New Moms May Want to Add Postpartum Massage to Their Recovery Toolbox

After nine long months of pregnancy and then childbirth, it can be hard to think about your own needs and make time for self-care. However, caring for your body post-pregnancy is just as important as caring for your body during pregnancy.

When you hear the words "postpartum massage," you might imagine a luxury spa treatment, but postpartum massage is focused on healing. The massage is a holistic treatment approach which entails a full body massage to speed healing and restore your body to its prepregnancy condition.

A postpartum massage can be a relaxing session or bodywork that addresses specific ailments, including linea alba separation (abdominal separation), cesarean scar massage or postural tension (low blood pressure while standing) from nursing, according to Chula Linda Gemignani, an approved provider and instructor of massage in California.

Anyone with a license to touch and the proper training, such as a massage therapist, midwife or doctor, is able to perform postpartum massage, said Rosita Arvigo, herbalist, doctor of naprapathy and founder of the Arvigo Techniques of Maya Abdominal Therapy and the Abdominal Therapy Collective.

New moms can get a massage anytime after birth. However, it's highly recommended that only medical professionals, such as an experienced midwife, perform a postpartum massage within the first 24 hours of birth. A massage in this time frame is typically a uterine massage, also known as a fundal massage. This type of massage is used to reduce cramping after childbirth and prevent postpartum hemorrhage, though the research on its efficacy is inconclusive.

Benefits of postpartum massage

Postpartum massages include some of the same elements as other types of massage and produce some of the same benefits. The massage helps a new mother heal from birthing the baby through natural childbirth or cesarean.

In her practice, Gemignani said many clients report a feeling of balance after the session.

"They are often holding baby on one side of their body and doing things with the other. This often causes low back and rib pain and a general sense of imbalance," she said. "The hunching over that happens countless times a day from nursing, diaper changes and general cooing over that darling new baby is an extreme example of FHP (forward head posture). This causes upper body and neck tension."

Gemignani noted a few additional benefits to the massage:

• Promotes relaxation, lowers cortisol and relieves stress. The stress-alleviating effects of massage are well known. One study found after a massage, participants' cortisol levels decreased by an average of 31 percent.
• Improves circulation and milk production. Massage therapy relaxes the body and increases circulation, and studies show it can even increase milk production. This is because massage increases prolactin levels, a lactation hormone. Researchers have also discovered breast massage can increase the quality of milk by increasing total solids, lipids and casein concentration.
• Balances hormones which can help decrease the onset of postpartum depression. After delivery, progesterone and estrogen levels, which were high during pregnancy, decrease dramatically. The hormones released during a massage can help restore hormone levels. For women who are suffering from postpartum depression, massage may be an effective treatment tool. Several studies have revealed the capability of massage to alleviate the effects of depression.

Other benefits of postpartum massage include releasing muscle strain due to labor and delivery, decreased swelling, better sleep and reduced pain.

The benefits of postpartum massage may go beyond healing your body. Arvigo said postpartum massage can be a source of spiritual and emotional healing, particularly if there was a harsh delivery or a great deal of emotional trauma.

"Birthing can be very emotionally draining, and abdominal massage is the best way to calm the body down safely," she said.

Postpartum massage contraindications

Like most treatments, postpartum massage is associated with certain risks. Massage can increase blood flow and have a negative effect on people with some health conditions, such as high blood pressure, preeclampsia, recent injury or congenital heart disease. Gemignani added there should be no deep leg massage or pressure if hypertension, varicose veins, swelling or signs of clots are present.

"For a cesarean section, any abdominal massage or core recruitment requires a wait until about six to eight weeks, when [the] scar is healed and scar tissue is formed," Gemignani said.

For mothers who have compromised circulation, the left-side lying position should be used. Gemignani noted this position is also useful if there is breast tenderness or the client needs to breastfeed while in session.

Seeking a massage therapist

For women looking to try a postpartum massage treatment, the American Pregnancy Association recommends seeking a massage therapist trained in prenatal and perinatal massage therapy. Gemignani agreed and said to make sure the practitioner knows how to do the side lying position in case you need to breastfeed or hold the baby. Although she recommended bringing someone to care for the baby, she acknowledged that not every mother is ready to be separated from her baby or is able to get someone to watch them.

"An experienced postpartum massage therapist will know specific steps to take to be accommodating," Gemignani said. "They will have soft towels available to you for any possible leakage. With side lying, they will be able to accommodate both client and baby and still be able to get a lot accomplished. They will be patient and accommodating."

When inviting someone to massage you, your body is in a vulnerable state, so it's imperative to choose a practitioner who you trust, who makes you comfortable and who approaches postpartum massage as a healer. Speaking from personal experience, Arvigo concluded, "When you're a healer, it's hard to live without healing."