Pregnancy, Labor, Postpartum Bodywork

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Talk about issues related to work with clients in the perinatal cycle. Resources, concerns, unusual situations, contraindication myths.
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  • Roger D. Werstler

    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?

    Jan 20, 2010

  • Rebecca Overson

    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?

    Feb 8, 2010

  • Rebecca Overson

    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. :)

    Feb 8, 2010

  • Rebecca Overson

    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.

    Feb 8, 2010

  • Elaine Stillerman, LMT

    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

    Feb 8, 2010

  • Rebecca Overson

    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?

    Feb 8, 2010

  • Rebecca Overson

    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.

    Feb 8, 2010

  • Elaine Stillerman, LMT

    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.

    Feb 8, 2010

  • Cherie Dreier

    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.

    Feb 8, 2010

  • Florence Renault

    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.

    Feb 8, 2010

  • Rebecca Overson

    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.

    Feb 9, 2010

  • Elaine Stillerman, LMT

    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).

    Feb 21, 2010

  • Rebecca Overson

    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:
    --------------------------------------------
    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"
    ----------

    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"
    -----------
    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

    Mar 8, 2010

  • Elaine Stillerman, LMT

    And let us not overlook the belly supports recommended for late pregnancy by obs and midwives to help lift the belly.. (If only these women were taught how to use their transverse abdominis muscles correctly. But that's another discussion...). Women with abdominal pressure and backaches have been wearing abdominal slings and belts for relief, but these slings and supports are actually more restrictive than the body cushions since they work against gravity. Yet no one in this discussion has even brought them up or suggested that they increase intrauterine pressure. In fact, they don't either.

    When used correctly, the body cushions are safe. They decompress the exaggerated lordotic curve, support the uterine ligaments, enhance lymphatic drainage, reduce hemorrhoid discomfort, encourage the OP baby to turn to OA, reduce sciatica, etc. And clients love them!.

    Elaine Stillerman, LMT
    www.MotherMassage.Net

    Mar 8, 2010

  • Renee Rainbow

    Hi Rebecca and all,
    I am the lead therapist in the spa I work in and have been doing massage for 25 years. It has been a while since my pregnancy massage training. Do you have any suggestions for books or dvd's to help me organize a pregnancy massage class for the massage therapists at the spa?

    Apr 14, 2010

  • leslie stager

    HI Renee
    Check out Mastering Pregnancy Massage DVD, which is the most comprehensive (3 hours) instructional film on pregnancy massage available. No other DVD compares with that at this point... others are very very basic. This one is like taking a class.

    ALso, check out the films at MotherTouchFilms.com for instructional in labor techniques, and my book: Nurturing Massage for Pregnancy: A Practical Guide to Bodywork for the Perinatal Cycle. It is extremely comprehensive and focused specifically on what is iimportant for massage therapists to know during pregnancy, labor, and postpartum. Its filled with technique instruction, photos, and there are online video clips as well. Through the book, you can access online materials available for instructors with class guidelines and outlines for setting up your own classes. That might be very helpful for you. WHen you get the book, on the inside cover is a scratch-off code to help you gain access to the material online.

    Elaine Stillerman also has a textbook covering similar material. Prenatal Massage: A Textbook of Pregnancy, Labor, and Postpartum Bodywork. These two books are the only full texts and the best out there at this point focused on this topic.

    Apr 15, 2010

  • leslie stager

    Greetings fellow massage therapists.
    I am writing after spending 2.5 months in Uganda, working with an organization building a maternity clinic in a village, and also working in a functioning maternity center that does many births each month. The conditions of living and medical care in Uganda are challenging, and everyone will say that their life is made of struggling and suffering.
    Working in the clinic I found is that many many women are very open to receiving nurturing massage during their labors, as otherwise they get very little, if any, nurturing support during their labor (not to mention throughout the rest of their lives). WHen I would touch them during labor, they would beg me to not leave them alone again, and all those who were open to my caring, were able to respond later that it helped them so much to alleviate pain and fear.

    At this clinic, as in most in Uganda, if women can make it to a clinic from their villages (there is no transport for most, so they may have to walk many km to get there), they must bring with them supplies for birth, including a big plastic bag which serves as a sheet on the exam table where they give birth. That is the only covering for the table. THey must also bring gloves for the practitioners, and all blankets and care for the baby. This may all cost too much for many woman, and in addition to the difficulties of transport to the clinic, and the cost to get service at the clinic, many do not come, and maternal or infant deaths are not uncommon. They also must bring an attendant, as the hospital does not provide food, bed coverings, or other care besides straight medical care. The Attendant buys and cooks food for the patient, and helps with their needs.

    When I return to the STates, I will begin exploring whether there might be interest for a group of massage specialists to travel together to offer their services for some period of time in Uganda. Massage for the women in labor, as well as for those in the rest of the clinic is needed.IT is a great way to get experience doing massage for women in labor or work as a doula.

    There is definitely a need for doctors, nurses, and midwives there as well, but I think that massage therapists could be a great addition to the staffing of the whole clinic.. to offer massage to the staff, and to offer massage to all the patients, not just in maternity.

    These people have all been traumatized by years of war, and by HIV and the loss of whole families to the disease, and by poverty and a corrupt government. And yet they have a remarkable faith and beauty that carries them through the losses and tragedies. I found it incredibly sad, and incredibly inspiring.

    If anyone has interest in this type of volunteer work, for massage therapists and for other medical staffing, please get in touch with me!

    Apr 15, 2010

  • Rebecca Overson

    Renee,

    I second Leslie's suggestions - her DVD and Elaine's book are fantastic and I use them in training and mentoring therapists at my clinic. I also recommend taking a live class (there are several offered) somewhere near you.

    Leslie, I would love to consider going to Uganda. My husband lived in Uganda for four months, and several of my family members have done humanitarian service in Ghana in the last few years (teaching sign language at schools for the deaf). I'm sure anyone in my family would jump at the chance to create another excuse to head over to Africa... please email me: info@SLCPrenatalMassage.com

    Thanks everyone!

    Apr 15, 2010

  • Rebecca Overson

    Also Renee, I would definitely suggest that you have someone teach the class who is currently practicing and well-versed in pregnancy massage. In my experience, this is critical for being able to instill confidence in other therapists and prevent prenatal massage myths from being perpetuated.

    Apr 15, 2010

  • Renee Rainbow

    Leslie and Rebecca,
    Thanks so much for your suggestions. I will follow up and order those items.

    Apr 16, 2010

  • Desiree Zeller, LMT, BCTMB

    Hey ya'll. If you live near Virginia you may be interested in the Claire Marie Miller Fertility Massage Certification Seminar coming up in August. We need some more people to make it a go. Expand Your womens' bodywork practice!!!!! Google; Nurturing the Mother Seminars.

    Jul 16, 2010

  • Robert Jones

    I wish I lived closer and could attend. But, I have taken the Mercier Therapy training that works not only for fertility, but for other female pelvic health issues.

    Jul 16, 2010

  • Kyle Norman

    Hi all. Recently I had a question from a client. If there are places on the body that one should be careful around during pregnancy, are there spots or techniques that could help promote/facilitate conception? Any and all thoughts would be welcome. If anyone believes this should split to a separate discussion, feel free to do so.

    Jul 25, 2010

  • Darcy Neibaur

    I am getting ready to take Massage Envy's Pre-Natal CE class. That is next on my agenda.

    Jul 26, 2010

  • Darcy Neibaur

    Became certified August 27, 2010 in Pre-Natal Massage. WOO HOO!

    Sep 8, 2010

  • Darcy Neibaur

    Thank you Rick. I so enjoyed the show last night with massagenerd.

    Sep 9, 2010

  • Colleen Smith, L.M.P.

    I got asked today if I knew anything about massage for turning a breech baby-in preparation for birth. Anyone have any comments on this?

    Sep 14, 2010

  • Rebecca Overson

    Colleen, I get asked this all the time. External Manual Versions (manually turning a baby) are not in the scope of practice for most MTs, I believe, However, I have lots and lots of information to share with clients who want to try to encourage optimum fetal positioning, such as:

    website www.spinningbabies.com has lots of good info
    Acupressure - esp. BL67 (at the base of the pinky toe, outside corner)
    visualization and meditation
    emotional release work - lots of babies get "hung up" when their momma is "hung up" about something regarding birth, pregnancy, parenting, or, when momma is a survivor of sexual abuse.
    Acupuncture (find a good LAc in your area that can assist)
    Moxibustion
    The Webster Technique - a chiropractic tecnique for balancing uterine ligaments, which can sometimes play a part in breech presentation
    NUCCA Chiropractice - upper cervical chiropractic - this specific technique is AMAZING for many things and I often send my breech clients for NUCCA. (visit nucca.org)
    Also, some lifestyle factors can contribute to breech, such as mom's "day job" - does she sit at a desk and mostly reach to one side, for example. I had a client that was a tattoo artist, so she sat and leaned to one side all the time, and lo and behold, her baby was breech.
    See if you can find a DEM (Direct Entry Midwife - not a nurse midwife, but one that does home births) who is skilled in turning babies.
    And last but not least....Many hospitals have specialist OBs that will do External Manual Versions but there are definitely risks associated, possibly lots of pain for the momma.
    I personally am also an advocate for empowering women to have vaginal births even if their baby is breech. There is a lot of research out there now coming forward saying that C-sections may not be the best option for breech. Problem is, many docs don't know how to deliver breech or they just won't do it, and if a mom is super-committed to a vaginal breech delivery, she will likely have to find a home birth midwife who is skilled in breech deliveries. I've seen a bunch of breech births on YouTube, they are utterly fascinating. I really trust the body and I try to empower women to trust their bodies too.

    Feel free to email me privately if you need help with this. Happy to support you.

    Rebecca Overson, LMT
    Salt Lake Prenatal Massage
    info@SLCPrenatalMassage.com

    Sep 14, 2010

  • Darcy Neibaur

    I finally received my Pre-Natal Certificate in my in box today. Boy that took way too long.

    Sep 18, 2010

  • Emma Cooksey

    I'm trying to work out whether it's worth accepting insurance. Do any of the therapists on here accept insurance for pregnant clients and, if so, how are the doctors making out their prescriptions for bodywork? Are the usual aches and pains of pregnancy covered by health insurance or would it only be unusual things relating to accidents only?
    Many thanks!
    Emma
    www.emmacooksey.com

    Oct 3, 2010

  • Rebecca Overson

    Hi Emma, I don't accept insurance - all my clients are self-pay - I'm sorry I can't be of more help to you but I would love to hear what you discover or what you decide to do.
    The closest thing I can think of would be that a doc might refer to an MT for low back pain, sciatic pain, etc, much like they currently do except the referrals go to physical therapists, etc. which are much more integrated into the medical system.
    Let me know what you find :)

    Oct 3, 2010

  • Emma Cooksey

    That's funny you mention that because it was talking to a physical therapist that got me thinking about it in the first place! I've been doing the rounds of the OB/GYN offices and they seem to equate making a referral with writing a prescription for treatment. I'll explore it some more and let you know what I find.
    Thanks ;0)

    Oct 4, 2010

  • Florence Renault

    Mine are self-pay, also, but I have a couple of clients that request receipts and then they turn them in to their insurance. Some submit with something from their physician. I think it depends on the company and the policy.

    Oct 4, 2010

  • Ariana Vincent, LMT, MTI, BCTMB

    I'm delighted to be a new member of this group. I've been a therapist for 30 years and an instructor for 12 years. I love prenatal massage. I teach a class in prenatal massage through Ariana Institute. My mom was a pediatric intensive care nurse at Ft. Sam Houston for 37 years, so I grew up loving kids, just like she did. To get to know me better, please feel free to visit http://www.arianainstitute.com/online.htm and/or drop me a line. Ariana Vincent, Ariana Institute


    Dec 8, 2010

  • Carol Nicolich

    Emma, it will take a bit of work to be able to accept insurance, you need to contact the various insurance companies to see if they will accept you as a provider. Once that happens, you will have to be very exact while filling out forms (making sure every "i" is dotted and every "t" is crossed. It will take a few weeks for your first payment gets processed but once is gets rolling you will be fine. You will be billing your clients in increments of 15 minutes.

    I hope this is of some help.

    Dec 9, 2010

  • Sue Heldenbrand

    I would like to extend an invitation to list in my holistic wellness
    directory. The basic listing is free. The premium listing is $20/year
    which allows you more exposure, links,  and submission of articles.
    Looking forward to networking with you. The link is http://www.synergisticcenter.com/Directory-listing-form.html.
    I have a separate directory for massage therapists and also for energy workers.
    http://www.synergisticcenter.com/Directory_massage.html

    Dec 26, 2010

  • Kim Savoie

    Hey everyone

    I am in need of three more people to partake in a test pilot Pediatric Massage for Children with Special Needs course offering 20 CE's

    NCBTMB approved

    Touch-For-Life.Com for more inforamtion

    Thank you

    Feb 23, 2011

  • Jessica Rooks

    Kim i have a friend who is also a massage therapist and is really interested in your CE class if there is still places available.

     

    Feb 23, 2011

  • Rebecca Overson

    Regarding Kim's special needs class - not to be a bugaboo, but I was very interested and suggested that one of my staff members (LMT) purchase the course because she has a daughter with special needs and is very interested in this area and excited for more training.

    She was disappointed to find out that all she received was a pediatric massage book (that is also for sale on Amazon.com for $40) with one small chapter on special needs. Who needs to pay $200 for THAT? After expressing her disappointment, she asked for Kim (Touch-For-Life.com) for a refund but was denied. Pretty miffed. So think twice about what you are paying your $200+ for... just sayin.

    Mar 22, 2011

  • Rebecca Overson

    Hello friends, just wanted to post that I am hiring Maternity Massage Specialists. I own Salt Lake Prenatal Massage in Salt Lake City Utah (more births per capita than any state in the nation!) and am seeking LMTs who are passionate about pregnancy, birth, and motherhood to join our team. More info here: http://www.slcprenatalmassage.com/2012/04/salt-lake-prenatal-massag...  Thanks!

    May 21, 2012

  • Laura Garza

    Just took CEU training for pregnancy massage.  Just curious how many of you use pregnancy wedge and the client supine?  The class I took only demonstrated back in the side lying position but every other prenatal therapist I spoke with tell me they do everything side lying.

    May 17, 2013

  • Geoff Pritchard

    Laura - I only use pillows to accomplish everything I need with prenatal clients. My certification came through Claire Marie Miller and she does 80% side lying. Be sure to remember that every client is different and each trimester is different. So, what might be comfortable early in pregnancy doesn't work later. 

    I would suggest offering a few complimentary sessions to pregnant mothers and get their feedback. It's even better if you can find ones that have previously received prenatal sessions and have something to compare it against.

    I'm not on this site too often, so feel free to follow up with me on my business page - Charm City Massage. Hope this helps!

    May 17, 2013

  • Bethany Reed

    I am a pre-natal massage specialist in NH and formerly in IL.  What I tend to do is just use 2 regular pillows & 1 body pillow.  I fold over the bodypillow (so it looks like 2 pillows stacked on top of each other), then I put one regular pillow on top of that & the other pillow at an angle in front of it, then I cover everything with a sheet & dress the table like normal.  Doing this I am almost always able to work on a pregnant woman supine for the first part of the massage & get to arms & legs easily.  After that I pull the pillows out (using good communication with the client of course) & place a regular pillow under their head & have them flip on their side.  I then hand the body pillow to them under the top sheet for them to place between their knees & rest their arm & belly on.  After I get done with that side I have them flip to the other side.  It works really well.  But every woman is different.  During early term they can usually lay flat on their back & sometimes their stomach, it's just everyone's comfort level.  Communication will be your best technique :)

    May 17, 2013

  • leslie stager

    HI there! I'm a former labor and delivery nurse and developer/ instructor of 60-hour MotherTouch Maternity Massage certification program. Also author of the textbook Nurturing Massage for Pregnancy, published in 2008 by Lippincott. I"d like to add to the discussion a few considerations and a clarification.

    Supine positioning is generally considered to be lying on your back (on your Spine - supine). After 2nd trimester, no pregnant clients should be supine for long due to potential for compression on the vena cava/aorta. Not to pick beans, but sounds like you are referring to semi-reclining or semi-fowlers position! Sometimes called Semi-supine. Usually about 45 degree angle of support. This prevents compression on those big blood vessels. 


    Pillows: PErsonally, I love the bodysupport system body cushion for all clients, pregnant or not. It offers great support for sidelying preventing compression on the shoulder plexus, supports under the belly to prevent strain on uterine broad ligament, lengthens the lumbar curve in prone positioning, has recesses for breasts and bellies when in prone position, folds up to be supportive for semi-reclining, and opens the chest and shoulders in supine position.  The bolster is solid and I only need 1-2 flat pillows on top of that for sidelying leg support. It eliminates alot of pillow shuffling!


    However, I teach the use of pillows for students who do not have the body cushion. I work primarily in sidelying because it is awesome, comfortable, relaxing and gives great access to the whole body. I like it also for all clients pregnant or not!

    Sidelying:  1 pillow under head, keeping cervical spine straight. 1 wedge under larger belly. Usually 3 Flat pillows under the legs, to ensure that the knee and trochanter are aligned, so that lateral hip rotators are in neutral, 1 pillow under the arm to prevent breast compression (over the sheet, that helps secure the sheet draping. )This is all demonstrated in my Mastering Pregnancy Massage DVD--3 hours of detailed instruction!

    Lastly.. if you are on Linked In, there are a bunch of massage groups that have been having  some interesting discussions about pregnancy massage.

    May 17, 2013

  • Bethany Reed

    Thank you for the clarification, semi-supine is exactly what I was meaning.  In my head it just registers as supine, pregnancy style hehe.  I am assuming that when you refer to using 3 flat pillows you're meaning them to be pretty flat?  The one's I've got have some good life to them & if I used 3 of them her knee would be well above proper alignment.  Just for clarity. 

    May 18, 2013

  • leslie stager

    Yes.. What I find is that many students try to use puffy type pillows , with lots of loft. They end up falling off the table, or legs fall off because they are too bouncy.  WHen I say Flat, I mean ... well, like a dead pillow!.. the ones that are squished down and solid so that you can layer them, and they won't go anywhere!

    May 19, 2013

  • Laura Garza

    Hi!  I have a new client who is 20 weeks with myofascial pain syndrome.  She is looking to have trigger point therapy done.  I do both pre-natal and trp work but not together.  Any advice?  She uses a tennis ball daily and says she has been getting trigger points released.  My inclination is to only do light trigger point work.

    Jan 7, 2014

  • leslie stager

    HI Laura, There may be concern with deep work if someone has had multiple miscarriages and is still earlier than 20 weeks gestation or so. Has there been an association of deep or TP work with miscarriage? Not that I've ever found, however,  I do know of women who have wondered about it when they  miscarried after deep work. I suggest avoiding the concern by doing more supportive work and less intensive release work until past that time. (note, that does not mean don't do any deep work at all)

    Because the body is changing so much, and relaxin is in effect in all the ligaments, I would  avoid a Full Body approach with TP, deep tissue, or Structural Integration type work... Too much can simply be Too much during pregnancy when so much is being formed, integrated, and generated...too much can destabilize and have painful backlash.  Otherwise, not in high risk category, or beyond that high risk miscarriage time... I'd say go for it with focused TP work.!

    Jan 7, 2014

  • Gordon J. Wallis

    Hi Laura.  I do trigger point work on pregnant women.  You have to assess if the client is healthy or not so healthy. I mean if she has a history of miscarriages and or super unhealthy looking, maybe not. But she sounds fine because she is already using a tennis ball.  You can certainly work her upper back, neck, hips and legs.  No deep work  on the lower back or abdominal area maybe.  

    Jan 7, 2014

  • Heather Jones

    I am in the market for prenatal cushions for some of my clients.  At the prior spa I worked for they had in house the pregnancy pillow maternity cushion bolster set.  I am wondering if that is the best for all of my clients.  I noticed as the baby grew it was more difficult for my clients to find comfort in this system.  It was a great system for the new pregnant Mom's.  I see that Oakworks makes a cushion system for side lying and the lists continues from other companies.  What is everyone using now a days for pregnancy support cushions?  

    Aug 27, 2014