Prenatal | Pregnancy Massage

Massage at any time, but especially during pregnancy, is a highly customized therapy.  I develop a rapport with my clients to learn their health history, unique sensitivities, body shape, and personal preferences.

I specialize in massage to improve the lives of women, and massage can substantially improve the quality of life for pregnant women in several ways both physically and psychologically.

Without any drug and in a quiet and peaceful environment, massage therapy as a complementary care option can ease many of the physical discomforts that occur during pregnancy and related stress such as:

  • Stiff neck
  • Backache
  • Leg cramps
  • Edema or swelling
  • Fatigue
  • Muscle tension, which can increase over pregnancy as extra weight accumulates.

Massage can also relieve headaches. I focus on the head, neck, and shoulders, which also reduces the chances of migraines or tension headaches by relaxing trigger points and muscle spasms.

 The benefits of massage during pregnancy result from:
Reduced stress on weight-bearing joints.
Improved circulation
Increased delivery of oxygen throughout the body
Increased lymphatic fluid clears away toxins and metabolic waste.

Affects on Biochemicals

Increases in the neurotransmitters, dopamine and serotonin, which can decrease depression or anxiety caused by hormonal changes. Also serotonin is a natural anti-pain chemical.
Increases in endorphin, which can decrease pain and improve mood, and decreases in stress hormones.

Improved sleep

“Massage is very effective at increasing deep sleep,” says Dr. Tiffany Field, Director and Founder of the Touch Research Institute, first center in the world devoted solely to the study of touch and its application in science and medicine, which is affiliated with the University of Miami.

 How Is Massage Done During Pregnancy?

 Massage during pregnancy is done with special cushioning to account for the changes in body shape:

 Through the second trimester, a small, wedged cushion placed under one hip provides a slight elevation that keeps the body aligned.
Throughout pregnancy:

To enable a pregnant woman to lie prone, cushions provide support around the abdomen
Strategic cushioning is also used to prevent strain on the lower back and pelvis from pressure applied during massage.

As needed, special techniques are used such as reflexology or Swedish massage to address specific issues.

 While massage can’t promise that your newborn will sleep through the night, it can provide you with a better night’s sleep both during pregnancy and afterwards by preventing or decreasing discomfort and stress.

 Women with normal, low-risk pregnancies can benefit greatly from a variety of massage techniques.  Women with a high-risk pregnancy, however, should consult their doctor or midwife before beginning massage therapy.

 Additional References

Studies Published By Investigators of the Touch Research Institute

Field T, Diego M, Hernandez-Reif M, Medina L, Delgado J, Hernandez A. Yoga and massage therapy reduce prenatal depression and prematurity.  J Bodyw Mov Ther. 2012 Apr;16(2):204-9.  Eighty-four prenatally depressed women were randomly assigned to yoga, massage therapy or standard prenatal care control groups to determine the relative effects of yoga and massage therapy on prenatal depression and neonatal outcomes. Following 12 weeks of twice weekly yoga or massage therapy sessions (20 min each) both therapy groups versus the control group had a greater decrease on depression, anxiety and back and leg pain scales and a greater increase on a relationship scale. In addition, the yoga and massage therapy groups did not differ on neonatal outcomes including gestational age and birthweight, and those  groups, in turn, had greater gestational age and birth weight than the control group.

Field T. Pregnancy and labor massage. Expert Rev Obstet Gynecol. 2010 Mar;5(2):177-181.  Massage therapy has been demonstrated to be effective during pregnancy. Women who received massage therapy reported decreased depression, anxiety, and leg and back pain. Cortisol levels decreased and, in turn, excessive fetal activity decreased, and the rate of prematurity was lower in the massage group. In a study of labor pain, women who received massage therapy experienced significantly less pain, and their labors were on average 3 h shorter with less need for medication. An underlying mechanism we have been exploring is that these effects are mediated by increased vagal activity. This likely occurs by the stimulation of pressure receptors that are innervated by vagal afferent fibers, which ultimately project  to the limbic system, including hypothalamic structures involved in autonomic nervous system regulation and cortisol secretion.

Field T, Diego M, Hernandez-Reif M. Prenatal depression effects and interventions: a review. Infant Behav Dev. 2010 Dec;33(4):409-18.  This review covers research on the negative effects of prenatal depression and cortisol on fetal growth, prematurity and low birthweight. Although prenatal depression and cortisol were typically measured at around 20 weeks gestation, other research suggests the stability of depression and cortisol levels across pregnancy. Women with Dysthymia as compared to Major Depression Disorder had higher cortisol levels, and their newborns had  lower gestational age and birthweight. The cortisol effects in these studies were unfortunately confounded  by low serotonin and low dopamine levels which in themselves could contribute to  non-optimal pregnancy outcomes.

The negative effects of depression and cortisol were also potentially confounded by comorbid anxiety, by demographic factors including younger age, less education and lower SES of the mothers and by the absence of a partner or a partner who was unhappy about the pregnancy or a partner who was depressed. Substance use (especially caffeine use) was still another risk factor. All of these problems including prenatal depression, elevated cortisol, prematurity and low birthweight and even postpartum depression have been reduced by prenatal massage therapy provided by the women’s partners. Massage therapy combined with group interpersonal psychotherapy was also effective for reducing depression and cortisol levels. Several limitations of these studies were noted and suggestions for future research included exploring other predictor variables like progesterone/estriol ratios, immune factors and genetic determinants. Further research is needed both on the potential use of cortisol as a screening measure and the use of other therapies that might reduce  prenatal depression and cortisol in the women and prematurity and low birth weight in their infants.

Field T(1), Deeds O, Diego M, Hernandez-Reif M, Gauler A, Sullivan S, Wilson D, Nearing G.  Benefits of combining massage therapy with group interpersonal psychotherapy in prenatally depressed women.  J Bodyw Mov Ther. 2009 Oct;13(4):297-303.  One hundred and twelve pregnant women who were diagnosed depressed were randomly  assigned to a group who received group Interpersonal Psychotherapy or to a group  who received both group Interpersonal Psychotherapy and massage therapy. The group Interpersonal Psychotherapy (1h sessions) and massage therapy (20 min sessions) were held once per week for 6 weeks. The data suggested that the group  who received psychotherapy plus massage attended more sessions on average, and a  greater percentage of that group completed the 6-week program.

The group who received both therapies also showed a greater decrease in depression, depressed affect and somatic-vegetative symptom scores on the Center for Epidemiological Studies-Depression Scale (CES-D), a greater decrease in anxiety scale (STAI) scores and a greater decrease in cortisol levels. The group therapy process appeared to be effective for both groups as suggested by the increased expression of both positive and negative affect and relatedness during the group therapy sessions. Thus, the data highlight the effectiveness of group Interpersonal Psychotherapy and particularly when combined with massage therapy for reducing prenatal depression.

Field T, Diego M, Hernandez-Reif M, Deeds O, Figueiredo B. Pregnancy massage reduces prematurity, low birthweight and postpartum depression.  Infant Behav Dev. 2009 Dec;32(4):454-60.   Pregnant women diagnosed with major depression were given 12 weeks of twice per week massage therapy by their significant other or only standard treatment as a control group. The massage therapy group women versus the control group women not only had reduced depression by the end of the therapy period, but they also had reduced depression and cortisol levels during the postpartum period. Their newborns were also less likely to be born prematurely and low birthweight, and they had lower cortisol levels and performed better on the Brazelton Neonatal Behavioral Assessment habituation, orientation and motor scales.

Field T, Hernandez-Reif M, Diego M, Schanberg S, Kuhn C. Cortisol decreases and serotonin and dopamine increase following massage therapy.  Int J Neurosci. 2005 Oct;115(10):1397-413. In this article the positive effects of massage therapy on biochemistry are reviewed including decreased levels of cortisol and increased levels of serotonin and dopamine. The research reviewed includes studies on depression (including sex abuse and eating disorder studies), pain syndrome studies, research on auto-immune conditions (including asthma and chronic fatigue), immune studies (including HIV and breast cancer), and studies on the reduction of stress on the  job, the stress of aging, and pregnancy stress. In studies in which cortisol was  assayed either in saliva or in urine, significant decreases were noted in cortisol levels (averaging decreases 31%). In studies in which the activating neurotransmitters (serotonin and dopamine) were assayed in urine, an average increase of 28% was noted for serotonin and an average increase of 31% was noted  for dopamine. These studies combined suggest the stress-alleviating effects (decreased cortisol) and the activating effects (increased serotonin and dopamine) of massage therapy on a variety of medical conditions and stressful experiences.

Field T, Diego MA, Hernandez-Reif M, Schanberg S, Kuhn C. Massage therapy effects on depressed pregnant women. J Psychosom Obstet Gynaecol. 2004 Jun;25(2):115-22.   Eighty-four depressed pregnant women were recruited during the second trimester of pregnancy and randomly assigned to a massage therapy group, a progressive muscle relaxation group or a control group that received standard prenatal care alone. These groups were compared to each other and to a non-depressed group at the end of pregnancy. The massage therapy group participants received two 20 min  therapy sessions by their significant others each week for 16 weeks of pregnancy, starting during the second trimester. The relaxation group provided themselves with progressive muscle relaxation sessions on the same time schedule. Immediately after the massage therapy sessions on the first and last days of the  16-week period the women reported lower levels of anxiety and depressed mood and  less leg and back pain.

By the end of the study the massage group had higher dopamine and serotonin levels and lower levels of cortisol and norepinephrine. These changes may have contributed to the reduced fetal activity and the better neonatal outcome for the massage group (i.e. lesser incidence of prematurity and  low birthweight), as well as their better performance on the Brazelton Neonatal Behavior Assessment. The data suggest that depressed pregnant women and their offspring can benefit from massage therapy.