Depression is a prevalent concern for a lot of women during pregnancy. Various studies have shown 11% to 49% of females suffer with the condition during the gestation period, depending on factors such as age and ethnicity1. Research also shows that depressed women are more likely to deliver prematurely, with their babies having low birth weights related to fetal growth restriction, which can continue into the first years of their life2.
Those of us who invest in regular massage treatments and yoga classes know the great sense of calm that can be enjoyed with regular sessions, which in turn reduces anxiety levels and helps us to be more focused and energetic outside of the treatment room or yoga studio. Even though many of us feel these positive side-effects, it’s always nice to have some scientific research!
Massage therapy has been shown to reduce prenatal depression and prematurity rates in a range of studies undertaken by Tiffany Field and her counterparts at Touch Research Institute, University of Miami School of Medicine, over the last two decades. In a 1999 study, pregnant women received twenty minute massage therapy twice a week for five weeks during the last trimester of pregnancy. The group of women reported reduced anxiety, depression and back pain as well as better sleep by the last day of the study3.
In 2004, clinically depressed pregnant women received a twenty minute massage twice a week from their twenty week stage up to thirty-two weeks gestation. The prenatal effects were consistent with those of the pregnancy massage for non-depressed women in the study mentioned from 1999. Over the course of this study the participants experienced fewer symptoms of depression, as well as lower urinary cortisol levels - a physiological measure of stress - compared to the standard control groups. The massage therapy receivers also had fewer obstetric and postnatal complications, including a lower prematurity rate.
In a later study, in 2009, women diagnosed with major depression were given twelve weeks of twice weekly massage therapy. In comparison to their control group counterparts the women with major depression not only experienced reduced depression by the end of the therapy period, but their cortisol levels remained reduced during the postpartum period. Their newborns showed lower incidence of premature birth and enjoyed improved birth weights.
Along with massage, yoga has also been noted to decrease prematurity. In a prenatal yoga study, pregnant women were assigned to a yoga group or a walking group4. The yoga group practiced physical postures, breathing exercises and meditation from 20 weeks until delivery. More babies were born with birthweight greater than 5.5lbs in the yoga group, and the incidence of preterm labour was significantly lower in the yoga group, in comparison to the walking group and control group.
In Tiffany Field’s most recent study she and her colleagues focused on the hypothesis that yoga, by virtue of being a form of self-massage in the way in which people work through a series of postures, was expected to have similar effects to massage on the stress measures of depression and anxiety, pain measures of the legs and lower back and neonatal outcome measures, in this case gestational age and birthweight.
The researchers took eighty-four prenatally depressed women and randomly assigned them to yoga, massage therapy or standard prenatal care control groups in a bid to determine the relative effects of yoga and massage therapy on prenatal depression and neonatal outcomes5. Following twelve weeks of twice weekly yoga and massage sessions, at twenty minutes each, both therapy groups versus the control group had a greater decrease of depression, anxiety and back and leg pain and a greater increase on a relationship scale. Both the yoga and massage therapy groups had similar neonatal outcomes in regards to gestational age and birthweight while also representing greater gestational age and birthweight than the control group.
The way in which these studies measure feedback is through use of established research questionnaires, including; 1) Sociodemograhic/Social Support Questionnaire; 2) Centre for Epidemiological Studies Depression Scale; 3) State Anxiety Inventory; 4) State Anger Inventory; and 5) Relationship Questionnaire. All assessments are conducted by trained research associates who have no information on the study’s hypotheses, to avoid any potential for bias.
I regularly see pregnant clients in my clinic with Pelvic Girdle Pain, Symphysis Pubis Dysfunction (or SPD), swelling in the ankles and/or wrists, lower back pain, pain in the intercostal muscles of the ribs, shoulder pain and calf cramps, to name a few. Regular massage during pregnancy can significantly improve these health problems and, as the research reiterates, depression and anxiety symptoms can also be improved for the mother, while having positive knock-on effects for the baby.
During my prenatal massage treatments we spend as much time as is needed going over current concerns, whether that be lack of sleep, mental health problems, muscular aches and pains, joint pain, or swelling and cramping. We also discuss previous injuries, accidents and conditions and with this information we can, together, set an intention for the treatment and plan a massage that best suits your goals.
Amy Moffat, Sept 2018
1 Frisch & Riecher-Rossler, 2010; Orr, Blazer & James, 2006
2 Rahman, Iqbal, Bunn, Lovel, Harrington, 2003; Westerberg, Henriksen, Ellingvag, Veierod, Juliusson, Nakstad et al., 2010
3 Field, Hernandez-Reif, Hart, Theakston, Schanberg, Kuhn, & Burman, 1999; Field, Diego, Hernandez-Reif, Schanberg, & Kuhn, 2004; Field, Diego, Hernandez-Reif, Deeds, & Figueiredo, 2009
4 Narendran, Nagarathna, Narendran, Gunasheela, & Nagendra, 2005
5 Field, Diego, Hernandez-Reif, Medina, Delgado, Hernandez, 2011; Yoga and massage therapy reduce prenatal depression and prematurity.