- Karen Stoner, LMT
Pregnancy and Massage: 3rd Trimester
Almost there! The body might feel uncomfortable
but you know it will be worth it when it’s over. With the discomfort comes stress, and stress can make it all worse. Massage can help the body be calm and ready for “the big event”
You may be feeling- Swollen legs & feet: The body has a lot of extra blood and fluid in the system to help cushion and feed baby, as well as protect the extra weight on mom's joints. As baby gets bigger, gravity pulls all that extra everything down so the legs and feet get flooded with all the extra fluid. Because there is so much blood flow and extra pressure, doctors also watch out for DVT or the possibility of blood clots in the legs.
How massage helps: Gentle massage, including lymphatic drainage style massage on the legs can help reduce the swelling and relieve some of the pressure on the feet and legs. Deep pressure massage is not done on the legs just in case anything like blood clots is happening, but lighter, relaxing massage is safe and can be very effective in moving some of that extra fluid out.
You may have- Leg cramps: Because of the increased fluid in the body, plus hormones running wild, the legs can get incredibly uncomfortable including cramps in the legs, especially at night when moving for the day has stopped. Sometimes these cramps can also come from mineral imbalances. Even though pregnant women usually take prenatal vitamins and watch their diets, the excess fluid and subsequent constant bathroom use can sometimes flush out a lot of those minerals including calcium, potassium, and magnesium which can then lead to an increased risk of calf cramps.
How massage helps: Massage can help drain the fluid in the legs and keep even distribution of both fluids and minerals flowing through the body so everything stays where it needs to be. Even though deeper massage isn't recommended on the legs at this time, massage to help relieve and calm down the cramps and tight muscles that the cramps leave behind can help the legs feel better.
You may have - Hip & back pain: Baby is pretty big now, and sitting right in an area that caries a lot. The hips are starting to really get loose to prepare for the birth, which causes all the muscles, joints, and ligaments to stretch and pull, plus that extra weight in front renders abdominal support for the back pretty much useless, which means the back may feel pinched, pulled, or just downright sore.
How massage helps: Relaxing and releasing any areas of tightness that are overly sore can help calm down the pain from the over stretched muscles and soften anything that is tight. Even though the hips are loosening and starting to spread, the muscles can still be tight, and loose hip muscles can help when baby is on the way out. Keeping the hips and low back loose can also help baby get into the correct position so that delivery may be quicker and easier.
You may have - Carpal tunnel: This might seem like it has no connection to pregnancy at all, but it can happen. The increased fluid and blood volume usually directs itself to the legs, but it can also affect the hands and wrists as well, decreasing the size of the channel the carpal ligament runs through and causing pain in the hands and wrists. Also, as the belly and breasts grow, the upper body can pull forward, causing a mis-alignment and almost like a "pinch" in the neck. Since the nerves for the hands originate in the middle-to-lower neck area, this change in the upper body's structure can also create more pain in the hands and wrists.
How massage helps: Massage can help alleviate the fluid buildup in the arms and wrists, and can help loosen the ligaments and muscles around the carpal area in the wrists to relieve the pain. Massage can also relax the tight muscles in the neck and upper body, helping the upper body to re-align itself and relaxing anything that is tight due to the pulling of the body changes.
You may feel - Excited but exhausted: This is the point that you are almost there- you will meet your baby sooner rather than later, but with that, your body is doing so much to prepare to bring the little one into the world, it is tired. Lots of extra weight, everything pulling and moving, trying to function with all these extra aches and pains is exhausting on the body - not to mention the hormones and disruption of normal sleeping. Also contributing to the exhaustion is stress of the impending delivery. First time parents can be anxious because they don't know what to expect and only have stories from others and over-exaggerated tv and movie drama screaming to represent childbirth. Even seasoned parents who have been through it before and "know what to expect" can be anxious and stressed because no two labors are ever the same. Add to that the anxiousness of looking ahead to the family dynamic with a new baby and how that will change all creates excitement but stress at the same time.
How massage helps: Massage can give mom a short time to relax and "turn off" her brain and have some calm time to relax and de-stress. Massage can also help calm down the central nervous system which calms the body down and eases anxiety. Getting a massage can also reassure mom that she is taking care of herself, and when mom is taken care of, it makes her more easily and able to take care of her family so it can help her confidence and overall health and well-being which in turn can ease the stresses and anxieties of the impending childbirth.
How is massage different in the third trimester? The massage in the third trimester is very similar to the second trimester - the massage is done in a side-lying position with support for the legs, head, and belly, and lift for the upper back when laying/sitting upright. More attention is put on the hips and low back to ease the major stresses in those areas. Leg work gets a slight extra evaluation especially if swelling is very intense to make sure there is no pitting edema, which is a little different than regular swelling, and can signal something else may be wrong in the body. The massage is more geared towards getting the hips loose and keeping the body calm and relaxed so that the body can prepare for childbirth.
When should massage not be done in the third trimester? Once again, similar to the second trimester, any high risk conditions such as high blood pressure, pitting edema, bleeding, fluid leaking, or DVT should be watched by a doctor, and massage be primarily avoided. If mom is on bed rest, massage is mostly contraindicated because bed rest usually signifies something major is going on, but there are a few massage techniques that may still be able to be done. When clients ask me how long they can have massage before delivery, I usually tell them "until labor starts or your water breaks". However, once labor has started, if in the hospital or under a doctor's watch and care, some massage can still be done during labor to help mom feel better and help the contractions be more effective, but it is at the discretion of the doctor if it is allowed.
One final note: Contrary to common myths, there is no proof that any type of massage can "start" labor - even if the due date has passed and mom is miserable, desperate, looking at an induction and they are looking for that magic switch to get everything going. Many old wives' tails speak about rubbing the feet to stimulate labor, however even though there are reflexology points int he feet that relate to the uterus, there is no documented proof that this can "start" labor (take it from a massage therapist who's first child was over 2 weeks late - you better bet every one of those points was hit and massaged thoroughly with not the desired results). Many women do report that they had a massage and went into labor that night, but this is merely a coincidence. Basically, the body doesn't like to do anything big while it is under stress. Cortisol, the stress hormone, can stop bodily functions from happening the way they should. Massage can help reduce cortisol and therefore allow the body to be relaxed and calm, so that it can get the "big event" started. This is perhaps why people believe massage can help start labor. Once labor has started, there are a few acupressure points that can help strengthen contractions to make them more effective, but they rarely can get things "started".