The magic touch: the best ways to enjoy the art of prenatal massage - For Moms Only - massage during pregnancy: recommendations

Swollen feet and ankles, a sore lower back, worn-out legs: No one needs pampering like a woman who's pregnant. When your body is changed and stressed in so many ways, indulging in a soothing massage can be a welcome break from some of pregnancy's aches and pains.

Massage has been used for decades by pregnant women and their partners, friends and midwives to relieve pain and tension. It can play a key role in attaining a higher level of wellness, especially when you're doing all you can to grow a healthy baby Besides just plain feeling good, its benefits abound: relaxation and decreased insomnia, stress relief on weight-bearing joints, relief of neck and back pain, assistance in maintaining proper posture, reduced swelling in hands and feet, lessened sciatic pain, fewer calf cramps, and headache and sinus congestion relief, among others.

"Massage also flushes the body with feel-good hormones called endorphins that provide a soothing in-utero environment for baby," says Elaine Stillerman, a licensed massage therapist and author of Mother Massage: A Handbook for Relieving the Discomforts of Pregnancy (Dell Publishing Co. Inc.).

Playing It Safe

During the second and third trimesters, pregnancy massage is usually safe. (Massage isn't recommended during the first trimester when the increased circulation flow may cause dizziness and add to existing morning sickness.) You'll experience the same setting as with a typical massage, though you'll want to avoid lying flat on your back after your fourth month of pregnancy.

"Special massage tables exist that enable you to lie on your stomach, but experts don't recommend such positioning because of the stress it places on vulnerable circulation areas, the uterine ligaments and the uterus itself," warns Sue Radosti, a certified pregnancy massage therapist in Sioux City, Iowa. Instead, the table should allow you to lie comfortably in a semi-reclining position or on your side; some spas use cushions that conform to your body or body pillows.

Kelly Lott, RMI CPMT, producer of the video "Pregnancy Massage: A How-To Guide for the Loving Birth Partner" (www.kellylott.com), notes that the massage therapist should ask whether you're having any problems with your pregnancy before you begin. If you are, the therapist will require approval from your primary health-care provider before proceeding.

If you have any of the following conditions, massage should not be performed: risk for preterm labor; blood clots or clotting disorders; heavy discharge (watery or bloody); diabetes; contagious illness; unusual pain; pre-eclampsia; high blood pressure; morning sickness; abdominal pain; fever; diarrhea or vomiting; any malignant condition.

Lott says skin rashes, open sores, bruises, inflammation, and raised or distended varicose veins should not be massaged. "Direct and sustained pressure should not be applied to the area between the ankle bone and heel on both sides of the foot," she adds. Many massage therapists believe this area corresponds to the female reproductive organs, and heavy pressure could promote early labor, explains Barbara Sobel, LMT, director of the Lincoln Institute of Body Therapy in Orange, California. "Take care not to bump or bruise those areas yourself," she advises.

A Helping Hand

When choosing a massage therapist, you'll want to find one who's trained and certified in prenatal massage. These individuals understand the changes a woman's body goes through during pregnancy, and they know what's safe for mother and baby "Still, there's a big difference between being certified and experienced," Sobel remarks. "Ask how many pregnancy massages the therapist does each week"

She points out that even if you usually see a male therapist for your sports/fitness massage, you may want to consider using a female therapist at this time, perhaps even one who has had children. And make sure you communicate with your therapist about the level of pressure being used; in particular, he or she should never use rough or hard motions on your abdomen. If you're uncomfortable in any way, speak up so that your massage experience can be altered and enhanced.

Massage performed by your partner or another labor coach can be useful during labor as well. Take your partner or a friend along when you get a prenatal massage so the therapist can demonstrate many of the comfort measures usable in the hospital and explain why some techniques are unsafe.

Lott explains that postpartum massage can speed recovery by relieving sore muscles and helping you to relax more easily. After approval from your health-care provider, you can generally get a massage 2-3 weeks after a vaginal birth or 4-6 weeks after a cesarean birth.

for more information

To find a prenatal massage therapist, ask for recommendations from your hospital, obstetrician, other health practitioner or friends. Also check out the following websites, which offer nationwide referral systems.

National Certification Board for Therapeutic Massage & Bodywork www.ncbtmb.com