Science & Sensibility

This is a guest post by Trish DeTura, RN, CNM, MS, MAMA President

Pregnancy is such an exciting time in a woman’s life filled with the great wonder of what is to be. However, it may also be a time of great stress as a woman’s body goes through a great metamorphosis. Some of the common discomforts of pregnancy are round ligament pain, indigestion, aching back and pelvic pressure, just to name a few.

Add to this list the mental/emotional challenges a woman experiences in pregnancy surrounding the uncertainty around motherhood, sadness and depression.

One wonders as a practitioner, what can I offer this woman that will benefit her and her unborn baby?

While attending the Art of Birthing Conference in the New York Academy of Medicine in 2000, I found a wonderful complementary technique.

Complementary techniques are popularly used by many women for the relief of aches and pains during pregnancy and birthing (Jones et al, 2012). Leanna Jones and her colleagues (2012) found complementary methods were most often offered and used in midwife-led births. Relaxation, acupressure/acupuncture, massage and immersion in water were found to provide pain relief and positive maternal outcome without invasive side effects. Also, regarding acupuncture/acupressure, a decrease in the use of forceps, ventouse and cesarean section was noted (Jones et al; 2012).

I learned about Maya Abdominal Massage from Rosita Arvigo and Ms. Hortense Robinson. Rosita is a naprapath, herbalist and teacher of Maya medicine. She who apprenticed with Don Elijio Pante, a traditional Maya healer, in Belize, Central America. Ms. Robinson is a midwife.

They shared how the Arvigo Technique of Maya Abdominal Therapy (ATMAT), restores the body to its natural balance by correcting the positions of organs that have shifted and restrict the flow of lymph, blood, nerve and qi energy. Thus, ATMAT promotes homeostasis.

As a result of ATMAT, the pregnant woman experiences an increase of arterial blood carrying oxygen, nutrients and minerals to the mother and her unborn along with removal of any waste via the venous system and lymph. In addition, the mom experiences a removal of any congestion or blockages enhancing better hormonal, nerve flow and flow of chi.

I thought this all made good physiologic and common sense. I was hooked! Onward to learning this technique to support women with all kinds of challenges then onward to learning the pregnancy aspect of this method.

This gentle, non-invasive approach of this abdominal massage begins at 20 weeks of gestation continuing up to when the woman delivers. ATMAT eases the common discomforts of pregnancy.

I find it to be a lovely complement to a midwifery practice, the mom gets to focus on her baby and her developing baby intimately, thus preparing her to open psychologically and physically to her pregnancy and birth.

Tiffany Field, Ph.D. at the Touch Research Institute in Miami, has collected extensive data on the profound healing effects of touch, which is what ATMAT is- healing and nurturing touch- for both the mother and her unborn.

In the Journal of Psychosomatic Obstetrics and Gynecology, Field (2010) published a study demonstrating that regular massage during pregnancy results in: decreased anxiety, improved mood, reduced back pain, improved sleep patterns, reduced stress hormone levels, fewer complications during labor and fewer complications for infants following birth.

Further, Field (2010) reports women who have received massage therapy experienced significantly less pain and their labors were on the average three hours shorter.

The data collected by the midwives providing ATMAT to their pregnant clients supports these findings. In addition to the shortening of labors, mothers who receive ATMAT bond with their unborn baby leading to less postpartum depression. This has been substantiated by Dr. Tiffany Field and her colleagues in a 2009 study revealing that postpartum depression was lessened as a result of prenatal massage.

It is my hope that one day the Arvigo Technique of Maya Abdominal Therapy will be recognized as an essential and vital aspect of maternity care. To learn more about this great modality please go to: www.Arvigotherapy.com

References:

Field, T. (2010). Pregnancy and labor massage therapy. Expert Review of Obstetrics and Gynecology, 5, 177-181.

Field, T., Diego, M., Hernandez-Reif, M., Deeds, O., & Figueiredo, B. (2009). Pregnancy massage reduces prematurity, low birthweight and postpartum depression. Infant Behavior & Development, 32, 454-460.

Jones L, Othman M, Dowswell T, Alfirevic Z, Gates S, Newburn M, Jordan S, Lavender T, Neilson JP.Pain management for women in labour: an overview of systematic reviews. Cochrane Database of Systematic Reviews 2012, Issue 3. Art. No.: CD009234. DOI: 10.1002/14651858.CD009234.pub2

Trish DeTura, RN, CNM, MS specializes in the Arvigo Technique of Maya Abdominal Massage, a non-invasive and natural technique of restoring health to the reproductive organs. She is in private practice in Hoboken, NJ. Contact her at trishdetura@gmailcom

Kathy Morelli Cesarean Birth, Childbirth Education, Continuing Education, Do No Harm, Guest Posts, Midwifery, Pain Management, Uncategorized complementary techniques, massage, Maya Abdominal Massage, midwife, Midwifery Care, mindbody techniques, relaxation, relaxation in childbirth

In Part 1 we talked about how to help your client choose a prenatal yoga class; in Part 2, we will look at breathing, meditation and relaxation in a prenatal yoga class and how it’s beneficial to the pregnant mother.

We know that learning relaxation and breathing techniques can help a woman better cope with her labor and enhance her birth experience.  A prenatal yoga class should incorporate relaxation (meditation), breathing, physical postures and movements to prepare a woman’s body for labor and birth.  If a woman has a consistent yoga practice for many weeks leading up to her labor and birth, she should be better prepared physically, psychologically and emotionally to cope with her labor.

When most people think of yoga, asana (physical postures) comes to mind.  Preparing the physical body, and to some extent reliving stress by increasing the endorphin levels, is good.  Beyond the physical, however, when a woman is pregnant her hormones can make her feel out of whack; she can have fears about the birth process; she can feel a need for community and friendship in a new way.  A good yoga class should provide for all of the above.

Let’s get to the nitty-gritty of how the non-physical aspects of yoga work for the pregnant woman.

 ”This study provides evidence that regular yoga practice in the last 10–12 weeks of pregnancy improves maternal comfort in labor and may facilitate labor progress. The researchers offer several theories for these effects. First, yoga involves synchronization of breathing awareness and muscle relaxation, which decrease tension and the perception of pain. Second, yoga movements, breathing, and chanting may increase circulating endorphins and serotonin, “raising the threshold of mind-body relationship to pain” (p. 112). Third, practicing yoga postures over time alters pain pathways through the parasympathetic nervous system, decreasing one’s need to actively respond to unpleasant physical sensations.

Prenatal strategies that help women prepare emotionally and physically for labor may help reduce pain and suffering and optimize wellbeing in childbirth by providing coping skills and increasing self-confidence and a sense of mastery. More research is needed to confirm the findings of this study. However, yoga’s many health benefits and the lack of evidence that yoga is harmful in pregnancy or birth provide justification for encouraging interested women to incorporate yoga into their preparations for childbirth.”

 Research Summaries for Normal Birth by Amy M. Romano, MSN, CNM and Henci Goer, BA

 
For more information on breathing techniques try Yoga Journal.
 

 
Meditation is taught to varying degrees in a prenatal yoga class, depending on the style of yoga and the individual instructor.  Meditation does not have to mean finding a quiet seat and looking inward.  It doesn’t mean “clearing your mind”.  Meditation can involve movement, breath, mantra, focal points, visualization, etc.  What meditation does is give the person focus.   How does it affect pain management?

“Women practicing mindful yoga in their second trimester reported significant reductions in physical pain from baseline to post-intervention compared with women in the third trimester whose pain increased. Women in their third trimester showed greater reductions in perceived stress and trait anxiety.  Preliminary evidence supports yoga’s potential efficacy in these areas, particularly if started early in the pregnancy.”

The effects of mindfulness-based yoga during pregnancy on maternal psychological and physical distress. 

Beddoe AE, Paul Yang CP, Kennedy HP, Weiss SJ, Lee KA.

“Yoga was associated with reduced pain (mean difference (MD) -6.12, 95% CI -11.77 to -0.47), one trial, 66 women), increased satisfaction with pain relief (MD 7.88, 95% CI 1.51 to 14.25, one trial, 66 women), satisfaction with the childbirth experience (MD) 6.34, 95% CI 0.26 to 12.42, one trial, 66 women), and reduced length of labour when compared to usual care (MD -139.91, 95% CI -252.50 to -27.32, one trial, 66 women) and when compared with supine position (MD -191.34, 95% CI -243.72 to -138.96, one trial, 83 women)…. Relaxation and yoga may have a role with reducing pain, increasing satisfaction with pain relief and reducing the rate of assisted vaginal delivery.”

Relaxation techniques for pain management in labour.

Smith CA, Levett KM, Collins CT, Crowther CA.

So, it would appear that a yoga practice during pregnancy reduces the need for medical interventions, and would also seem to shorten the overall length of labor.

“The experimental group (yoga group) had significantly less pain and more comfort than the control group at each of the three measurement intervals during labor and at the postpartum measurement. This finding was consistent and significant across all three pain-measurement instruments used. The researchers do not present data about mode of birth. However, the length of the first stage of labor and total duration of labor were significantly shorter in the yoga group (mean length of first stage = 520 minutes in yoga group vs. 660 minutes in control group; mean total time in labor 559 minutes in yoga group vs. 684 minutes in control group)….”

Research Summaries for Normal Birth

Amy M. Romano, MSN, CNM and Henci Goer, BA

Yoga also seems to have an impact in the health and well being of the baby.  I would surmise that this is due to the lower levels of stress hormones in the mother’s body having a positive effect on the uterine environment.  When mama is happy, baby is happy.

 “Complications such as pregnancy-induced hypertension with associated intrauterine growth retardation as well as preterm labor and prematurity were less frequent in the yoga group. These effects are difficult to interpret as they could have derived from the physical postures, the breathing, the meditation and/or all components of the yoga sessions.”

…

“In the yoga group, compared with values obtained before a practice session, the high-frequency band of the heartrate variability spectrum (parasympathetic or vagal activity) increased by 64% in the 20th week and by 150% in the 36th week, and both the low-frequency band (sympathetic) and the low-frequency to high-frequency ratio were reduced. Moreover, the low-frequency band remained decreased after deep relaxation in the 36th week in the yoga group, all of these being adaptive autonomic responses to stress.  Thus, yoga reduced perceived stress and improved adaptive autonomic responses to stress in healthy pregnant women.”

Complementary Therapies in Clinical Practice
Volume 17, Issue 1 , Pages 1-8, February 2011

To conclude, yoga has a multifaceted effect on not only the pregnant mother’s body, but also her mind and her baby.  More research needs to be done to further discover why yoga works.  However, since it does work; is a complementary practice to childbirth education; lowers rates of medical intervention; reduces the length of labor; and reduces the likely hood of prematurity, shouldn’t we consider referring our clients to a prenatal yoga class?

Tell me about your experiences with prenatal yoga and better birth outcomes.

Deena Blumenfeld Childbirth Education, Guest Posts, Pre-term Birth, Research, Uncategorized breathing in childbirth, Childbirth Education, lamaze, meditation, Prenatal Yoga, relaxation in childbirth, yoga breathing