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The article was translated into English using automatic translation. The editors are working on its improvement.

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Pregnancy is a special time in a woman’s life. This period is associated not only with the joy of expecting a child, but also with a number of possible small problems - both on the physical level and on the psycho-emotional level. All of them, of course, are a consequence of hormonal and physical changes in the body of the expectant mother and occur even during the normal course of pregnancy.<hr /> Evgenia Radionova, director and teacher of the International School of Massage<hr /> Here are some of them: pain in the back, neck, lumbosacral region, sacroiliac joints, lower extremities, cramps of the calf muscles; general fatigue, dizziness, insomnia, headache; psycho-emotional and physical stress. One of the means to solve these problems and prepare for childbirth is massage. It should be noted that traditional massage techniques are not suitable for pregnant women; in this case, a special individual approach is required; the massage therapist must have the necessary knowledge and qualifications. It is also advisable that the patient, before undergoing a massage course, receive advice from her supervising doctor. There are a number of contraindications to the use of massage during pregnancy:<ul><li style="text-align: justify;"> acute inflammation of blood vessels and lymph nodes, venous thrombosis and thrombophlebitis, pronounced varicose veins;</li><li style="text-align: justify;"> gestational diabetes;</li><li style="text-align: justify;"> heat;</li><li style="text-align: justify;"> vomit;</li><li style="text-align: justify;"> preeclampsia or eclampsia (eclampsia is a disease that occurs during pregnancy in the postpartum period, in which blood pressure reaches such a high level that the life of the mother and child is threatened; a form of late toxicosis of pregnancy - editor&#39;s note );</li><li style="text-align: justify;"> intestinal disorder;</li><li style="text-align: justify;"> threat of miscarriage;</li><li style="text-align: justify;"> placental dysfunctions;</li><li style="text-align: justify;"> infectious diseases;</li><li style="text-align: justify;"> diseases of hair, nails, skin;</li><li style="text-align: justify;"> tumors, etc.</li></ul> The main tasks when performing massage for pregnant women are relaxation, pain relief, activation of blood circulation and lymph flow, elimination of congestion in the pelvis and lower extremities; strengthening muscles, relieving stress on joints; improving general metabolism, preparing for childbirth. Research conducted by the University of Miami (USA) over 10 years showed that when using massage twice a week for five weeks, the level of cortisol (the “stress hormone”) and norepinephrine in a woman’s body significantly decreases, while at the same time the level of dopamine and serotonin increases. These changes ultimately lead to fewer complications during birth and fewer complications in newborns, such as low birth weight. During normal pregnancy, a massage can last from 10 to 60 minutes. The optimal number of general massage procedures is 1-2 per week. Particular attention should be paid to the patient&#39;s position during the massage. The body position should be as comfortable as possible and ensure complete relaxation.<hr /> Positions for massage There are three options for the position of a pregnant woman when performing a massage: lying down/lying on her side; sitting, half sitting. Lying/side lying position. During the first trimester, women can lie on their stomach. However, many experts do not recommend performing massage in the first trimester at all, which is associated with a high risk of pregnancy failure. If there is no danger of miscarriage, then when performing a massage in the prone position, you can place small pads under the subclavian areas to eliminate possible pain in the mammary glands. During the second and third trimesters, the patient can lie on a specially equipped couch, with openings for the chest and abdomen. But if your office does not have such equipment, then the patient may lie in a lateral position. Although it should be noted that experts disagree on the safety of special couches for pregnant women. Such couches often do not fully provide patient comfort. Very often the stomach does not fit into the opening, which creates additional pressure on it, or the stomach collapses, which creates additional stress on the uterus. The “side” position is the most commonly used and most comfortable. The leg that is on top is bent at the knee and hip joints. The bottom one is straight. Soft pillows should be placed under the bent knee and under the stomach. In this position, you can massage the neck, back, lower back, buttocks, and also massage the limbs. It is not recommended to lie on your back after the 20th week. Sitting position. The most comfortable position is sitting, with the patient sitting astride a chair, arms folded on the back, and a pillow can be placed between the back and the patient. In this position, you can massage the buttocks area, lower back, back, neck, shoulders, and scalp. Half-sitting position. The patient is in this position, leaning on the half-bent back of the couch; legs slightly bent and spread apart. You can put a pillow under them. This position reduces intra-abdominal pressure, especially in the last trimester. This position is convenient for performing a massage of the legs, arms, abdomen, and head.<hr /> Purposes of massage When performing a massage, it is best to use base oils or a neutral cream to make your hands glide easier. The use of aromatic or essential oils is not recommended due to possible increased individual sensitivity of the patient. The technique of performing massage in the first trimester (in the absence of contraindications) should be mainly aimed at general strengthening of the body, preparing the body for the second and third trimester. In the second and third trimesters, massage should have a more specific focus, such as eliminating back pain, reducing swelling of the limbs, etc. For swelling, cramps of the calf muscles and muscles of the inner thighs, the use of massage and static stretches will be effective. During the entire forty weeks, you can freely massage reflex points and areas of the hands and feet. But it should be especially emphasized that there are a number of zones and points of acupressure (reflexology) that are absolutely contraindicated for use during pregnancy. Exposure to them can lead to stimulation of the uterus and pelvic muscles and, as a result, miscarriage or premature birth. At the same time, the impact on many “forbidden” reflex points and zones in the first trimester is completely justified in the later stages and in the postpartum period. By influencing these points, you can reduce nervous tension, relieve pain, eliminate swelling, and, in the postpartum period, improve the function of the mammary glands.<hr /> Stages of performing a massage The massage starts from the back. First, superficial and deep strokes are performed. The technique is the same as in classic general massage. Pressing on the stomach is naturally prohibited. This is followed by rubbing, the purpose of which is to increase blood circulation and warm up the body. When kneading the long back muscles, some muscle pain is possible. In this case, it is necessary to perform light soothing strokes and move on to softer kneading techniques. It is prohibited to act on the lumbar region in the first trimester. The area of the shoulder blades and the collar area should be worked out more carefully; it is in these areas that, as a rule, there is the greatest muscle tension. After this, we move on to the foot massage. It is simply irreplaceable for relieving fatigue and swelling. All movements are from the periphery to the center. You should not act on the inner upper surface of the thighs, as well as on the lower third of the inner surface of the lower leg, since many biologically active points that are associated with the uterus and pelvic muscles are concentrated here. At the same time, we work the calf muscle well. Hand massage is also performed from the periphery to the center, working on each finger, palm, forearm and shoulder. As for the front surface massage , here it is necessary to use exclusively stroking, and the movements should be very soft, smooth and rhythmic. This is especially true for the abdominal area. Many experts completely exclude and do not recommend any impact on the abdomen by a specialist, leaving this care to future parents. In the last trimester of pregnancy, as well as in the postpartum period, massage of the mammary glands is possible. To prevent stretch marks in this area, on the hips and abdomen, it is recommended to use creams containing vitamin E (in the absence of individual sensitivity to the components of the cream).<hr /> Stimulation of active zones and points of the face In addition to carrying out the general classical massage scheme, it is also possible, at the patient’s request, to perform a short massage that stimulates active zones and points of the face that have a direct effect on the nervous system. Activation of these points will certainly relieve nervous tension and stabilize the emotional state. By acting on them you can achieve a state of greater relaxation. The work is performed using movements with pressure, circular movements or specific movements, directly affecting the nervous system. These zones can be divided into two groups: zones and points on the face and zones and points associated with the face. Zones and points on the face .<ul><li style="text-align: justify;"> Lips: the main movement is orbicular stretching of the lip area.</li><li style="text-align: justify;"> Mastoid prominence: Circular pressing movements using either the pads of the fingers or the thenar area of the hand.</li><li style="text-align: justify;"> Nose-bridge: movements in the form of kneading along the bridge of the nose with three fingers, the remaining two fingers of each hand go along the lagrimal line, with a friction movement we go down to the wings of the nose. Such manipulations will help reduce muscle tension, having a sedative effect on the nervous system and imparting relaxation to the facial muscle system, which will have a beneficial effect on the general condition.</li><li style="text-align: justify;"> Eyebrows: in the eyebrow area the brow arch is stretched, also affecting the eye area with orbicular movements.</li><li style="text-align: justify;"> Eyes: in the eye area we can apply small circular movements with gentle pressure. Among other things, this manipulation lowers blood pressure by reducing the frequency of contractions of the heart muscle.</li><li style="text-align: justify;"> Temples: in the temple area we make circular movements with the fingertips and friction movements with the hypothenar.</li><li style="text-align: justify;"> Lower jaw: it must be taken into account that this is the only movable part of the face, so here it is necessary to use movements with pressure, moving them against the direction of movement, towards the temple and grabbing the temple.</li></ul> Zones and points corresponding to the face. Working on these zones and points significantly promotes relaxation, although they are not located on the face. And the state of rigidity and hardening in these areas contributes to tension on the face itself. Shoulder-scapula: when massaging the face, it is recommended to capture this area with mobilization movements. In addition, we must remember that the shoulder-scapula area is directly connected to the cervical area. Cervical-occipital (cervical) area: working on the cervical area and neck muscles is very important to achieve maximum relaxation. To do this, you can use cervical stretches and mobilization movements along the upper spine and cervical region. Here you can add light pressure on the vertebrae, combining these movements with work on the shoulder. Skull area: here you can use light pressure on the cranial vault and combine them with movements along the cervical area in the form of circunction. Temporal lobes: In this area, you can apply circular alternative movements with pressure, while combining them with mobilization movements on the head. These movements can also be combined with mobilization movements along the spine (head in flexion position). You can finish the massage with a relaxing scalp massage.<hr /> Main conclusions To summarize this article, we would like to once again highlight the most important points:<ul><li style="text-align: justify;"> Before performing a massage, pay attention to the absence of contraindications;</li><li style="text-align: justify;"> movements when performing massage for pregnant women are smoother, slower, more rhythmic;</li><li style="text-align: justify;"> do not use intermittent vibration techniques;</li><li style="text-align: justify;"> do not affect reflex points and zones that are associated with the pelvic muscles and uterus;</li><li style="text-align: justify;"> During the massage there should be no pain, the entire focus is solely on relaxation, relieving stress and pain;</li><li style="text-align: justify;"> a woman who is expecting a child is in a state of heightened emotional sensitivity, so all your movements should be soft, your thoughts should be pure, and your heart should be open.</li></ul> Article taken from Cosmetologist magazine

Massage for pregnant women: distinctive features of the technique