This blog post will outline some of the changes that occur for a pregnant person and how these can impact their body and the function of muscles and bones. It will also cover mental impact and emotional changes, how massage can help, and finish with some thoughts on when massage might not be appropriate.
Changes in Pregnant Bodies
The fertilised egg will implant in the uterus wall for a successful pregnancy to have a chance of developing. This can be via traditional methods or assisted conception. It is progesterone which supports the growing blastocyst and in the early days, this progesterone is created by the uterus itself. If a pregnancy does not occur, the progesterone dips massively and the uterus lining is shed during menstruation. The embryo begins to grow its placenta, which attaches to the uterus wall, and it is the placenta which continues production of progesterone to allow the embryo to grow.
Progesterone is a hormone which will have an impact all over the body. All hormones are evolved to have a specific job, which they do, but they are non-discriminatory. That is to say, the progesterone won’t just stay localised in the uterus to support a pregnancy. It will be all throughout the body, carried via the bloodstream, and it will act wherever there are receptors to trigger. One of the roles of progesterone is to decrease the contractility of the uterine muscle. This means it stops the uterus from contracting to expel the lining. However, it will also work on other smooth muscles within the body, being responsible for a sluggish digestive system, constipation and bloating, poor function of the oesophageal sphincter, and resulting with reflux. Progesterone will also loosen veins and valves which, along with the extra lymph, can result in swelling in hands and feet as well as varicose veins which can occur in the legs, vulva, and anus. Swelling in the hands and wrists may affect the carpal nerves leading to carpal tunnel syndrome. Swelling in the feet and legs can in some rare cases be indicative of further issues with pre-eclampsia.
Relaxin is a hormone which works to relax the strong ligaments of the body to allow space for the baby to grow and eventually birth through the pelvis. However, it starts working quite soon and will not only relax appropriate birthing ligaments but all ligaments. Ankles turn more easily, backs get put out more readily, old and healed sites of injury begin to ache again. The main pregnancy culprit caused by relaxin is PGP or Pelvic Girdle Pain (also called SPD, Symphysis Pubis Dysfunction). This refers to pain in the centre of the pelvis at the front, round by the hips and sacroiliac joint. As the strong ligament at the front of the pelvis relaxes, the parts of the pelvis become more mobile and unstable which causes pain and discomfort, especially when moving from one position to another.
As the baby grows, the uterus usually swells out in front of the pregnant person. Because this growth is relatively gradual, the pregnant person won’t necessarily be aware of the changes to their posture, centre of gravity, and mode of movement. What tends to happen is the belly leads, the lordosis of the spine increases, putting extra pressure on the lower lumbar region, the toes and feet turn out to accommodate the side-to-side waddle which shortens the piriformis in the pelvis and thus putting more pressure on the front of the pelvis and perhaps more pain. The chest may thrust out which will lengthen the muscles in the thorax and compromise the function of the diaphragm and breathing. The muscles of the abdomen may separate (Diastasis Recti) as the baby grows which will contribute to the poor core stability and back pain and poor pelvic floor function. Coupled with office working, more sedentary lifestyles, and bucket seats in cars, you can begin to understand why so many pregnant people struggle with pregnancy discomfort.
There are also many emotional changes that need to be respected for a pregnant person. Whether the pregnancy was welcomed, waited for, unexpected, or not wanted – there are so many emotional states that may be experienced. Being mindful of these is important and not assuming that everyone feels the same about their pregnancy, even week to week.
How Massage Can Help
Pregnancy massage can help pregnant people in a number of ways. Physically, relieving the tension and tightness of muscles. The relaxin and progesterone will be making ligaments loose. Ligaments hold bone to bone and create a sturdy structure for our body. Removing some of this stability makes the muscles work harder to provide stability. Overworked muscles are tight and can ache and cause pain in their own way. Pregnancy massage will help to improve blood supply to these muscles, reduce the tightness, and relieve the ache and pain of working in a compromised way. This will be especially needed around the hips, sacrum, and gluteal muscles. This is why pregnancy massage is beneficial throughout pregnancy.
Skin-to-skin touch during pregnancy massage will create endorphins and oxytocin—feel-good hormones of relaxation and well-being. Stimulating the body’s own relaxing hormones during pregnancy massage will help ease the aches and pains as well as helping the pregnant person to feel good and to relax. Baby usually enjoys the pregnancy massage as well, often waking and responding to the oxytocin with kicks and rolls.
Time taken for a pregnancy massage will provide mental space to process thoughts and feelings. Some may be positive, some may not. Time to connect with the bump during pregnancy massage, accept changes to lifestyle, body, and relationships may all occur for pregnant people.
Pregnancy massage is time to rest, personal time just for the pregnant person and this is so valuable in a life which is usually so busy and time just for the self is not always protected.
Making a Pregnant Person Comfortable
Taking a thorough medical and pregnancy history will help us to give you the best pregnancy massage. Identifying how each individual person feels about being pregnant, any pelvic and reflux issues they have will help me give you the best position possible for maximum comfort during your pregnancy massage.
A pregnant person with reflux may want medication on hand to relieve any pain, or they may want to start off on their left-hand side and finish on their right which may reduce any reflux. They may also want or need to be slightly elevated, head higher than the stomach to prevent acid moving up their oesophagus.
A pregnant person with PGP will need to keep their pelvis aligned and be advised not to open the knees wide, they may struggle to get on or off the bench and may benefit from a floor setup. Turning from one side to another may be challenging too and should be done slowly, keeping the knees together or with the pregnant person coming onto their hands and knees and turning this way.
Pregnant people in the third trimester will probably not be comfortable lying on their back at all, so this should be avoided.
Book a Pregnancy Massage
Pregnancy massage can be beneficial for pregnant people both physically and emotionally. A good pregnancy massage can relieve muscular tensions from the compromised body as well as nurture the changes being experienced and allow time and space to process feelings.
