Seeking advice on pregnant client

megan c

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This Saturday I will be doing my first 60 minute massage on a pregnant client/friend. I have dealt with pregnant shiatsu clients before, but have not done (Western) massage on one.

I have worked on this woman several times before (pre-pregnancy). She is currently at 15 weeks, so early in the second trimester. She broke her wrist ("distal radial fracture") a month or so ago and is getting the cast off this week, so she wants to have arm work done. She has also requested shoulder and neck work and has chronically tight upper traps and scalenes. I let her know about some contraindicated areas and that I would not be able to work deeply there. She is 38 and I'm pretty sure this is her first pregnancy.

She is also having trouble sleeping since the pregnancy. She used to take sleeping pills but doesn't want to take anything, (even OTC meds) for that while she is expecting. I know of several TCM type self care things to suggest to her, but I'd love to hear other "natural" safe-for-pregnancy tips anyone may have.

Basically, I am looking for any advice you'd give a first timer in pregnancy massage. I have a set of body cushions, but don't have any experience using them for a draped massage (used to shiatsu only).

I feel like such a newbie!

Thanks! :oops:
 


For the most part in draping your basic massage rules still apply. Just have some extra towels and/or an extra sheet on hand for some extra draping. You will more than likely want to do a bit of side lying posture with her as well. And overall just keep her comfortable. I am sure that you will do very well. I have extreme confidence in you!
 


At 15 weeks she may or may not want the body cushion -- I know I didn't, not that early. So either way is possible.

I really don't think you need to expect any problems. The main thing I think when working with pregnant women is to focus on what you *can* do, not what you can't. Don't worry too much about no-go points, but just enjoy providing her such lovely comfort and pleasant, familiar sensation. (Can you tell I loved massage when I was pregnant?) Lots of pregnant women, especially first-timers, experience heightened sensations, so keep scents down low, movements slow, and transitions gentle. Quite a few of my expectant mothers (and me too) really enjoyed lighter pressure too, for that same reason.

Oh, I hope you enjoy yourself during the session! Working within the energy of pregnancy is such a joy, the baby is there dancing with you and, I am convinced, feeling its own experience and telling you what they need, too.
 


Take into consideration the contraindications of prenatal work, most are the shiatsu point areas in the sacrum, neck, hands, feet and ankles. But just go with the flow. At this point you probably will not need the body cushion, at 15 weeks most women don't show yet and are very comfortable still getting a regularly positioned massage. They are just coming back for comfort and relaxation, so modify the prenatal as you go, moreso the prenatal massage positioning is after she is no longer able to lay prone.
 


Thanks everyone for the advice. She has been sleeping on her side (I got the impression that being on her back (at least for sleeping) is not currently comfortable for her). She mentioned that it will be "interesting" to see what it's like to be on her back for the massage. I told her about side lying position and the cushions.
 
Seeking advice on pregnant client

Gessika said:
She is also having trouble sleeping since the pregnancy. She used to take sleeping pills but doesn't want to take anything, (even OTC meds) for that while she is expecting. I know of several TCM type self care things to suggest to her, but I'd love to hear other "natural" safe-for-pregnancy tips anyone may have.
What about Bach Flower Essences' Rescue Sleep?

If you know of a reputable herbalist in the area a prenatal blend of skullcap and passionflower might do the trick!
 


BJB-LMP said:
At 15 weeks she may or may not want the body cushion -- I know I didn't, not that early.
Use the bodyCushion, she is not going to know if she wants it or not, and it reduces so much tension in the back anyway, pregnat or not, may as well use it. (The bodyCushion can be prescribed by a doctor for incurance payments for people with bad backs, if that's not an indication for a reason to use it, I don't know what it)

BJB-LMP said:
The main thing I think when working with pregnant women is to focus on what you *can* do, not what you can't.
I'm totally the opposite to this - know what you can't do and that way the rest can flow. There are too many people thinking it's ok to use heat on a pregnant client, hot stones, table warmers, heat packs - you can't. As for lighten up and reduce scents - know where you MUST lighten up and where you can work deeper, and don't use ANY essential oils.

She should NOT be on her back during the massage or sleeping, just elevating the right side will provide enough tilt for it to be safe (depending on how cushy the table is, a towel folded over about 3 times can be enough to make it no concern.

With her sleeping problems, was she a back, tummy or side lying sleeper before pregnancy? If she was a tummy sleeper, she'll want the bodyCushion ASAP. (II'm sure most of my tummy sleepers would pay just to lie on the bodyCushion for an hour without the massage :) ) Has she got a large hips compared to her waist? If she was not a side lying sleeper beforehand, that can make it very uncomfortable, the squashed shoulder can be very disruptive - sleeping using a pillow mimicing the bodyCushion side lying setup can be a great releif.
 


melb said:
BJB-LMP said:
The main thing I think when working with pregnant women is to focus on what you *can* do, not what you can't.
I'm totally the opposite to this - know what you can't do and that way the rest can flow.

I think we are saying the same thing.

I guess what I meant is that so many massage therapists get so fussy and "can't"-focused when working with pregnant women, that it comes across to the client that she is being difficult and therefore denied.

Instead of seeing a tempting menu of delights, professionally hand-picked as safe and wonderful for expectant mothers, she is often confronted with a worried face, a long muttered list of the services she won't be offered, and at last a kind of hands-thrown-up attitude of "what am I going to DO with you?" followed by a tentative, mediocre massage. (Oh my yes, I suffered through a few of those.) That, to me, is focusing on what you can't do.
 
Pregnancy

Hello,

Certainly try and avoid any skin care products that have parabens. There is testing that shows the paraben family, which is used as a preservative to give the product a longer shelf-life, can cause damage to the child, especially boys and it has shown to cause retardation.

I have seen stretch-mark creams that of course are made for a woman during pregnancy, that do contain parabens. I would hate to think that the manufacturer is aware of the effects of parabens, but stil continue to sale product to pregnant women. Our dollar-driven society never ceases to amaze!

Sombraman
 


Pandoras_Gift said:
Take into consideration the contraindications of prenatal work, most are the shiatsu point areas in the sacrum, neck, hands, feet and ankles. But just go with the flow. At this point you probably will not need the body cushion, at 15 weeks most women don't show yet and are very comfortable still getting a regularly positioned massage. They are just coming back for comfort and relaxation, so modify the prenatal as you go, moreso the prenatal massage positioning is after she is no longer able to lay prone.

Where are the shiatsu point areas in the sacrum and neck?
 
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