Perhaps one of the most promising areas in which massage therapy has been shown to be beneficial is working with pregnant clients.
Both complementary and alternative medicine (CAM) and obstetrics and gynecology (OB-GYN) journals have published papers showing the many benefits that massage therapy can provide these clients. Such benefits, according to research by Tiffany Field, Ph.D., published in 2010 in Expert Review of Obstretrics & Gynecology, include decreased depression, lessened anxiety and reduced leg and back pain.
In a 2005 survey, Shu-Ming Wang and colleagues found pregnant women actively seek out these benefits, and prenatal health specialists are more than willing to recommend such treatment.
The researchers found that almost 62 percent of pregnant women in the survey wanted CAM treatment, and almost the same percentage of prenatal health specialists were willing to recommend CAM for treating lower-back pain. Approximately 61 percent of these specialists would recommend massage therapy specifically for lower-back pain during pregnancy.
Before massage therapists treat their first moms-to-be, an entire system of record-keeping and liability should be considered when working with pregnant clients.
According to Judith Koch, director of education at the Institute of Somatic Therapy, massage therapists must take certain special precautions regarding documentation for pregnant massage clients. Koch specializes in developing content for online courses on prenatal massage, as well as presenting live seminars on the topic. (Koch is the paying sponsor of this MASSAGE Magazine Resource Center.)
Koch advises using the standard SOAP notes format many massage therapists already use for their clients. She doesn’t deviate from the SOAP format because “that format works well for all clients, regardless of condition.”
In addition to standard SOAP notes, Koch recommends putting together a release-form packet for each client. Such a packet should list common contraindications for prenatal massage.
Some examples Koch provided include pre-term labor or possible miscarriage; preeclampsia or eclampsia; gestational diabetes; deep vein thrombosis; or any other high-risk diagnoses from the client’s obstetrician.
This release form should also list the most common symptoms associated with each of these conditions. Koch elaborated that this form also “provides a space for the client to write out any of the above symptoms or any other conditions she has that may be relevant to massage, or to write ‘none.’”
The packet Koch recommends includes a contract for the client to sign stating that if she thinks she may be developing any of the listed symptoms or conditions, she is to contact her obstetrician immediately, ask her obstetrician if she should continue to receive massage, and keep the massage therapist aware of any new diagnoses prior to further massage treatments. Koch also recommended including in this contract a paragraph releasing the therapist from liability.
Complete Client Records
Prenatal massage is a valued therapy that can benefit the health of the pregnant client and her fetus. By offering a detailed intake process, including SOAP charting and release forms, the massage therapist engages in client education and—should any unforeseen medical complications arise—protection of her own practice’s assets.