Complementary and alternative medical (CAM) therapies are a varied lot, but they suffer from a common ailment: a general lack of uniform certification standards. The result is that while some practitioners are highly trained and highly knowledgeable, others are, to varying degrees, less so.
Massage is included in this group. There is no single umbrella organization guiding the training of massage therapists; a licensed massage therapist (LMT) is licensed by a specific school or training program. Maternity massage is a particular problem area because it's a specialty: Just because someone is fully trained in, say, Swedish massage therapy doesn't mean he or she is fully trained in prenatal Swedish massage therapy.
And it matters. Prenatal massage involves different techniques than regular massage. There are simple ones, such as position. A woman receiving a prenatal massage will lie either face-down on a maternity-specific massage table (which has a hole cut out for the belly) or else, more commonly, on her side, with her belly propped up and protected by pillows in later trimesters. This latter position is often the preferred one, since the abdomen is better supported.
Other changes are more technique-oriented. For instance, many therapists trained in prenatal massage avoid the abdomen altogether, and the rest use very light pressure and only an open, soft palm -- there is no kneading or pressing there. They avoid specific pressure points believed to stimulate the uterus, and keep leg massage superficial in case of pregnancy-related blood clots. They use extra oil over varicose veins, which respond poorly to friction.
The safest prenatal massage is performed by a therapist with advanced training in the specialty, rather than one who took a class or two as part of an overall massage program. Massage schools and certifying organizations can provide names of qualified therapists, as can many obstetricians, midwives and pregnant (or once-pregnant) friends. It's also fine to simply ask a potential therapist whether he or she completed a training program in prenatal massage on top of general massage training.
So, aching back? Trouble sleeping? Sounds like someone could use a prenatal massage with a highly-trained specialist -- after clearing it with her care provider, high-risk pregnancy or not. The extra peace of mind can only help an aching body loosen up, breathe deep and enjoy.
For more information on pregnancy, massage and related topics, check out the links on the next page.