{"id":692,"date":"2018-04-05T09:00:32","date_gmt":"2018-04-04T23:00:32","guid":{"rendered":"http:\/\/blog.amt.org.au\/?p=692"},"modified":"2018-04-04T10:58:45","modified_gmt":"2018-04-04T00:58:45","slug":"10-pregnancy-massage-mythconceptions","status":"publish","type":"post","link":"https:\/\/blog.amt.org.au\/index.php\/2018\/04\/05\/10-pregnancy-massage-mythconceptions\/","title":{"rendered":"10 Pregnancy Massage Mythconceptions"},"content":{"rendered":"

By Sharon Livingstone<\/h4>\n

\u201cSometimes massage therapists, when confronted with the lack of evidence to support this idea, will respond, “Well, I’ll avoid it just to be careful.” One should always err on the side of caution when in doubt, but that does not mean we have to be governed by false fears. By erroneously thinking they need to avoid the feet and ankles “just in case\u201d, massage therapists perpetuate this misconception.\u201d<\/em><\/p>\n

Alice Sanvito, Massage Therapist, Massage St Louis<\/em><\/p>\n<\/blockquote>\n

Did you know that 64% of people who received massage and other CAM treatments prior to<\/u> pregnancy continued to have treatment during<\/u>\u00a0pregnancy?(1)<\/p>\n

When a pregnant person books in to have a massage, they actually want a massage. No pregnant person wants to be refused treatment based on misinformation, false information and unsubstantiated myths.<\/p>\n

So Where Do The Myths Come From?<\/strong><\/h6>\n

Pregnancy massage myths aren\u2019t only spread by massage therapists. They\u2019re prevalent in massage schools, beauty schools, online forums for pregnant people, and even trip up many GPs.<\/p>\n

Leslie Stager, author of Nurturing Massage for Pregnancy<\/a>, wrote an article for ABMP about pregnancy massage misinformation<\/a> which discusses where the myths originated. Stager discovered that during the 1900s, when midwives and home birthing were being replaced by a medical model of care, \u201cPregnancy was identified as a dangerous and fragile condition with many forms of activity viewed as potential adversaries to a healthy outcome<\/em>\u201d.<\/p>\n

Although there was a shift back to the home-style and less intimidating birthing methods during the 1970s and 80s, for some unknown reason massage therapists remained in the \u201cpregnancy is a dangerous and fragile condition\u201d camp. We were still being taught that the slightest touch would damage a pregnant person and\/or their baby.<\/p>\n

During the 1990s, evidence of the benefits of prenatal massage was growing. According to Stager:<\/p>\n

\u201cResearch indicated that massage could help decrease stress and the production of catecholamines (stress-related hormones), improve hormonal functions, speed labor, reduce pain from contractions, and increase the frequency and ease with which a mother touched her new infant, benefits known to traditional birth attendants long ago.\u201d<\/em><\/p><\/blockquote>\n

The Myths of Pregnancy Massage<\/strong><\/h6>\n

1. Massage causes miscarriage<\/u><\/strong><\/p>\n

This myth underlies most of the other pregnancy massage myths and ignores commonsense. Miscarriage has many causes but massage is not<\/strong> one of them.<\/p>\n

Medline Plus lists causes and prevention of miscarriage<\/a> on their website. Massage is not listed.<\/p>\n

In her article on Clearing Up Misconceptions About Pregnancy and Massage<\/a>, Alice Sanvito from Massage St Louis wrote:<\/p>\n

For most miscarriages, the cause is unknown, but some known causes are chromosomal defects, failure of the fertilized egg to implant properly, maternal age, or excessive use of drugs or alcohol. Moderate exercise, sex, and working outside of the home do not cause miscarriage. If normal activity is not sufficient to cause miscarriage, there is no reason to believe that a relaxing massage would in any way cause it, either.<\/em><\/p><\/blockquote>\n

There is no evidence<\/u> to suggest that massage causes miscarriage.<\/p>\n

Miscarriage has its own set of myths. The \u201cFurther Reading\u201d section at the bottom of this article includes some useful information on miscarriage.<\/p>\n

One of the most common reasons I’ve heard from Massage Therapists for not treating pregnant people is a fear of litigation.\u00a0If miscarriage occurs after a pregnant person receives massage, there appears to be a belief that the Massage Therapist will be sued. Stager failed to find any evidence of a successful lawsuit. Equally, I found no information on a massage therapist being sued (successfully or unsuccessfully) for causing a miscarriage.<\/p>\n

2. Massage is contraindicated in the first trimester<\/u><\/strong><\/p>\n

This myth seems to arise out of the first myth and may be connected to the fact that miscarriage most commonly (in 80% of miscarriages) occurs within the first trimester.(2)<\/p>\n

Most massage therapists have probably massaged a pregnant person in their first trimester without realising it because the client may not have known they were pregnant.<\/p>\n

There is no research-based or clinical reason for not touching a pregnant person during the first trimester.<\/p>\n

3. Don’t massage during entire pregnancy<\/u><\/strong><\/p>\n

This myth is generally grown from fear and may derive from the outdated belief that pregnancy turns a pregnant person into something fragile, where even the slightest touch will cause unknown but horrific outcomes.<\/p>\n

Unless a known contraindication is present, such as those listed under “Contraindications for massage during pregnancy” below, there is no evidence to support avoiding treatment.<\/p>\n

4. Don’t massage over the abdomen<\/u><\/strong><\/p>\n

\"\"

Does this look like a dangerous and not recommended activity?<\/p><\/div>\n

If it\u2019s OK for the pregnant person (or their partner) to rub a pregnant abdomen, then why not a massage therapist? Bub may kick back if it doesn\u2019t like it (or if it does).<\/p>\n

The history of pregnancy is happily littered with supportive partners providing a nice abdomen rub, without the impediment of knowing about all those massage myths.<\/p>\n

Commonsense test: Ask a pregnant person with kids how often their kids kick, hit, sit on or cuddle that pregnant belly.<\/p>\n

5. Don’t massage over the lumbar region<\/u><\/strong><\/p>\n

This myth is sometimes restricted to the first trimester, most likely due to the unproven link to miscarriage. Please refer to \u201cmassage does not cause miscarriage\u201d above.<\/p>\n

Commonsense test: A pregnant person with low back pain will rub their own back with no fear of harming their baby, so why would a qualified Massage Therapist cause harm?<\/p>\n

6. You must have specific pregnancy massage qualifications to treat pregnant people<\/u><\/strong><\/p>\n

Massage Therapists are trained to treat clients with a variety of presentations. They don\u2019t undertake specialist training before treating a client who has fibromyalgia or Crohn\u2019s Disease or Multiple Sclerosis or who is recovering from surgery. Massage Therapists can obviously undertake further study on treating pregnant people, particularly if they would like to specialise in this area, but it is not mandatory<\/u> or a prerequisite for performing massage on a pregnant person.<\/p>\n

7. You must have clearance from the treating medical practitioner before treating pregnant people<\/u><\/strong><\/p>\n

The GP, OB\/GYN or other treating specialist may have reasons to advise their patient not to have massage and, in that scenario, Massage Therapists should defer to the treating doctor. However, unless there is a contraindication such as those listed below, there\u2019s no requirement to get clearance from the treating medical practitioner. Any potential issues should come to light through a thorough pre-treatment intake.<\/p>\n

8. Massage of the feet and ankles causes miscarriage and\/or pre-term labour<\/u><\/strong><\/p>\n

There is no evidence that massage of the feet and\/or ankles causes any detrimental impact on the pregnant person.<\/p>\n

Alice Sanvito\u2019s article discusses the reasons behind this myth, and suggests that the information comes from foot reflexologists and acupuncture practitioners.<\/p>\n

\u201c… when researchers have tried to use acupuncture on these points to induce labor in women past their due date, they have failed.\u201d<\/em><\/p><\/blockquote>\n

\"\"

Force into the ankle has as much chance of inducing labour in Achilles as a pregnant person.<\/p><\/div>\n

A study undertaken by Neri et al<\/a> (2014) supports this statement, as does this 2017 Cochrane review<\/a> on reduction of Caesarean rates in post-date pregnancy.<\/p>\n

If an acupuncture needle can\u2019t find an alleged specific point to induce labour, then how can a Massage Therapist? If acupuncture can\u2019t induce labour post-date<\/u>, then why would massage result in pre-term<\/u> labour or miscarriage?<\/p>\n

Commonsense test: Are partners (and kids) of pregnant people who rub the pregnant person\u2019s tired feet causing harm? What about shoes and walking – do they induce labour?<\/p>\n

9. You need to pay extra professional indemnity insurance to treat pregnant women<\/u><\/strong><\/p>\n

Any insurer that tries to extract extra money from a Massage Therapist for performing massage on a pregnant person needs to be dumped and\/or given a stern talking to.<\/p>\n

Massage is a low risk activity, that\u2019s why our insurance premiums are so low.<\/p>\n

10. Don’t treat with the pregnant person in the prone position<\/u><\/strong><\/p>\n

While pregnant people are told not to lie supine because it may compress the inferior vena cava and potentially harm the mother and starve the baby of oxygen, there is no evidence to support the myth that women can\u2019t be massaged while prone and supported by the use of bolsters, pillows, pregnancy cushions or a special treatment table, as long as the client is comfortable and remains comfortable.<\/p>\n

Contraindications for Massage During Pregnancy<\/strong><\/h6>\n

There are some instances where massage is contraindicated, including:<\/p>\n

-Specific advice from treating medical professional.<\/p>\n

-Placenta Previa (but not in all cases)<\/p>\n

-Some high risk pregnancies (OB\/GYN will advise):<\/p>\n