while pregnant, I'd far more enjoy a prone massage than sidelying. I had a hip issue while pregnant with my 2nd and lying on my side, even while supported, caused great pain to my pubic symphysis. Situations like that make it even trickier to find good positioning during pregnancy. :)

So - again, I educate, I discuss the options, I trust them to make an informed choice, I let them choose, and I make it clear that they are responsible for their health and well-being.

Jennifer, does that answer your questions? Since the written word carries no tone of voice, I can't tell if you are simply asking or making a case against it.

With the information and experience I currently have, I don't believe that one way of positioning is better than the other, but I'm open to learning. They both have pros and cons, and, there is a lot of "fear" out there that I don't think is helpful, either. I trust women, I trust pregnancy, I trust birth.

I am open to any and all input. Hence the reason for starting the discussion in the first place. :)

Comment by Rebecca Overson on February 8, 2010 at 9:33am

Hello friends, I'm happy to be here. I have been an LMT in Utah since 1995. I have a prenatal/postpartum massage therapy practice, and I'm expanding March 1st to a larger facility where I can also teach birth education classes and so forth.

I am grateful to find this group and I look forward to conversing with you all. I think there is so much misinformation about pregnancy massage. I have great respect for Elaine Stillerman and Leslie Stager and other pioneers in this field, and I'm glad to see you are both here. :) (perhaps others - I haven't dug deep enough just yet - I am new to this board.)

Leslie, I loved your "Proceed With Caution" article in Sept/Oct 2009. Very good stuff, dispelling the myths that one can push a magic button and start labor :)

Now for my first question. Has there been any discussion already about client position, particularly prone positioning on bodyCushions?

I know that Carol Osborn-Sheets and Kate Jordan don't recommend it. Carol makes a compelling case against it in her book.

However, as a woman who has borne two children, and as an LMT for 14 years, I absolutely HATED being told by massage therapists (at facilities I visited while pregnant) that I could not lie face down whatsoever, even while supported on bodyCushions. Even while 14 weeks, 21 weeks, 32 weeks, whathaveyou. A sidelying massage is simply not relaxing for me, and many of my clients look forward to a little comfortable face-down time. Having used bodyCushions on ALL clients - pregnant or not - for 14 years - I personally loved using bodyCushions to relieve my back throughout both of my pregnancies, right up until the end.

I am unaware of any "research" in this arena. I totally understand the arguments against prone on bodyCushions, but I still maintain it can be done safely and properly without undue pressure on the breasts or abdomen, and while adequately supporting the uterus.

Can we discuss this?

Comment by Roger D. Werstler on January 20, 2010 at 7:17pm

Great question...I have connected with two hospitals giving their employees massages. I have met and massaged several pregnant employees in the maternity department. They loved my work and encouraged me to network with the maternity department as therapist. I'm trying currently to get into the education program for expectant parents. It has taken five years of efforts to get to this level. Suggestions on creating a better involvement with the moms-to-be?

Comment by Shelli Davis-Redford on January 19, 2010 at 8:18pm

Hi Kylie! How did you come about arranging such an affiliation or arrangment with the hospital? SOme advice would be greatly appreciated.

Comment by Kylie Steines on December 9, 2009 at 8:58am

I'm in Wisconsin, I'm nationally certified...is that what you were asking? I'm not there during the delivery, I'd be there all the time....with no breaks lol. I do also massage following a C-section too. The hospital loves having me there, it really boosts the patient satisfaction scores for them. The mom's also get a free 30 min. gift cert.to come back and see me in my outpatient setting once they are discharged. So they get a free massage while in the hospital and once their discharged. It's really a great program, there are so many women who have never had a massage and this is their chance to experience having one.

Comment by Kathleen on December 9, 2009 at 8:48am

Kylie, where are you located? What are the massage licensing laws like where you are? That sounds like a fantastic setup! I'm in PA, just outside of Philadelphia, and I'm pretty sure that any bodywork that's happening with pregnant women is outside of the hospital situation - unfortunately, there are maternity wards closing left and right around here, and the hospitals that do offer delivery like to get slicey with the knife.

Comment by Elaine Stillerman, LMT on December 9, 2009 at 8:33am

Just in time for the holidays, Elsevier Publishing is offering a 20% discount on all their massage and bodywork titles, including Prenatall massage: a textbook of pregnancy, labor, and postpartum bodywork (Mosby, 2008). Makes a terrific gift for prenatal practitioners. Go to the MotherMassage website (MotherMassage.Net) for details..
Elaine Stillerman, LMT

Comment by Kylie Steines on December 9, 2009 at 7:30am

The hospital and clinic are connected so my room is in on the clinic side of things, but I see the moms right in their hospital rooms. I got hired as a Certified Occupational Therapy Assistant, but they knew I was a massage therapist too when hiring me. They had wanted to start a massage program so I just fit right in. I didn't have to do any convincing, administration was in my favor already. I have done my own research on implementing it into the rest of the hospital, but haven't had the time lately to get that started yet.

Comment by Nicola Hogan on December 8, 2009 at 10:24pm

Wow Kylie, that is awesome that you have a room to work from in the hospital. I work as a Mobile pregnancy massage therapist, in Australia. How did you go about getting the room and permission to work from the hospital? I think it is a great idea and would love to see this integrated in my community.

Comment by Kylie Steines on December 8, 2009 at 10:02pm

I am a massage therapist/COTA who works in a hospital setting as well as a day spa. Right now I have a room to see outpatient's at the hospital and I massage moms after they've given birth in the OB. Just wondering if anyone else out there also does the same? It was really a rewarding place to be working. I love it!!!

• ‹ Previous
• 1
• …
• 4
• 5
• 6
• 7
• 8
• Next ›
• Page