In addition to gentle stretching, says Miller, prenatal massage includes long, integrating strokes to work the tension out of the muscles and improve circulation. Increasing the blood flow is especially helpful for the pregnant woman who does not get much exercise or motion, says Laura Favin, a prenatal massage therapist and national spokesperson for the American Massage Therapy Association. "It brings nutrition to the body and the fetus, and it flushes out toxins that are in the muscles back into the circulatory system." Because of this, massage has been shown to help alleviate the symptoms of edema and carpal tunnel syndrome.
Prenatal massage releases more than physical toxins, however. Often in this quiet, restful time, emotional concerns will surface.
"Women will deal with emotional issues sometimes on the massage table that they didn't realize were present until I start working on them," says Miller. She adds that massage therapists don't instruct or guide when these issues arise; they are simply "present" to the client, listening if she needs to talk, continuing the massage in silence, if she prefers.
Miller has seen many issues surface during her eight years as a therapist—many revolve around the pregnancy itself, particularly apprehension in first-time mothers. "After working with a woman for a month, I can see the transition as she begins to gain confidence in her body and to realize she can depend on it to do what it was designed to do." Massage, Miller asserts, aids in maintaining that mind-body connection. "The women I work with on a regular basis have shorter labors and do better in labor and delivery because they do have such a connection with their bodies," she says.
Prenatal massage benefits the baby, too. Miller says babies often move in response to her touch. She says she had one client whose husband could only feel the baby move just after a session.
There are times when prenatal massage can pose danger to the baby. Women in high-risk pregnancies or who have nausea or vomiting, fever, or discharge of any sort should check with the doctor before getting a massage. They should also check if they have abdominal pain or swelling beyond the usual edema. Additionally, Miller recommends waiting until after the first trimester to begin massage therapy. While massage is not dangerous, this is the time of highest risk for miscarriage, and Miller says she would not want a woman to feel massage had endangered the child.
After that time, Miller recommends monthly through the second trimester, then bi-monthly, then weekly, pretty much paralleling prenatal visits to the doctor or midwife. "The third trimester burden really takes its toll on a woman's body, and that's when she needs the work (massage)," says Miller.