Advice for the Massage Therapist: Postpartum Massage
The Postpartum Massage Session
Today, I want to reach out to my colleagues who wonder about postpartum massage and ways it might be different from a regular massage session.After 20 years as a massage therapist, I have made every fopaux in the book. As a mentor, I hope to save you as many awkward moments in your practice as I can. I hope this article helps get you well sorted for postpartum massage. After reading the benefits of postpartum massage (below), you might also want to learn effective bodywork for postpartum massage. If so you’re in luck! Check out my upcoming pregnancy massage certification! I will be teaching at my home in Nevada City. Come join this beautiful retreat and deep study.
From Prenatal to Postpartum Massage
You spend nine months helping out your pregnant client with regular massages and then the time comes -they have their baby! Every birth is so different. Generally though, what I’ve experienced, is that after birth there’s a time that my client will be retreating, adapting to their new life and bonding with their baby. They may also have children already and so, could be helping their children adapt to life with a new family member. No matter what their life circumstances, you can assume that they are navigating a lot. After they have their baby, there will suddenly be an empty place in your schedule. It’s bound to be soon replaced by a new client body but you just can’t help but wonder how your missing client is. After seeing them (and their baby) through one of the most dynamic times of their life, it’s absolutely understandable they would be on your mind!
How Do I Reach out After Baby Comes?
Those prenatal clients almost become like family and then ‘poof’, they’re gone. I always feel so happy for them and I also miss them. Sometimes, they will send me a photo of their new baby or eventually, I become curious about how they are doing. After a month or so goes by, if they have not contacted me, I will reach out.
Every Birth is Different
I never send a congrats email. Every birth is different. The last thing someone wants when having a challenging postpartum experience is to be addressed with expectations on where they “should be” in their journey. A “Congratulations” implies that they “should be” celebrating. There’s a possibility that there may have been complications in labor or adaption to parenthood might be challenging for your client. My advice to you is that if you were not present at the birth, then make no assumption about what’s taken place. Even if you were at the birth, you don’t know how it’s going for your client.
Rather than sending ‘congratulations’, send a message expressing curiosity in how your client is doing. I do this so I am sure to stay in rapport with them. If they respond, I’ll let them know that I’m here for them when they need me for postpartum bodywork or a relaxing massage. This respectful communication avoids any assumption that everything is well and leaves your client feeling accepted and supported.
When to reach out
Once your client is ready to receive a massage they’ll invite you to a house call or will come into the office. If you don’t hear from them in a couple months time, an email that highlights the benefits of postpartum massage with a coupon attached may be just what they need to ignite their attention towards self care once again. I have had so many clients thank me for reaching out. They are so wrapped up in adapting to their new life they completely forget about massage. Then they come in for their postpartum massage session and are in bliss!
Benefits of Postpartum Massage
- Promotes relaxation and lowers cortisol
- Improves circulation
- Reduces back pain, sciatica, ribs out, neck and shoulder pain from nursing, diaper changes and all of the looking downward
- Postpartum massage helps with milk production
- Releases muscle strain due to labor and lifting, carrying baby
- Balances hormones which can help decrease the onset of postpartum depression
- Helps the pregnant client heal from birthing the baby through natural childbirth or cesarean
- Prenatal and postpartum massage grows a peaceful, core understanding of connection that can travel from massage therapist to client and then client to baby/partner (when partnership is applicable).
- Offers the pregnant client a listening ear to voice any concerns or process their birth
- Relieves stress and promotes peace
Advice for the postpartum session:
This following are general guidelines I from my book. If you would like to learn specifics on what my postpartum steps are, sign up for my pregnancy massage training before it fills. I teach an inspiring postpartum section on Day 4. This class leaves you well resourced with any client experiencing postural restrictions and you will be carrying these steps out to all of your not-pregnant clientele for years to come.
Invest in a memory foam topper
Your postpartum client will be relieved that they finally get to lie on their belly, back or any position during their postpartum session. Their breasts may be sore and full of milk. A memory foam topper is helpful. Also I find a memory foam topper to be thoughtful to have for any massage therapist who does side-lying bodywork. No one wants to be on their side on a hard table. I encourage all of my students to invest in a memory foam topper. Your clients will love you for it!
MER Milk Ejection Reflex / Letdown (“Leaking”)
Breasts may leak breast milk during the session so provide a towel for your client to place under or over breasts whether lying prone or supine. The hormone oxytocin is active, which causes the milk ejection reflex (MER) or ‘letdown’.
What if clients baby wants to nurse during the session?
I let all of my prenatal clients know that when baby comes, they are welcome to come in for a massage with a baby sitter and that if baby needs to nurse it is not a problem at all. I can easily accommodate a nursing baby and client on my table in the side-lying position and we can get just as much accomplished.
Get to the neck first!
Normally the client feeds baby right before the session. As a general rule I start my client on their back and give them a wonderful neck massage so that is accomplished before baby needs to feed again. The neck is not as easy to access side lying whereas back and legs are. So, get to the neck first!
The importance of gentle and soft abdominal massage is crucial after a C section to help break up scar tissue. The surgeon’s cut may have been precise but scar tissue forms differently for everyone , sometimes irregularly and may even create adhesions over internal organs. Gentle massage will help break up those scar patterns so the client does not have unwanted back or pelvic pain. Adhesions can also prevent further pregnancies which is another reason to be sure to offer abdominal massage. Any abdominal massage or core recruitment requires a wait until about 6-8 weeks when scar is healed and scar tissue is formed.
“Adhesions are bands of scar-like tissue. Normally, internal tissues and organs have slippery surfaces so they can shift easily as the body moves. Adhesions cause tissues and organs to stick together. They might connect the loops of the intestines to each other, to nearby organs, or to the wall of the abdomen. They can pull sections of the intestines out of place. This may block food from passing through the intestine. Adhesions can occur anywhere in the body. But they often form after surgery on the abdomen.”11 NIH > U.S. National Library of Medicine > https://medlineplus.gov
Your client has just gone through one of the biggest passages of their lives and will probably want to share their birth experience as you work. Allow for this unwinding with a listening ear. Eventually, they will drop into receiving your touch. Telling their story will help the process of letting go into the present moment. The more present they can be with themselves, the more present they can be for their baby. If their birth was traumatic invite them to make eye contact with the version of themselves who was going through all of that and show the one who was in the middle of the trauma that she made it. Let her inhale this into every cell as she arrives to the present moment.
“The postpartum period has been termed the “fourth stage of labor”, and has three distinct but continuous phases.
The initial or acute period involves the first 6–12 hours postpartum. This is a time of rapid change with a potential for immediate crises such as postpartum hemorrhage, uterine inversion, amniotic fluid embolism, and eclampsia.
The second phase is the subacute postpartum period, which lasts 2–6 weeks. During this phase, the body is undergoing major changes in terms of hemodynamics, genitourinary recovery, metabolism, and emotional status. Nonetheless, the changes are less rapid than in the acute postpartum phase and the patient is generally capable of self-identifying problems. These may run the gamut from ordinary concerns about perineal discomfort to peripartum cardiomyopathy or severe postpartum depression.
The third phase is the delayed postpartum period, which can last up to 6 months (1). Changes during this phase are extremely gradual, and pathology is rare.
This is the time of restoration of muscle tone and connective tissue to the pre-pregnant state. Although change is subtle during this phase, it behooves caregivers to remember that a woman’s body is nonetheless not fully restored to pre-pregnant physiology until about 6 months post delivery.”2Postpartum period: three distinct but continuous phases, Mattea Romano, Alessandra Cacciatore, Rosalba Giordano, and Beatrice La Rosa, J Prenat Med. 2010 Apr-Jun; 4(2): 22–25. Journal of Prenatal Medicine
Good luck to you on your massage journey!
I hope after reading this you now feel ma little more resourced to incorporate pregnancy massage into your practice.
Aside from quotes from other articles, this article is written in an all-inclusive, non-binary writing style that honors all gestating clients. We do not need to use she her moms and mothers to describe the pregnant, laboring or postpartum client. See my book, “A Dynamic Guide to Pregnancy Massage” for more of my non-binary writing.