First Trimester Massage

I love getting away from it all. I love my work and have huge affection for each of my clients, but when I have down time, I really like to step away from it all. We’re talking no mobile signal, no client contact, and if my laptop comes out, its because I feel the urge to write, or share, or plan. Having head space is very important to me as both a massage therapist, but also as me outside of that role.

Earlier this year, a long weekend of peace and tranquility was somewhat disturbed and my brain sent into overdrive by a conversation I overheard. I am not in the habit of eavesdropping, but in a quiet lounge with one other couple having a conversation with the onsite therapist, it was a little difficult not to hear, even if I wasn’t professionally interested (which of course I was!!).

As with all the guests at this place, this couple were on a weekend away and had decided to book a little extra pampering, and were reviewing the ‘menu’ of options on offer when the therapist came to talk to them in the lounge. Now I understand why this initial stage would usually be ok in a public place, but what followed made me feel very sad.

Clarification

Before I continue, may I just say that I have huge respect for beauty therapists. Having decided on a career, they spend significant amounts of time and money on qualifying and then continuing their professional development, and work very hard. Anyone who has been on the receiving end of any form of beauty therapy knows that they works hard physically, but also engage with their clients fully throughout the treatment (at least you hope so!), whether it be a french manicure, a wax or a facial that you have booked in for. I have had occasions where a massage from a beauty therapist has left me more stressed and irritable when I got off the table than when I got on it, which is deeply frustrating and reiterates my belief that not all massage is created equal. However, I have also been attended to by beauty therapists in a massage which have seen me drop into a beautiful state of utter relaxation, where I have been nurtured, cared for and where I leave feeling whole (if slightly embarrassed to have snored!). I leave all massages such as this, no matter who the therapist, feeling as though I have had a whole body therapy session.

Back to the catalytic conversation. Having driven a fair way the previous day, the lady’s husband said he could do with a deep tissue massage, to which his wife agreed her back was killing her and could she please have the same. “But I’ve just discovered I’m about 10 weeks pregnant?” There was a question in her statement, but without a pause, the therapist offered her excited congratulations, but gently and swiftly whittled her available options down to a handful of treatment, because “massage in the first trimester just isn’t safe”.

The lady in question was deeply disappointed but opted for a relaxing facial instead. I’m still not quite sure how I bit my tongue.

Defence

As practitioners and therapists (whether that is bodywork or talking therapy), we are all only as good as our teaching, our experience and our own enthusiasm for growth. I was very lucky that when I realised what I wanted to learn to massage. I found various syllabuses but chose one that really attracted me. The Massage Training Institute (MTI - the awarding body for my qualification) stood out for me as being comprehensive and grounding, offering an introduction to a tremendous range of working styles and theories, whilst teaching the ethos of massaging people rather than of bodies. During our course we discussed, and if we chose had the opportunity to, work with clients in all sorts of situations, from cancer to degenerative disease, from the young, the seriously mature (in age!) to including pregnant ladies.

I get it, not everyone was lucky enough to have the training and the knowledge imparted that I did, and I certainly don’t blame the therapist in question. A lot of spas and beauty salons will greatly reduce the number of therapies available to a lady during her first trimester for liability issues, or for ‘practitioner protection’. Some may even continue this ‘reduced service’ throughout pregnancy. But why?

When I was doing my pre-course reading for my Well Mother Pregnancy Massage course, I was stunned to read that:

At least 15% of confirmed pregnancies end in ‘spontaneous abortion’ [gotta love those medical terms] before 12 weeks. The true rate of pregnancy loss is likely to be much higher, as it often occurs earlier. It is more common in a first pregnancy (Lewis 2001) Pregnancy and Childbirth: A holistic approach to massage and bodywork, Suzanne Yates, p54

I knew that there was a number, and that it was 'significant' but had no idea it was so high, particularly by conservative, reported standards. These numbers are most likely to be the reason for this fear based decision. In fact, the text continues “reassure women that regular moderate exercise and receiving bodywork do not increase the chances of miscarriage, as most causes are genetically based [that is the genetics of the fetus]” - p56. However, thanks to the litigious society in which we now appear to exist, there may well be uneducated, fear based liability issues for spas and their employees, but likewise the lack of knowledge and understanding means that a number of therapists and practitioners prefer to play it safe in order to protect themselves. As well they should. After all, ignorance is NO defence.

So I do totally understand why the therapist reduced the list of treatment options to the pregnant client. But this didn’t help the client with her painful back.

Progress

The wonderful work that is being done by the likes of Suzanne Yates, who founded Well Mother, in teaching specialised prenatal massage courses means that it is now possible for a lady to seek and get a wonderfully personalised massage during any stage of her pregnancy, with some practitioners also doing additional training to attend to their clients during labour. I was so thrilled when I found this course, and each time I work with a pregnant client, I feel even more honour that they are inviting me into their world to share just a small part of their latest adventure. Yes, the bodywork is the focus of each session, but the appointments themselves set aside time for the mother-to-be to stop trying, to stop working, to just ‘be’.

Benefits

My colleague Kate Codrington has said it beautifully:

The first trimester can often be a vulnerable period as your body undergoes the incredibly profound changes; excitement and anxieties are high, you will probably be tired, emotional and nauseous long before your belly shows. On the inside you are doing amazing work – your baby grows from a single cell to a recognisably human creature measuring 5cm long. It can be hard to find positive support at this time and much of the advice in the media is confusing and contradictory. Kate Codrington Massage - Connect with your Baby

With the general consensus of opinion around pregnancy being that it remains a ‘secret’ until the first scan which is usually at around 12-14 weeks (again, a fear based 'decision'), the first trimester can be a daunting and isolating time for a pregnant lady. Even if you leave aside the emotion aspect, whilst her body is doing the most amazing job of growing another human being (brain, organs, the lot form in this time) there’s all the physical changes going on in her own body too. We’re talking sore breasts, nausea (‘morning sickness’ really should be renamed!), vomiting, dizziness, extreme tiredness, etc. Once the pregnancy is ‘medically confirmed’, there can be the expectation that the medical community will open it’s doors and welcome you in to it's safe haven, but typically the first appointment with a midwife might be as late as the 10th or 11th week. So where can a hormonal, exhausted, tense and physically wrung out lady turn?

“The massage therapist may be able to help by bridging this gap - providing advice and encouragement or simply acting as a sounding board in addition to the comfort that nurturing physical touch can bring” The journey to motherhood by Anna Hope.

What feels right to you?

Ladies who receive massage during their pregnancy should always experience the treatment guided by what she wants and what feels good, with the massage therapist offering a clear treatment plan that is discussed and agreed upon; if  there is a deviation, then it should always be with the agreement of the client. For example, massage during pregnancy can be a wonderful time for the mother-to-be to bond and connect with her baby, but with the uncertainty caused by the potential increased risk of miscarriage during the first trimester, it is often something women would prefer to leave until they are more certain that their pregnancy is ‘safe’. Some women will find that they would prefer not to do this connecting work until much later in their pregnancy.

So I call each pregnant lady to listen to herself and learn to be guided by her own intuition, to have the confidence to explain clearly what she does and doesn’t want to her massage therapist. After all, you are there to receive a personalised treatment that’s perfect for you as you are feeling on the day of the appointment.

When NOT to get a massage during the first trimester

I know, talk about a volte face. But there are a few symptoms that, if you were to come in for a massage with me during your first trimester I’d suggest you check with your midwife or GP at the earliest opportunity. I don’t include these points to scare, but to inform:

  • Unexplained severe or moderate abdominal pain
  • Vaginal bleeding
  • Inability to or pain whilst urinating
  • Pelvic cramps
  • Fever or feeling of weakness

A long way to go

Researching this article, I decided to Google ‘massage in the first trimester’ and got an incredible number of forum threads. Anxious women who were going on pampering hen parties, going to spas, or heading off to yoga retreats only to find out that they were pregnant and being turned down, refused treatment. Understandably there were lots of opinions on topics including aromatherapy oils (which could damage your baby!), the pros and cons of acupuncture, what base oil was deemed ‘ok/safe’ or not. Oh people.

Mothers-to-be, trust yourselves. If you are wanting a massage, do please seek out a practitioner or therapist who has undertaken (or is under going!) further training in pregnancy massage work. The Well Mother website has a list of qualified practitioners, and yes I'm on there. If you can’t find someone in your area but have a massage therapist of choice, talk to them about pregnancy massage, their knowledge, advice and opinion will help you decide if you feel safe with the thought of them working with you and your baby during this precious time - I thank those pregnant clients who came to me before I started this chapter of my massage journey. Or ask any of your friends and family who might have mentioned having a massage whilst they were pregnant. Whilst recommendations are a great way to find a pregnancy massage therapist, we are all individual and in order for you to relax and enjoy a massage, you need to feel safe and comfortable in the therapists’ company and their practice room. Any therapist worth their salt will be happy to meet you to chat through any concerns you have before your first appointment. If they aren’t the right person for you, try again!

Remember, trust yourselves.

 

POST SCRIPT - I've recently been pointed in the direction of an American article in their Massage Today publication entitled Prenatal Massage During the First Trimester. See, it's not just me!