MamaBabyBliss Pregnancy Massage Manual · The baby’s skin is the first organ to develop in the womb and even from very early on a baby can feel and communicate through its skin

MamaBabyBlissPregnancyMassageManual.docx ©MamaBabyBliss2017

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MamaBabyBlissPregnancyMassageTrainingCourse

CPDDiplomaForTherapistsCourseOverview

WelcometotheMamaBabyBlissPregnancyMassageTrainingCourse.TheaimofthecourseistoteachPregnancyMassagetoqualifiedmassagetherapistsandotherfullyqualifiedbody-workers.AllcandidatesmusthaveapreviousqualificationinAnatomy&Physiology.TheTrainingPackageincludesthefollowinglearningmaterials:

• A75-minuteinstructionalvideothatincludesafilmeddemonstrationoftheentirePregnancyMassageSequencebeingdemonstratedonapregnantwoman,withdetailedclose-upsandinstructionsofalltherelevantsegmentsandmassagestrokes.

• ThevideoalsoincludesasegmentonMassageforLabour.

• AdetailedPregnancyMassageCourseManualthatcoversdetailedinformation:

o TheBenefitsofPregnancyMassageo ConsiderationsforaConsultationo ContraindicationsforPregnancyMassageo EquipmentListo UseofMassageOilso PregnancyMassageSequence:anoverview–thiswillbesupportedbythevideoo MassageDuringLabour–thiswillbesupportedbythevideoo CommonAilmentsDuringPregnancyo HowMassageCanAidParticularAilmentsDuringPregnancyo Baby’sDevelopmentintheWomb(canbegiventoclients)

• Thetrainingalsoincludesmoduleson;

o AdaptationsforPostnatalMassageandMini-TreatmentsforNewMotherso MassageTechniquesforLabour


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CriteriaforQualification

• FirstofallyoumustreadthePregnancyMassageTrainingManualandwatchthePregnancyMassageTrainingvideo.Werecommendyoudothisseveraltimesuntilyouareconfidentwiththestrokes.

• Aspartofyourqualification,youwillberequiredtosubmitthreecasestudiesforpregnancymassagethatmustbesupportedbydetailedwrittenClientModelReflectiveEvaluationsforeachmassagesession(seeattached).Studentsmaymassageonevolunteeroverthreesessionsorthreeindividualvolunteers.(*ForDistanceLearningcandidatesonly)

• StudentsmustalsosubmitasignedPre-natalMedicalHealthCheckforeachvolunteer(see

attached),andobtainasignedClientDeclarationFormfromeachvolunteertovalidatetheirpracticaltraining(seeattached).Thiswillalsoenableustocontacteachcasestudy,ifnecessary.Thehealthcheckcanbeprintedandusedforyourfutureclientsonceyouhavequalifiedandwerecommendyougothroughthehealthquestionnairebeforeyourclientarrivesforherappointmentinordertoavoiddisappointmentshouldshehaveanycontraindications.

• Aspartofthefinalassessmentprocess,allstudentswillberequiredtosubmitaWorksheet

onPregnancyMassage,Anatomy&Physiology(seeattached)soastoensureyouhaveathoroughunderstandingofthebenefits,contraindicationsandkeyaspectsoftheAnatomy&PhysiologyofPregnancyMassage.


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TheBenefitsofMassageinPregnancyMassageduringpregnancycanofferarangeofwonderfulbenefits.Notonlycanithelpawomantorelax,massagecanalsohelpsupportherbodyandhermindduringatimeofmajorphysiologicalandemotionalchanges.Aswellasprovidingbenefitsthroughoutpregnancy,massagecanalsoprovidevaluablesupporttoawomanandherpartnerthroughoutlabourandbirth.Massagecanbeenjoyedthroughoutpregnancyfrom14weekson,butespeciallyduringthesecondandthirdtrimesters,massagecanhelpsupportawomanasherbodyundergoesthevariousstressesandstrainsthatcandevelopthroughoutthelatterstagesofpregnancy.Massagecangenuinelyhelptorelieveachesandpainsandothercommonhealthproblemsexperiencedduringpregnancy.Massagealsohasmanybenefitsforherbaby.Thebaby’sskinisthefirstorgantodevelopinthewombandevenfromveryearlyonababycanfeelandcommunicatethroughitsskin.Aswellasthis,recentstudieshaveshownthatunbornbabiesareaffectedbyanystresstheirmotherisexperiencing.Evenfromasearlyas17weeks,motherswhoarestressedinpregnancy'transmit'theeffecttotheirunbornbaby.Thereforeitisvitalthatmothers’stresslevelsremainataminimumthroughouttheirpregnancyandmassagecanbehugelybeneficialinachievingthis.


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ConsiderationsforYourPregnancyMassageConsultation

Pregnantclientshaveveryspecificneedsandyouneedtotakethefollowingintoconsideration,soastoensuretheirsafetyandcomfortatalltimes.PleaserefertothePregnancyMassageTrainingvideoforfurtherguidance.

• Ensurethatyourmassagecouchcanaccommodateapregnantclientbothintermsofweight

andwidth.Bearinmindthatyouwillneedtobeabletoaddanextracushionunderherbellysothetableneedstobewideenoughtoaccommodatethis.

• Manywomenarewearyoflyingontheirstomachduringpregnancyanditisrecommendedthatapregnantclientbemassagedlyingonhersidetoavoidcompressiononthestomach.Theabdomenalsoneedstobesupportedinthesidelyingposition.

• Forthatreason,makesureyouhaveextrapillows.Youwillneedoneunderyourclient’s

head,onetosupporttheabdomenandonetoplacebetweenherlowerlegsasshewillbelyingonherside.Checkthatyourclientiscomfortableandwellsupportedbeforeyoubegin.

• Youwillneedatleasttwolargetowelstocovertheclient,dependingonthestageofher

pregnancy.Whenexposingdifferentpartsoftheclient,youneedtomakesurethatshefeelsfullycoveredandsecure.Attheendofthemassage,youmaywishtousealightblanketandmakesurethatyourclientiswellcovered.

• Useanappropriatemassageroutinetakingintoaccountyourclient’sneeds.Itisessentialto

conductadetailedmedicalhealthchecktoassessyourclient’scasehistorysothatyoucanaddressanyailmentsshemighthave.

• Makesuretheclientiscomfortablebeforecommencingthemassage.Itisagoodideatoask

yourclienttoemptyherbladderbeforehand,aspregnantwomenoftenneedtopoptotheloo.

• Checkwiththeclientifthepressureisappropriateandaskhertoadviseifthereisany

discomfortduringthemassage.Rememberthatwhatthemotherexperiencesi.e.paincanalsobepickedupbythebaby.

• Pregnantwomenmaysufferfromdryskin,soitisimportanttouseagood,nourishingoil

(visitwww.mamababybliss.comtopurchaseTummyLovePregnancyMassageOil).Youshouldnotuseanyessentialoilsunlessyouarequalifiedinaromatherapyassomemaynotbesafeorsuitableforpregnancy.

• Afterthemassage,makesurethatyougiveyourclientplentyofwatertodrinkandthatyou

ensureshecomesoffthecouchgentlyandslowly.

AdditionalEquipmentYouWillNeedAnti-bacterialwipes,afootstool(thisisoptionalbutaclientmayfinditusefultohelphergetonandoffthecouch),oneortwoextrahand-towels,tissues.


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Contraindications

PLEASENOTE:MASSAGESHOULDBEAVOIDEDDURINGTHEFIRSTTRIMESTEROFPREGNANCY(i.e.THEFIRST14WEEKS)ASWOMENAREATHIGHERRISKOFMISCARRIAGEDURINGTHISTIME

Inmostcases,pregnancymassagecanbereceivedsafelyfrom14weeks.However,therearecircumstances,whereitisnotappropriatetoreceiveamassage.Itisessentialthatyouconductamedicalhealth-checkandcasehistorypriortoconductingthemassageandifawomanhasbeendiagnosedorisexperiencinganyofthefollowingshemayNOTbemassaged:

• Morningsicknessorextremenausea• Heavyvaginaldischargeorifitis

bloodyorwatery• Highbloodpressure• Pre-eclampsia• Diabetes(iftakingmedication)

• Hightemperature/fever• Abdominalpainorcramping• Vomiting/diarrhoea• Unusualpain• Contagiousillness

Aswellastheabove,theusualcontraindicationsforgeneralmassagewillapply.

Ifaclienthasbeendiagnosedwithahigh-riskpregnancy,cautionmustbeexercisedandwrittenmedicalconsentmustbeobtainedbyyourclientpriortoanymassagebeingundertaken.TheDepartmentofHealth,SocialServicesandPublicSafetyintheUKdefinesahigh-riskpregnancyasanyofthefollowingconditions:Maternal(i.e.conditionsthemothermayhavebeforebirth):

• Hypertension• RenalDisease• Respiratorydisease• CardiacDisease• Haemoglobinopathy• Infections(e.g.varicella)• PsychiatricConditions• Drugmisuse• Obesity

Perinatal(aconditionthemothermayhavesufferedfrom,justbeforeorafterthecurrentoranypreviousbirths)

• “BadObstetricHistory”• Re-currentPregnancyLoss• Prematurity(includingruptureof

membranesandlabour)• MultiplePregnancy• RhesusDisease• AssistedConception• FoetalAnomaly

ComplicationsDevelopingDuringPregnancy

• PlacentaPraevia• Foetalgrowthrestriction• GestationalDiabetes

Ifyouareinanydoubtwhethertomassageatanystageofherpregnancy,pleaseasktheclienttoobtainGPconsent.


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ThePhysiologicalChangesDuringPregnancy

Womensufferfromanumberofproblemsduringpregnancyandmassagecanbeextremelybeneficialformanyofthem.Themostcommonailmentsthatwomenmaysufferfrominclude:

• Lowerandupperbackpain• Sorenessandtensionintheshoulders• Swellingofhandsandfeet(oedema)• Soreorachingwrists–carpaltunnelsyndrome• Headaches• Calfcrampsor‘twitchylegs’• Insomnia/fatigue/anxietyoroveralltiredness• Sciaticpain• Heartburn• Morningsickness• Sinuscongestion• Muscularstiffnessandcramp• SPD–symphysispubisdysfunction• Moodswings• Increaseintheneedtourinate

Manyofthesesymptomscanbeattributedtothenaturalchangesthatshehasundergoneduringherpregnancythatwillhaveanimpactonherbody,mindandemotionalstate.Massagecanbeextremelybeneficialinhelpingalleviatemanyofthesymptomsassociatedwiththesephysiologicalchanges.

TheMuscularandSkeletalSystem

Duringpregnancy,awomancanputonanywhereupto40lbs.inweight,largelyaroundherabdomen,hips,buttocksandthighs.Thisincreaseinweight,alongwiththebaby’spositioninthewomb,canaffectthemuscles,nervesandmobilityofherjoints,causingsomeverytypicalpregnancyailments.Becausethemajorityofextraweightisdistributedaroundherabdomen,itnaturallycausesthewoman’scentreofgravitytoshiftforwardandsocanalterherposturesignificantly.Tocompensate,thenaturalcurveofthespineinthelumbarregionbecomesexaggerated,whichcauseslowerandupperbackpain.Mostwomencontinuetoworkthroughouttheirpregnancy,whichcanalsoexacerbatetheproblemandaddtensionandsorenesstotheupperbackandshoulderregion.Tohelpstabilisethebodyandtohelpaccommodatethegrowingbaby,thehipsmayalsoexpandlaterally,puttingadditionalpressureonthesacroiliacjoints,causinglowerbackacheandsorenessinthemusclesoftheareaastheystretch.Asthebabyandtheuterusgrows,itcanalsocompressthesciaticnerveandwomenmayalsoexperiencesciaticpaindownthebackofthethigh,lowerpartofthelegandthesoleofthefoot.


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TheCirculatoryandLymphaticSystemDuringpregnancy,thevolumeofbloodinapregnantwoman’sbodycanincreasebyupto50%.Themother’shearthastoworkharderbecauseasthefoetusgrows,ithastopumpmorebloodtotheuterusandbytheendofpregnancytheuterusisreceivingonefifthofthewoman'spre-pregnancybloodsupply.Byboostingcirculation,massagecanhelpeasetheloadonthemother’sheartandhelptokeepherbloodpressurestable.Massagewillalsohelpbringoxygenandothervaluablenutrientstothecellsofboththemotherandbaby.Astheuterusgrowsbigger,itcaninterferewiththereturnofbloodfromthelegsandthepelvicareatotheheart.Asaresult,swelling(oedema)iscommon,especiallyinthelegsandankles.However,swellingcanalsooccurinthewristsduetotheincreaseofinterstitialfluid,leadingtocarpaltunnelsyndrome.Massagecanhelpthemother’sbodytoeliminatewasteproductsthroughthelymphaticandcirculatorysystems,whichcanhelpreducetheswellinginherlimbs.Itiscommonforvaricoseveinstodevelopinthelegsandthesameconsiderationsaswithregularmassageneedstobetakenintoaccount.

TheEndocrineSystem

Hormonesplayanessentialroleduringpregnancypreparingthebodyforbirth.Becausethebodyishavingtogrow,tomakespaceandprepareforbirthingababy,certainhormonesarereleasedduringpregnancythatcausemuscles,ligaments,cartilageandbonestosoften.Asthepregnancyprogresses,thereleaseofthehormone,relaxin,allowsligamentsofthepelvistosoften,soastoenablethebabytotraveldownthebirthcanal.Sometimes,relaxincanbeproducedearlyon,whichcancausesorenessandachinessinthehipandgroinareaknownassymphysispubisdysfunction(SPD).Thisisnotacontraindicationtomassage,however,clientsmayneedhelpwhencomingonandoffthemassagecouchandafootstoolshouldbeprovided.Humanchorionicgonadotropin(HCG)-ahormonethatisuniquetopregnancy–isproducedbytheplacenta,whichhelpsstimulatetheproductionofprogesterone.Progesteronehelpssoftensmoothmusclesandisessentialforenrichingthehealthoftheuterusandthefoetus.However,itcanalsoleadtoproblemssuchasvaricoseveins,constipationorhaemorrhoids.Anincreaseofoestrogencausesbreaststoswellandcancausesorenessandtenderness,whichisanotherreasonwhywomenshouldnotbemassagedontheirfront.Fluctuatinghormonelevels,alongwithtirednessandpotentialanxietyabouttheimpendingbirthcanalsoleadtoapregnantwomanbeingmoreemotionalandsensitivethanusual.Massagecanalsobeextremelybeneficialforbalancinghormonelevelsandhelpingtoreleasestress-relievinghormonessuchasoxytocinandendorphins.

TheDigestiveandRespiratorySystemAstheuterusbeginstogrow,itpushesthestomachupwardstowardsthediaphragmandcompressestheinternaldigestiveorgans,whichcancauseheartburn,averycommonailmentinlatepregnancy.Thegrowinguterusalsocreateslessspaceforthediaphragmandlungs,whichcausesshortnessofbreath.Boththeseailmentscanbeexacerbatedbyphysicalexertionandstress.Massagewillhelpawomantorelaxandreleasethehormoneoxytocin,whichwillhelpreducestresslevelsandsohelpalleviatethesesymptoms.


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TheUrinarySystemDuringpregnancythekidneysneedtoworkhardertofiltertheincreasedvolumeofbloodandthisfilteringprocessresultsinmoreurine.Also,thegrowingsizeandpositionoftheuteruscanleadtoanincreaseintheneedtourinate.Becauseofthis,womenoftenneedfrequentlootripsatnightthatcancauseextremetiredness.Arelaxingmassagecanprovideawomanwiththewelcomeopportunitytorestandhelphersleepatnight.


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HowMassageCanAidParticularAilmentsInPregnancy

PLEASEWATCHTHEPREGNANCYMASSAGEVIDEOFORAPPROPRIATE,RELEVANTMASSAGETECHNIQUESANDREADTHESECTIONOFYOURMANUALON‘BABY’SDEVELOPMENTINTHE

WOMB’

FirstTrimester1-13WeeksThiscanbeatimeofgreatanxiety.Thereisahigherriskofmiscarriageduringthistrimester,sowomen,althoughtheymaybeexcitedaboutthepregnancy,mayfeelreluctanttosharethenewswithfamilyandfriends.Duringthistime,asthebodyadaptstothepregnancy,italsoundergoesmanychanges.

• Themusclesandfibreoftheuterusarebeginningtolengthenandthicken.Byweek12theuterusisbeginningtomoveoutofthepelvis,becominganabdominalorganandtheheartispumpingextrabloodtofeedthealreadydevelopingbaby

• Hormoneproductionincreasesgreatly.Progesterone,forexamplehelpstomaintainthepregnancyandlowerbloodpressure,whileoestrogenstimulatesdevelopmentofthemilkglandsandstrengthenstheuterus.

• Thesehormonalchangeswillalreadycausethemother’sbreaststoswellandtheymaybecometender

• Themother’smetabolicrate,breathingrateandheartratewillallhaveincreasedasthebodyadjuststothepregnancy.

• Shemayexperiencenauseacommonlyknownas‘morningsickness’althoughitcanoccuratanytimeofday.

• Asthebodyisadaptingtopregnancy,manywomenexperienceextremefatigueandtirednessduringthefirst12weeks.

• Shemayfeelnervousoranxiousaboutthepregnancy,especiallyduringthefirsttrimester.• Frequenturinationmayoccurasthehormonelevelsarechanging.

Pointstonote:Theriskofmiscarriageismuchhigherduringthefirsttrimesterthanany,soitisacontraindicationtomassageapregnantclientduringthefirsttrimester.Iftheclienthasahistoryofhigh-riskpregnancies,pregnancycomplications,ormiscarriage,youmustensurethattheclienthasobtainedGPconsentbeforeyouconductthemassage.Pleasenote:morningsicknesscanalsocontinueafterthefirsttrimester.Iftheclientsuffersfrommorningsickness,itmaybeadvisabletoavoidmassagingthestomacharea,asthismaymakethesymptomsworse.


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SecondTrimester14-26WeeksThisisthetimewhenmothersoften‘bloom’.Herhormonelevelsshouldhavestabilisedasherbodyhasadjustedandsettledintothepregnancy.Sicknessandexhaustionwillhavelessenedandherappetiteshouldhavenormalisedandherenergywillhavereturned.Themotherwillfeelalotlessanxiousandwillbemoreconfidentabouttalkingopenlyaboutherpregnancy.

• Thedigestivesystembecomessluggishallowingtimeforthebabytoabsorbvitalnutrients.Thismaycauseconstipationandheartburn.Stresscanmakeheartburnworse,soamassagewillhelptoreduceanxietyandtensionandcanhelpeasesymptoms.

• Duetotheincreaseddemandsplacedonthewoman’sbody,irondeficiencyandanaemiaiscommon.Thisisaconditioninwhichthereisinsufficienthaemoglobinintheblood.Symptomsmayincludetiredness,lossofappetite,brittlenails,dizzinessandpaleskin.Aswellasincreasingtheirironin-take,afullbodymassagecanhelpasitwillhelpboostbloodandlymphcirculation,plushelprelievetiredness.Bystimulatingcirculationitwillalsoraisetheredbloodcountandthereforeproducemorehaemoglobin.

• Backacheinpregnancyoftenoccursasaresultofthewoman’schangingpostureasthebabygrows.Massagecanhelpgreatlyasitwillhelploosenanytightmusclesandhelprelievetensionintheback

• Ligamentsandjointsarebeingsoftenedbyhormonalaction.Inthepelvisthiscanleadtosymphysispubisdysfunction,whichcanbeverydebilitating.Massagecanalsoassistinhelpingreleaseoxytocinandendorphins,whichcanhelpminimisethediscomfortandpain.

• Migraineandheadaches–tenpercentofpregnantwomensufferfrommigraine.Headachescanalsobecausedbyhormonalactionorbystressortensiononthehead,neckandshoulderareaasaresultofpoorposture.Massagewillagaingreatlyassistinrelievingtensionandimprovingbloodcirculation.

• Themothermayexperienceshortnessofbreath,astheuterusmoveshigherupintheabdominalcavity.Massagecanhelpawomantorelaxandsoencouragedeeperbreathing.

• Asthe‘bump’grows,theskinwillstretchcausingtightnessandstretchmarks.Somewomenalsoexperienceachangeinskinduringpregnancysuchasthelineanegraorchloasma.Massagewithagoodnourishingoilcanhelpmoisturiseandsoothetheskin.

Pointstonote:

• Pregnantwomenshouldnotlieontheirbacksinasupinepositionforlongperiodsastheweightoftheuteruscanputpressureonthevenacavaandreducethebloodsupplybacktotheheart,resultinginfaintnessandlowbloodpressure.Formassage,womenshouldbeencouragedtolieontheirside.


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ThirdTrimester26-40WeeksThethirdandfinaltrimesterisanexcitingtimeaswomenbegintoapproachthebirthoftheirbaby.However,itisalsothetrimesterwheremanywomenbegintoexperienceevenmoreailmentsasthebabycontinuestogrowtofull-termandtheirweightcontinuestoincrease.Theywillstillexperiencemanyofthesameailmentsasinthesecondtrimestersuchasbackacheandheartburn(possiblyevenmoreextreme)andsomeothers.

• Thecirculationisworkingtwiceashardasitusuallydoes,solegcramps,oedema(swellingintheanklesandhands)canbeacommonsymptomsoflatepregnancy.Massagecanbeveryhelpfulinhelpingtoboostcirculationandencouraginglymphtomovearoundthebody,helpingtoremovetoxinsandreduceswelling.

• Insomecases,womenmaydevelopcarpaltunnelsyndromeduetotheswellinginthehandsrestrictingnervesinthewrist.Aswellasmassage,womencanbeencouragedtorotateandflextheirwriststohelpimprovelymphaticdrainage.

• Atthisstagetheheartisworking25%harderandpressurefromtheuteruspreventsthelungsfromexpandingfully,whichcancauseevenmorebreathlessness.Massagewillagainhelpbyboostingthecirculationandrespiratorysystem.

• Asthebabyhasgrownevenmore,heartburnmaybecomeworse.Aswellasthebenefitsofhavingamassage,womenshouldalsobeadvisedtoeatsmallmealsandkeepthemselvesproppedupatnightonpillows,iftheproblembecomessevere.

• Thebabybeginstodescendwhichplacespressureonthebladder.Womenwillneedtomakeevenmorefrequenttripstotheloo,oftenseveraltimesatnight.Thiscancausetiredness.

• Becausethebabyisheavierandbeginningtodescenddown,shemaybeexperiencingpaininthelowerbackandsacralarea.Massagewilldefinitelyprovidewelcomerelieffromthebabybearingdowninthisarea.

• Manywomenalsobegintofeelanxiousandstressedatthisstage.Theymayfeelworriedabouttheimpendingbirthandthepreparationstheystillneedtomake.Mostwomenalsoworkuntillateintotheirpregnancyandsomaystillhavetobalancethepressuresofworkandtheadditionalphysical,mentalandemotionalstressesandstrainstheyaregoingthrough.Massagecanbeinvaluableinhelpingrelievephysicaltensioninthebodyandhelpingreduceanxietyandtheexhaustionthatmanywomenexperienceinthelaterstagesofpregnancy.

Pointstonote:• Atthisstagetheemphasisshouldbeonrelaxationandhelpingrelieveanysymptomsofthe

above.Alwayscheckwiththeclientaboutwhatpressureisappropriateduringmassageasshemaybemoresensitivetodeeperstrokes.

• Alwayscheckwiththeclientastowhethershehashighbloodpressure.Ifsheissufferingfromhighbloodpressure,massageMUSTBEAVOIDEDandshemustbeadvisedtoconsultherGPassoonaspossibleasthiscouldbeanindicationofpre-eclampsia.


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Baby’sDevelopmentintheWombThedevelopmentofyourbabyinthewombisawonderfulprocess.Wehavecompiledamonth-by-monthtimescaleofwhathappensinthewomb.Butkeepinmindthatdifferentpregnanciesdodevelopatdifferentrates.Also,bearinmindthatthemethoddoctorsandmidwivesusetodateyourpregnancymeansthatyoucouldbearoundtwoweeksoutfromthistimescale.Inthisdescription,wehaveadoptedthemethodthatdoctorsuse.Forexample,wherewewrite"week8"wehavecountedthisfromthefirstdayofyourlastperiod-yourbabywillusuallyonlybesixweeksoldatthispoint.

HowdoctorsdateyourpregnancyTheaveragepregnancylastsfor38weeksfromthedateyouconceive(thisiscalledconception).However,doctorsusuallydateyourpregnancyfromthefirstdayofyourlastmenstrualperiod-thatisthedayyourlastperiodstarted.Usingthismethodapregnancyissaidtolast40weeks(280days).Yourduedateisusuallycalculatedas40weeksfromthefirstdayofyourlastperiod.However,fertilisationofyoureggbyspermhappensadayortwoafterovulation,whichoccursinthemiddleofa28-daycycle,andthenitisacoupleofdaysbeforethefertilisedeggimplantsintheuterus,soforthefirsttwoweeksofthe40-week"pregnancy"youarenotactuallypregnantatall.

Firstmonth

Aftertheegghasbeenfertilisedbythesperm,itstartstodivideintomorecells.ThishappensallthetimeitiscarriedalongtheFallopiantubetotheuterus.Bythetimeitreachestheuterusthefertilisedegghasbecomeaclusterofcellswhichfloatintheuterinecavityuntilitembedsinthewalloftheuterus.Thisimplantationinthewalloftheuterusiswhenconceptioniscomplete.Thisisroughlyfourweeksafterdayoneofthelastmenstrualperiodifyouhavea28-daycycle.

SecondmonthAtfiveweekstheembryoisthesizeofagrainofrice(about2mmlong)andwouldbevisibletothenakedeye.Ithasthebeginningsofabrainwithtwolobesanditsspinalcordisstartingtoform.Atsixweeksof"pregnancy"(threetofourweeksafterfertilisation)theembryohasaheadwithsimpleeyesandears.Itshearthastwochambersandisbeating.Smallbudsarepresentthatwillformarmsandlegslater.Thebeginningsofthespinecanbeseenandthelowerpartofthebodylookslikeatail.Atsevenweeks,thelimbbudshavegrownintoarmsandlegs.Nostrilscanbeseenontheembryo'sface.Theheartnowhasfourchambers.Ateightweeks,theeyesandearsaregrowing,andyourbabyisabout2cmlongfromcrowntorump.Theheadisoutofproportionwiththebodyandthefaceisdeveloping.Thebrainandthebloodvesselsintheheadcanbeseenthroughthethinskin.Thebonesinthearmsandlegsstarttohardenandelbowsandkneesbecomeapparent.Fingersandtoescanalsobeseen.


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ThirdmonthWhatisknownastheembryonicperiodfinishesattheendofweek8andthefoetalperiodbegins.Thisperiodseesrapidgrowthofthefoetus,andthefurtherdevelopmentoftheorgansandtissuesthatwereformedintheembryonicperiod.Atweek9theheadisalmosthalfthecrowntorumplengthofthefoetus.Thenthebodygrowssubstantiallyinlengthuntilbyweek12,theheadismoreinproportion.Bythetimeyouare12weeks'"pregnant",yourbabyisjustover5cmlongfromcrowntorump.Itsbodyisfullyformed,includingears,toesandfingerscompletewithfingernails.Theexternalgenitalsappearedinweek9,andnow,byweek12,havefullydifferentiatedintomaleorfemalegenitals.By

week12theeyeshavemovedtothefrontofthefaceandtheeyelidsremainclosedtogether.

FourthmonthYourbabymaysuckitsthumbnow.By14weeksyourbabywillbeabout9-10cmlong.Itsbodyisnowcoveredwithalayeroffinehaircalledlanugo.By16weeksitsfaceisbecomingmorehumaninappearance,althoughthechinissmallandthemouthisquitewide.Between16and24weeksyoushouldfeelyourbabymoveforthefirsttime-itmayatfirstfeellikebutterflies.

Fifthmonth

Therapidgrowththatyourbabyhasbeenexperiencingnowbeginstoslowalittle.Byweek20yourbabymeasuresabout18cmfromcrowntorumpandishalfaslongasitwillbewhenborn.Thelegsarenowinproportionwiththebodyandthefingernailsarewelldeveloped.Fainteyebrowsarevisible.Atthisstage,youwillfeelyourbabymovingaboutalot,oftenwhenyouliedown.

SixthmonthBy24weeksyourbaby'sorgansarefullyformed.Thebabynowhasthefaceofanewbornbaby,althoughtheeyesareratherprominentbecausefatpadsareyettobuildupinthebaby'scheeks.Theeyelidsarefuseduntilweeks25to26whentheyopen.Theskiniswrinkled,redandthinwithlittleunderlyingfat.Theskiniscoveredwithawaxysubstancecalledvernix,whichprotectsitwhileitisfloatingintheuterus.Thebodyiswellmuscled,butstillthin.Thebabyhasbecomebetterproportioned,withthesizeofthebodycatchingupwiththesizeofthehead.Yourbaby'shearingisalsowelldevelopedbythisstage;thebabywillrespondtonoise.


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SeventhmonthBy28weekslanugohairhasalmostgoneandhairispresentonthehead.Fatisbeingdepositedundertheskin.

EighthmonthYourbabyisbecomingplumper.By30weeksthetoenailsarepresentandby32weeksthefingernailshavereachedtheendsofthefingers.Thebaby'seyeswillbeopenwhenthebaby'sawake.Byabout32weeksthebabywillhavesettledintoadownwardpositionasthereisnolongerenoughroomleftinthewombforittomoveaboutfreely.Youwillfeeloccasionalvigorousjabsofthebaby'sarmsandlegs.Ifyourbabyisaboy,histesteswillmigratedownintothescrotumintheeighthmonth.

Ninthmonth

Sometimebetween36and40weeks,thebaby'sheadwillengage-thatis,theheadwillbelyingjustontopofyourcervix.By40weeks,yourbabyshouldbeplumpandhealthy.Thelanugohairthathadcoveredyourbabyhasnowmostlydisappeared,althoughsomehairmayremainlowontheforehead,infrontoftheearsanddownthecentreoftheback.Thetoenailsshouldhavereachedthetipsofthetoes.

Fullterm

Byfull-term,yourbabyshouldweighabout2.7-3.5kg,althoughfull-termbabiescanweighanythingfrom2.5-5kg,andmeasure35-38cmfromcrowntorumpand44-55cmfromthebaby'sheadtoitstoes.Thesearejustaveragefigures,though,andtherecanbewidevariationinthemeasurements.Sonow,38weeksafterconception,yourbabyhasallitsorgansandbodysystemsreadyforthebigmomentwhenitisbornintotheworld.


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PregnancyMassageSequence

PLEASEREFERTOMAMABABYBLISSPREGNANCYMASSAGEVIDEOFORAFULLDEMONSTRATIONOFEACHSEQUENCEPRIORTOCOMMENCINGTHEMASSAGE

Alwaysensureyouhaveconductedadetailedmedicalcheckandcasehistorywithyourclient.Massageshouldbeavoidedifyourclientissufferingfromhighorlowbloodpressureandalwaysseekmedicalconsentifanyothermedicalconditionsareidentified.Itisimportanttocheckifyourclientissufferingfromanycommonpregnancyailments,sothatyoucantailorthemassageaccordingly.Thesemayincludebackache,soreshoulders,swollenlegs,generaltirednessormildanxiety.Itisalsobesttoaskyourclienttoemptyherbladderbeforethemassagebegins.Yourclientshouldbemassagedwithoutanyclothingonotherthanherunderwear.

Whatyouwillneed

Youwillneedastableandsolidmassagecouchthatissuitabletotaketheweightofapregnantclient.Asyouwillbemassagingyourclientonherside,youneedtomakesurethatthecouchiswideenoughtocomfortablysupportherwhilesheislyingonherside.Youshouldhaveatleast3pillows:oneforunderyourclient’shead,onetosupportherbellyandonetoplacebetweenherlowerlegs.Youwillalsoneedtwolargetowelstocoveryourclientandablanketifnecessary.Useagoodnourishingoilbutavoidanyessentialoils,assomemaynotbesafeforpregnancy.Youwillalsoneedacoupleofsparehandtowelsandapackofanti-bacterialwipes.Itisalsoagoodideatohaveafootstooltohandtohelpyourclientgetandoffthecouch.Youmayfinditusefultohaveanextrachairtohandtoplaceanyextraitemslateron.

PositioningYourClient

Placeacushiononthebedforyourclient’sheadandaskyourclienttoliedownonherside.Itdoesnotmatteronwhichsideyouchoosetostart,asyouwillbemassagingbothsidesofyourclient.Nowplaceacushionunderyourclient’sbellyforsupportandanothercushionbetweenherlegs.Coveryourclientwithtwotowelsandcheckthatsheiscomfortable.

MotherandBabyRelaxationTobeginrestyourhandonyourclient’sarmandherbaby,makingsureyouhaveaskedpermissiontotouchherbellyfirst.Nowaskyourclienttotakethreedeepbreathsinandout,andbreathetogetherwithher.Thisisalovelywaytoconnecttoyourclientandherbaby.


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BackMassageManywomensufferfrombackacheduringprenancy,soitisworthspendingsometimeconcentratingonallareasoftheback.Itisimportanttocheckwithyourclientduringyourmedicalevaluationifthereareanyparticularareasthatshewouldlikeyoutofocuson.Applysomeoiltoyourhands.Beginwithsomesoothingstrokesofeffleuragetowarmupthearea.Onceyouhaverepeatedthisafewtimesyoucanintegratedeeperstrokesincludingpetrissage.Remembertocheckwithyourclientthatsheishappywiththepressure.Repeatseveraltimesfocusingonalltheareasonbothsidesofthespine.Avoiddirectpressureonthevertebraeofspine.Includesomegentlekneadingandinching.Keepthemovementsflowingandrepeatseveraltimes,allthewayfromthesacrumatthebaseofthespine,rightuptotheshoulderandneckarea.Youcanincludeavarietyofstrokesincludinggentlekneadingandinchingworkingallthewayuptheback.Finishwithsomegentleeffleurageandrestyourhandsonthesacrum.

MassagingtheSacrumAsthebabygrows,thesacrumisanotherareathatcanoftencomeunderpressureandmassagecanbewonderfulforrelievinganysorenessinthisarea.Applysomeoiltoyourhands,andthenusingthepalmofyourhandmakeafigureofeightonthesacrum.Repeatthisseveraltimesasitisgreatforrelievingtensioninthelowerback.Thenstillusingthepalmofyourhandmakesomegentlecirclesalloverthesacrum.Nextusingbothhandsmakeaheartshapeandsweepingmovementsalloverthearea.Nowandthenyoucansweepyourhandsallthewayupfromthesacrumtotheneckandshoulders.Usingbothhandsincludesomegentlekneadingoverthesacrumandtheouterfleshypartofthehiparea.Sweepyourhandsallthewayupthebackandfinishbygentlyrepeatingsomeofthestrokesandmassagingthelowersacrum.

MassagingtheShoulders&NeckAsmanywomencontinuetoworkthroughouttheirpregnancy,theymaysufferfromtightnessintheirshouldersandsowillwelcomeamassageintheshoulderandarea.Applysomemoreoilandthenmassagedeepintoupperbackandtheshoulderareausingacombinationofsweepingeffleuragemovementsanddeeperpetrissagestrokestohelprelievetension.Youcanuseyourpalms,fingersandthumbstoworkintotheshoulders,alwaysmakingsurethepressureisappropriateforyourclient.Gradually,beginworkinguptheneck.Keepingcontactwiththeclientmovetothefrontofthebedandcontinueworkingontheneckareausingcaterpillaranddeeperpetrissagestrokes.Workrightuptothebaseoftheskull.


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HeadMassageUsinganti-bacterialwipes,wipeanyresidualoiloffyourhandsandplaceyourhandsonyourclient’sscalp.Justrestyourhandsforamomentonherhead,asthisisverysoothing.Massageallovertheclient’shead,usingthefingertipsofbothhandstomakecirclesworkingalloverherscalp.Youcanincludedeeperstrokesandcombingtohelprelieveanytensioninthearea.Alotofwomensufferfromanxietyduringpregnancyastheyworryaboutthewell-beingoftheirbabyandtheimpendingbirth.Aheadmassagecanbegreatforrelievinganytensionandworrysoit’sworthspendingagoodfewminutesmassagingthehead,asitisdeeplyrelaxing.Finishwithsomegentletapotement.Pleaseensureyouwipeyourhandswithanti-bacterialwipesbeforecontinuing.

MassagingtheArmsNextmoveontothearmsandhands.Applysomeoilandmassageitallthewayupyourclient’sarm.Gentlytakeyourclient’shand.Spendsometimemassagingherhand,herpalmandherfingers.Nextgraduallybeginmassagingtheinsideandoutsideofthelowerarm.Graduallymoveuptheupperarm,usingacombinationofeffleurageandpetrissage.Finishwithgentleeffleurageallthewayupanddownthearm.

MassagingtheTummy&Abdomen

Massagingthetummyislovelynotonlyforthemotherbutforthebabytoo.Thebaby’sskinisalreadyveryreceptivetotoucheveninthewomb.Makesureyoumakecontactwiththetummywiththetowelonfirstandmakesurethatyouhaveaskedyourclient’spermissiontotouchherbellybeforeyoustartyourmassagesession.Applysomemoreoiltoyourhands.Usingbothpalms,massagealloverthebellymakingslow,sweepingcircles.Continuethisseveraltimes.

Youcanalsointroduceagentlewringingstrokeconnectingthebellywiththesacrum.Returntomassagingalloverthebellyusingyourpalms.Don’tbesurprisedifyoufeelakickortwo.Gently,restyourhandsonthebellyattheend.


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MassagingtheLegs:UpperLeg&LowerLeg

Asyourclientiscarryingextraweight,itwillbewelcomereliefforhertotaketheweightoffherfeetandshewillreallyenjoyalovelylegmassage.Thisisalsowonderfulforhelpingrelieveswollenanklesandanyfluidretention.Applyplentyofoilandlightlymassageitintothewholeleg.Beginatthetopofthelegusingsomeeffleurage,caterpillarandpetrissagestrokes.Youcanalsointegratesomewringingandsomekneading,butalwayskeepitslowandgentle.Workyourwaydownthelegandspendsometimemassaginghercalvesandankles.Youcanuseacombinationofeffleurage,caterpillarandpetrissage.Massagetheoutsideoftheankle.Becarefultoavoidanypressurepointsonthefeetortheinnerankleasthisareaconnectswiththeuterus.Finishwithsomegentleandlighteffleurageworkingallthewayupanddowntheleg.Coveryourclientwithhertowelsandrestyourhandonherarmandbellytoletherknowthatyouhavefinishedthefirsthalfofhermassage.

Changingyourclient’sposition

ITISIMPORTANTTOGETYOURCLIENTTOSWITCHSIDESSAFELYANDWITHOUTANYROLLING

OVERONTHECOUCH

Onceyouhavecompletedthemassageononesideitistimetogetyourclienttolieonherotherside.Youneedtodothissafelyandwithoutgettinghertorolloveronthecouch.Wewillnowdemonstratethecorrectwaytogetyourclienttochangeherpositionfromoneendofthecouchtotheother.Firstofallgentlytellyourclientthatitistimeforhertositup.Removethecushionsandgiveheratowelorawrap,ifyouwish.Askyourclienttositupslowly.Placeapillowattheotherendofthecouchforherhead.Nowaskyourclienttolieonherothersidewithherheadattheoppositeendofthecouch.Thisavoidsanyrollingonthecouchorplacinganyunnecessarystressesorstrainsonyourclient.Placeanotherpillowbetweenyourclient’slowerlegsandunderherbellyforsupport.Removethewraportowelifyouhaveusedoneandcoveryourclientwiththetowels.Onceagaincheckthatsheiscomfortable.Youcannowrepeattheentiresequenceontheotherside.


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PostNatalMassage

AtMamaBabyBlisswearepassionateaboutmotherhoodandarededicatedtosupportingnewmumsaswellasmums-to-be.Inordertosupportmumsaftertheyhavehadtheirbaby,wehavedevelopedtheguidetopostnatalrecovery.Pleasealsoseeourminipost-nataltreatmentsheetforadditionaltreatments.

GuidetoPostnatalRecovery

Whatisthepostpartumphase?Duringthefirstweeksaftergivingbirth,themother’sbodybeginstohealandadjusttonotbeingpregnant.Thisiscalledthepostpartumperiod.Whathappenstothebodyduringthepostpartumperiod?Awomanislikelytofeelsoreforafewdaysandverytiredforseveralweeks.Itmaytake4to6weeksforawoman’sbodytofullyhealafterbirth.Itisnormalduringtheearlyweeks,toexperiencebleedingandafter-painsastheuterusshrinks.Recoveryandhealingwilltakelonger,ifshehashadacaesarean(orC-section)birth.Havingababyisabigadjustmentandmanywomenfeeltiredandoverwhelmedduringthefirstweeksandevenmonthsafterchildbirth.Lookingafterababyisnotonlyphysicallytiring,butcoupledwithsleeplessnightsandricochetinghormones,itisananxioustimeasamothergetsusedtohavinganewlittlepersontolookafter.Thiswillinevitablyhaveanimpactonhermentallyaswellasemotionally.Anxietyanddepressionarecommonsymptomsofmotherhood.CurrentstatisticsfromtheNHSreportthat1in5womensufferfromsomekindofanxietyordepressionduringpregnancyandearlymotherhood.Self-careisessentialduringthistimeandhavingamassagecannotonlyhelpeasephysicaltensionbutalsogiveanewmothersomevitalrestandrelaxationthatsheneedsanddeserves.Thiswillhelpsupportherphysical,mentalandemotionalstate.PhysicalailmentsduringthepostpartumperiodandthebenefitsofmassageTherearemanycommonailmentsafterbirthincludingsorebreasts,constipation,pelvicboneproblemsandbackache.The‘TrulyBumptious’treatmentcaneasilybeadaptedintoapostnataltreatmentfocusingonthetroublespotstoeaseawayachesandpainsandnurtureanewmum.BreastproblemsBreastengorgementiscommonbetweenthethirdandfourthdayafterdelivery,whenthebreastsbegintofillwithmilk.Thiscancausebreastdiscomfortandswelling.Soreorswollenbreastscancontinuewhileamotherisbreastfeeding,makingituncomfortableforhertolieonherback.Becausethe‘TrulyBumptious’treatmentisconductedwiththeclientlyingonherside,itisanidealpostnataltreatmentastherewillbenopressureonthebreasts.


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Back-ache,tightshouldersandhipsTheseareperhapssomeofthemostcommonailmentsanewmummaysufferfrom.Lowerbackachecanoftenbeduetothebirthorupperbackachemayoccurfromsimpleeverydaydutieslikecarryingherbabyinaheavycarseat.Tensionintheshouldersisalsoacommonexperiencearisingfromfeedingthebabyinawkwardpositions.Awoman’shipsmayalsobetenderastheyrecoverfrombeingexpandedduringthebirth.Becausethe‘TrulyBumptious’treatmentisconductedwiththeclientontheside,itenablesyoutoworkdeepintotheshoulders,backandacrossthehiparea.Alwaysbemindfulofpressureonanyareasthataretender.Tiredness,stressandanxietySleeplessnightandthephysicalstrainsoflookingafteranewbornbabycanleadtoexhaustionandincreasedlevelsofstress.Throughmassage,wearestimulatingoxytocinandendorphins,whichwillhelpreducecortisollevelsandhelpcounterstressanddepressioninthemother.Thefollowingarealsocommonailments.Massagemaystillbehelpfulintermsofgivingthemothersomevital‘me-time’butwillhavelessofadirectbenefit:PelvicboneproblemsRecoveryfrompelvicbonessuchasseparatedpubicbonesorafracturedtailbone(coccyx),cantakeseveralmonths.Themotherwillbeundermedicalsupervisionandtreatmentmayincludeice,nonsteroidalanti-inflammatorydrugs(NSAIDs)andsometimesphysicaltherapy.Whereappropriate,massagecanagainbebeneficialforpainrelief,butyoumustavoidanydeeppressureoverthehipandsacralarea.ConstipationandhaemorrhoidsThesecanbeacommonoccurrenceasawoman’shormonesreturnbacktonormal.Hometreatmentmeasuresareusuallyallthatisneededtorelievemilddiscomfortfromhaemorrhoidsorconstipation,includingeatingahigh-fibredietwithlotsoffruits,vegetables,andwholegrainsanddrinkingplentyoffluids,especiallywater,fruitjuicesandherbaltea.Massagecanbehelpfulifatummymassageispermitted.Pleaseseenotesunder“ConsiderationsforPostnatalMassage”.VaginalandperinealproblemsSorenessinthevaginaandtheareabetweenitandtheanus(perineum)iscommonafterdeliverybutcanoftenbeeasedwithhometreatment.Recoveryfromanepisiotomyorperinealtearcantakeseveralweeks.


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ConsiderationsforPostnatalMassage

The‘TrulyBumptious’treatmentcanbeeasilyadaptedfornewmothers.

• Aswithanyconsultationitisessentialtoconductadetailedclienthealthcheck(pleaseseethe“ClientPostnatalHealthCheck”.Thiswillenableyoutotailorthetreatmentfocusingonanytroublespots.

• Thetreatmentcanbedeliveredinexactlythesamewayasforpregnancywiththefollowingconsiderations:

o Theclientmusthavehadherpostnatalcheck-upwithherGP.Shemustmakeany

medicalcommentsonthePostnatalConfidentialHealthCheck.Ifthereareanyconditionsthatfallunderthecontraindicationsofregularmassage(asadvisedunderyourA&Pqualification)thenyoumaynotconductamassage.

o Ifshehashadacaesarean,thenitisacontraindicationasthisisclassifiedassurgery.o Alwaysaskpermissioniftheclientishappytohavehertummymassagedasthis

maystillbeatenderarea.o Modifypressureandavoidanydeepstrokesonareassuchasthesacrumandhipsif

theclientmentionsthattheyaresore.o Intermsofequipment,itisstilladvisabletohaveallthesameasforthepregnancy

massageincludingafootstoolasatiredmummaystillfeelalittleunstablegettingonanoffacouch.


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AnIntroductionToTheProcessOfLabour

Labouristheprocessofababybeingbornandthefollowingisaverybriefoverviewofthestages.Itisanintricateprocessandifyouwishtospecialiseinmassagingclientsduringlabour,wedorecommendyoudofurtherbackgroundreading.AreadinglistisincludedattheendoftheStudentAssessmentWorksheet.

StagesOfLabour

Therearethreedistinctstagesoflabour:Firststage–dilationofthecervix

• Latentphase(0-4cmdilated)• Activephase(4-10cmdilated)

Secondstage–fullydilatedtillexpulsionofthefoetus

• Descentofthehead• Pushingphase

Thirdstage–followingexpulsionofthefoetustilltheplacentaandmembranesaredelivered.

Stage1–CervicaldilationStageonelastsfromtheinitiationoflabouruntilthereisfulldilationofthecervix.Thecervixwillbecomethinner(aprocessknownaseffacement)andstretches(dilation)asthebaby’sheadwilldescendand“engage”withthepelvis.Thisprocessissupportedbycontractions,whicharenaturalintervalsofthetighteningandrelaxingoftheuterinemuscle(thelargestmuscleinawoman'sbody),whichhelpbringthebabyintotheworld.Firststagelabourisgenerallythelongeststageandcanvarygreatlywomantowoman,lastinganythingfromhourstodays.Duringthisphase,itisveryimportantthatthemotherstaysrelaxedandmassage(withherpermission)canhelpgreatly.Thefirststageisdividedintotwoparts:

• Thelatentphase,whichisdefinedasperiodbetweenthestartoflabourupuntilthecervixis4cmdilated.

• Theactivephaseisfrom4cmofcervicaldilationuntilthecervixisfullydilated(10cm).Duringtheactivephase,itisexpectedthatthecervixshoulddilateatleast1cmanhourinwomenwhoarehavingtheirfirstbaby.However,thiscanvarywomantowomananddependingontheprogressoflabour.

Thecervixinwomenwhohavehadapreviousvaginalbirthtendstodilatemorequickly(about2cmandhour)althoughagainthereisnohardandfastrule.Duringthefirststageoflabour,themidwifeordoctorwillregularlydoavaginalexaminationtoassesshowdilatedthecervixis,howthebabyisdescending,andthecolouroftheamnioticfluid.Thisisdoneatleasteveryfourhours,ormoreregularlyifnecessary.Thedescentofthebaby


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throughthebirthcanalisalsotrackedbyexaminingtheabdomen.ThebabyismonitoredeitherintermittentlyorcontinuouslyusingaCTGforsignsofdistress.

Stage2–Expulsion

Thisisfromthetimeoffulldilatationofthecervixuntilthebabyisdelivered.Duringthisstagetherearetwophases:

• Theinitialpartisapassive(descent)phase;wherethebaby’sheadmovesdownthroughthemother’svagina.

• Thisisfollowedbyanactivephasewherethemotherfeelsthedesiretopush.Thisurgetopushisusuallylessstrongifthewomanhasanepidural.Thepushinginvolvescontractingtheabdominalmusclesintimewitheachuterinecontraction.Pushingusuallycomesinstinctivelysothemotherdoesn’tneedtoworryabout“notknowinghowtopush”,however,itisimportanttopushintimewithuterinecontractionstomaximiseefficiencyandminimisefatigue.

Oncethebabyisdelivered,theumbilicalcordwillbeclampedandcutbythemidwife/doctor.Thebabyisthenfreetobeheldbythemother.

Stage3–Deliveryoftheplacenta

Thethirdstagelastsfromthedeliveryofthebabytilldeliveryoftheplacentaandmembranes(afterbirth).Thirdstagelabourmaybe:

• Active:thedoctorormidwifegivesadrug(oxytocin)viaaninjectionintothemother’sthighjustasthebaby’sheadiscrowning(widestpartcomingthroughthevaginalopening)tohelptheuteruscontractdowntospeedupdeliveryoftheplacenta,andtheygentlypullonthecordoftheplacentatohelpdeliverit.Activemanagementofthirdstageisfaster(around5-10minutes)andhasbeenshowntoreducebloodlossafterdelivery,somanyhospitalsprefertousethismethod;or

• Physiological:Nodrugsorpullingontheplacenta.Theplacentadeliverswithoutassistance,orwithgentlepushingfromthemother.Thistakesabitlongerthanactivethirdstage(upto30minutes).

Aftertheplacentaisexpelled,continuedcontractionsoftheuterusconstricttheuterinebloodvessels.Thispreventsextensivebloodloss.Mostwomenwilllosesomebloodduringthedeliveryprocess–thisisexpected.Whentherearelargervolumesofbloodlost,amidwifeordoctormayneedtomanagethis.


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MassageDuringLabourMassageduringlabourcanplayavitalrole.Thismodulewillenableyoutoshareanddelivermassagetechniquestoaclientand/orherpartnerthatcanbeappliedduringlabour.WerecommendwatchingtheMassageDuringLaboursequenceontheMamaBabyBlissTrainingVideoinconjunctionwiththismodule.

Howdoesmassagehelpduringlabour?• MassagehelpsstimulatethebodytoreleaseENDORPHINSandOXYTOCINwhicharenaturalpain-

killingandmood-liftinghormones.o Oxytocinalsohelpsprogresslabourandexpeltheplacentaafterbirth.o StimulatingtheskinalsohelpsreleaseOXYTOCIN‘thelovehormone’.o Oxytocinalsohelpspromotefeelingsofattachmentandbondingbetweenmotherandbaby.

• MassagecaninhibitthereleaseofADRENALINE,whichcanhindertheprogressoflabour.• Massagecanhelpthepartnerplayapractical,supportiveroleandkeeptheminvolvedinthe

processoflabour• Forlabourtoprogressnaturally,itisvitalforthemothertostaycalmandrelaxed.Massagecanhelp

enablethis.Howtoprepare

Themostimportantruleisthatamassageshouldonlybegivenduringlabourifthewomanwantsit.Somewomenwanttobetouchedothers,don’t.Thebestwaytomanagethisistoagreethatthemotherwillaskherpartnerforamassageifshewantsone.Orthepartnermayaskherpermissionbutshouldonlyproceedifsheagrees.Noequipmentisneededandthebestistobeguidedbythewomanandthepositionsshewantstoadopt.Shemaywishtostandorbeonallfoursleaningagainstawall.Orshemayprefertobeseated.PleasewatchtheMamaBabyBlissvideoforsuggestedpositioningandmassagestrokes.

EarlyLabourMassagewillbehelpfulduringearlylabourtohelpthemotherstayrelaxedandsupportherthroughcontractionsbyhelpingreleasepain-relievinghormones.Theaimistorelaxandletthewomanrecover.Strokesshouldbekeptlightandgentle

SuggestedMassageStrokesForEarlyLabour

MassageDuringContractionsSpinalStrokesStartatthenapeoftheneckandsweepdowntothebaseofthespine.Usingalternatehands,workeithersideofthespinenotdirectlyonit.Keepcontinuousmovementbyusingonehandafteranother.MassageBetweenContractions

Generally,massagearoundthesacralareaandonthelowerback,buttocksandthighsismosteffectiveStrokesshouldbedeepanddonesmoothlyandrhythmicallyAbdominalmassagecanbeusefulbutuseverygentlestrokes.


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SacralCirclesFindtheflatboneatthebottomofthespine.Thisisthesacrum.Useonehandtosupportthefrontofthehipbone.Usetheheeloftheotherhandtoapplysomepressureonthesacrum(remembertocheckthepressure)andkeepingthepressureeven,slowlymoveroundinsmallcircles.SacralSnakeUsingtheheelofthehandmovefromthefarlefttoright.Returntotheleftusingthehandinawrigglymovement.SacralHeartUsingtheflatsofboththehandsstartatthebaseofthespine.Pushupwhenthewomanbreathesout,makingaheartshapebacktostartingpositiononbreathingin.SacralWarmthPushgentlyonthesacrumtowarmthearea.Repeatasmanytimesandatapacethatiscomfortable.

SuggestedMassageStrokesForSecondStageLabour

Thesetechniquesmaybebeneficialduringthesecondstage,asthemotherwillneedtobeuprightinaforwardleaningposition.Shecanleanforward,withherkneesspreadwideagainstayogaball.Again,itisalwaysimportanttocheckifthewomanstillwantstobemassaged.

MassageDuringContractions

ButtockKneadingKneadthemother’sbuttockswiththeflatpartofbothfists.Turnthefistoutwardsduringthecontractiontointensifypressure.HipMassagePuttheheelsofyourhandscentrallyatthebaseofthespine.Leanforwardandpushoutwardsacrossbuttockstohips.Glidehandsbacktostartingpositionasyourpartnerbreathesin.

MassageBetweenContractions

SweepingStrokesStartatthebaseofthespine.Movebothhandssmoothlyupeithersideofthespineuptotheneck.Movethehandsroundtheshouldersandglidebackdowntothebaseofthespine.FootMassageIfyouaresittingonastoolorareinarecliningposition,thenalovelyfootmassagebetweencontractionscanalsohelpgreatlywithrelaxation.

Documents

MamaBabyBliss Pregnancy Massage Manual · The baby’s skin is the first organ to develop in the womb and even from very early on a baby can feel and communicate through its skin