Maternity massage therapy is one of the most personally rewarding and professionally satisfying massage therapy specializations.
Maternity massage addresses the many needs of women throughout an entire childbearing cycle, rather than just during pregnancy. If you are considering entering the world of bellies roiling with life, labor’s powerful groans and the sweetness of a mom embracing her newborn, you will need a sense of what this really entails.
This article overviews this specialization, including its history and current possibilities. You will get a glimpse at what practicing maternity massage therapy is like in the words of several seasoned practitioners, and how to get the educational foundation you need to have similar success. You will learn about the benefits of professional touch to mothers, babies and families, helping you to appreciate the widespread positive impact that specializing with this population might have for women and our world.
Maternity massage therapy is the use of therapeutic massage and bodywork to support the physiologic, structural and emotional well-being of pregnant, laboring and postpartum women. Some therapists expand their support to the pre-conception period or to the long-term well-being of women for a year or more after giving birth. Therapists may apply various forms of massage therapy, including circulatory, deep tissue, neuromuscular, passive and active movement modalities, craniosacral and Asian bodywork therapies, among others.
A typical prenatal session, performed by a therapist specializing in maternity massage therapy, addresses pregnancy’s various physical challenges, such as pain in the lower back, pelvis or hips from postural and functional changes. Therapists emphasize autonomic sedation to maximize the stress-reducing effects to both relax mom and improve uterine blood supply for optimal fetal and maternal outcomes. Many women unburden their fears and other anxieties about childbearing during their sessions. Some therapists include techniques that may help the mother-to-be develop the sensory awareness necessary to birth more comfortably and actively.
“With each new pregnant woman, I try to assume nothing and hope for nothing. I try to make that hour just what she wants,” explains maternity massage therapist David Lobenstine of New York, New York. “If that just means she takes a good nap, then that’s exactly what she needed.”
Lobenstine says simple relaxation can be as profound as more advanced techniques, but that his clients are often surprised at the depth of work that can be achieved in a single 60-minute session.
“They are startled that we can cultivate change so quickly,” he says. “They are thrilled that we can alleviate some of their rib tightness or make their lower back feel longer, or flush some of the density from their ankles.”
His pregnant clients realize, he adds, “that it is possible to feel centered—even if only for a moment—in their ever-changing bodies.”
A Growing Specialty
Over the last three decades, thousands of licensed massage therapists have trained to become maternity massage therapy specialists. But nurturing touch during pregnancy, labor and the postpartum period isn’t a modern concept.
For many centuries, midwives have used their highly developed hands-on skills in supporting gestation and birth. Massage and movement during the childbearing experience was and continues to be a prominent part of many cultures’ maternity care. Most of the world’s more peaceful cultures use touch prominently during pregnancy and early childhood.
When childbearing became increasingly medicalized over the last 150 or so years in Western countries, technology ascended over touch in caring for expectant and laboring women. In addition, prior to the 1980s, most massage-therapy educators considered pregnancy a contraindicated condition for receiving massage. Around then, several pioneering massage and bodywork therapists, intrigued by its potential value to women and their families, explored, researched and assembled contemporary foundations for the safe and effective practice of maternity massage therapy.
This foundation includes a growing research basis for the inclusion of maternity massage therapy as an adjunct to perinatal health care. In animal research, scientists found lack of cutaneous stimulation had far-reaching effects. Pregnant rats restricted from licking their abdomens and teats had poorly developed placentas and 50 percent less mammary-gland development. Their litters were often ill, stillborn or died shortly after birth, in part due to poor mothering skills.
On the other hand, women whose care included more touch enjoyed benefits for themselves, their infants and their families. Compared with those who had an equal amount of relaxation therapy, pregnant women massaged twice weekly for five weeks experienced less anxiety and decreased leg and back pain. They reported better sleep and improved moods, and their labors had fewer complications, including less premature births. Depressed second trimester women had similar reductions in pain and complications when they received massage therapy rather than relaxation sessions or normal prenatal care. Studies show when women receive nurturing touch during later pregnancy, they touch their babies more frequently and lovingly.
When the touched half of 90 laboring women were contacted reassuringly for just 5 to 10 seconds whenever they expressed anxiety, their blood pressure and number of anxious expressions significantly decreased. Women whose partners massaged their head, back, hands and feet for 20 minutes hourly for five hours of labor had less pain and anxiety and improved mood. During labor, the presence of a doula, a woman providing physical and emotional support, including extensive touching and massage, reduces the length of labor and number of complications, interventions, medications and Cesarean births. When massage therapists work with laboring women, they often report similar positive outcomes.
Most prenatal and perinatal massage therapy specialists work with women in their private practices. Like therapists whose focus is on other hands-on specialties, word-of-mouth is one of the most successful means of marketing a maternity massage practice.
“Even early on in my specialty practice for pregnant woman I relied on word-of-mouth,” says Linda Hickey, R.M.T., owner of Calgary Maternity Massage in Calgary, Alberta, Canada. “I still maintain you only need one mother to come and experience our magic. She will soon see [other] pregnant women and share your name.”
Other maternity massage therapists enjoy the growing employment opportunities at spas, resorts, chiropractic and wellness centers catering to expectant women.
“Working in a spa with the unique needs of pregnant women can be both rewarding and frustrating,” explains Lobenstine. “Spa managements’ fear of our litigious society, and of bad publicity, often trumps a more rational approach to treatment. As my managers began to understand the depth of my training in maternity massage therapy, they began to value and utilize my expertise and that of other similarly trained therapists.”
He notes many women can be anxious about their pregnancies, and the mixed messages offered by the medical community about the potential dangers of massage can sometimes increase that anxiety.
“The front desk now mentions the details of our certifications when talking to clients,” he adds. “For a client needing reassurance, just knowing that we have received specialized training can put them at ease and make them more willing to book an appointment.”
Lobenstine says he plays a valued role at his spa, “and I know that I am helping it function responsibly.”
The Medical Setting
Midwives represent a natural fit for partnership with maternity massage therapists.
“Get to know the allied birth professionals, midwives especially, as well as yoga and childbirth-education instructors in your community for your own referral list,” Hickey suggests. “Find the people that match your style and refer, [and] they will refer back in time, too.”
Physicians and hospitals are also increasingly open to working with qualified maternity massage therapists.
“I have had the honor to work in the maternity department doing postpartum massage for Greenwich Hospital,” says maternity massage therapist Lisa Faski of Greenwich, Connecticut. “Patience, understanding and a flexibility of both time and body mechanics are essential to successful massage sessions in a hospital setting.”
Working around hospital beds and having equipment for innovative positioning is challenging, adds Faski. Precautions must be taken to provide safety and to avoid discomfort.
“Many obstacles may stand in the way of beginning a session on time or continuing through without interruption,” she adds. “Despite these and other difficulties, the rewards in this job are numerous. I am blessed to be a part of this very special time in the lives of these families.”
Some maternity massage therapists have successful cooperative ventures with other massage therapists, and others hire qualified therapists to staff their maternity massage therapy centers.
Successful maternity-massage therapists rely on comprehensive maternity knowledge at the core of their practices. After a few prenatal or postpartum sessions, most therapists find their basic massage training insufficient to safely meet the complex physiological, musculoskeletal and emotional concerns of the childbearing year.
Available continuing education training ranges from courses of several hours to modular programs totaling as many as 125 or 200 hours. Many employers require about 30 hours of maternity-massage therapy instruction, and most therapists find well-executed courses of this length to be appropriate learning experiences for their needs.
“I opened Sage Spa about six years ago, after 15 years in private practice,” says Susan Stratton, owner of Sage Spa in Brooklyn, New York. “Our 14 staff therapists serve a general clientele, including about 35 percent with maternity concerns. All therapists complete specific, quality perinatal massage therapy training.”
Therapists “must not only be able to do this work, they must also really want to do it,” Stratton adds. “They continue to learn, from each other and from the experts that I bring in to expand their expertise.”
Effective curricula include: normal pre- and perinatal physiology and progression; high risk factors and medical complications of pregnancy; research-based protocols for how to adapt your work or eliminate various massage therapy techniques and methodologies, depending on the individual, her health issues and trimester of pregnancy; how to effectively address common and specific prenatal, labor and postpartum needs; and how to consult with physicians or midwives when conditions warrant.
Some courses include required evaluations for course completion and certification. (Note: Most states have no specified requirements to practice maternity massage therapy.) Many therapists particularly appreciate an approach to maternity massage that is steeped in a deep trust for the normalcy and joy of pregnancy, along with a respect for its many challenges and possible risks.
Look for a course developed by a respected expert in this specialization and taught by experienced, career instructors. Confer with therapists in your area with advanced perinatal training for their impressions and advice on the value of their learning experiences. Compare curricula, completion requirements and learning strategies to find the best match for your interests and perspectives. Some courses are more exploratory of one’s own childbirth experiences; others are more or less technical and clinical in their approach. Course techniques include differing modalities, and practice recommendations on positioning, safety and effectiveness can be frustratingly contradictory or inspiring in their variety, depending on one’s perspective.
Reaching into the creative realm of pregnancy offers an abundance of magical moments and a promising career focus. You can become a maternity massage therapist, joining one of the fastest-growing massage-therapy specializations in complementary health care.
Carole Osborne is an internationally recognized instructor of maternity massage therapy who has been in practice since 1974. Author of Pre- and Perinatal Massage Therapy, her course by the same name prepares therapists for maternity work. She contributed to Penny Simkin and Phyllis Klaus’ book, When Survivors Give Birth, and to Teaching Massage Therapy. Her first book, Deep Tissue Sculpting, is also an established professional textbook. She was the American Massage Therapy Association’s 2008 National Teacher of the Year. For more information, visit bodytherapyassociates.com.