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Trimester Information for Massage Practitioners

First: 14 weeks from the 1st day of last period

Baby:  from egg to 3 " long, fully developed body, arms, legs, nails, ears

Mother:  uterus grows; heartbeat heard at day 26; increase in nausea and vomiting possible; at 10 weeks relaxin begins affecting joints - minimal structural changes occur; fatigue; increased blood volume and increased heart rate; metabolic changes; increase in frequency of urination; constipation; anemia; headaches and dizziness possibly due to hormonal changes.

Massage:  Risk of miscarriage the highest; no abdominal massage; do massage to assist circulation; no reflex massage; no passive ROM if nauseated

Treatment plan: focus on postural alignment; pelvic, diaphragm, rib cage, low back.
teach relaxation techniques and deep breathing exercises, kegel exercises, pelvic clock exercises

Second: 14-28 weeks
Baby: grows to 11" and 1 1/2 lbs. fingerprints, eyebrows and eyelashes form; 16 weeks sensitive to light; 24 weeks hearing develops; 29 weeks opens eyes and looks to light source.

Mother:  Structural changes: stress on low back upper back, pectorals; rib cage flares out at base and elevates; diaphragm elevates at rib attachments; breathing is mostly costal; abdominal breathing difficult; linea alba separates;  center of gravity changes to adapt to extra weight held in front.
Varicose veins and muscle cramping occur.  Skin stretches. Breasts swollen and tender.

Massage: Decreased risk of miscarriage; deep tissue ok on areas of chronic stress; joints less stable due to relaxin especially SI joint, symphysis pubis and hips.

Treatment plan: Focus on increasing breathing capacity, releasing abdominal attachments at lower rib cage; releasing intercostals. Watch for sciatica, low back and upper back  problems related with changes in center of gravity.  Continue to teach relaxation and connection to breathing.  Open up pelvic floor by working on adductors, hamstrings and rotators later in this stage.

Third: 28-40 weeks

Baby: 14-16 " and 2 1/2 -3 lbs: at start; grows to 5-9 lbs. and 20" in length; 29 weeks lungs developed; 32 weeks brain development, eyes track movement, sleep patterns develop.

Mother:  Shortness of breath, difficulty breathing as uterus grows to rib cage; diaphragm rises 1 1/2 " upward; Difficult to move and walk; hemorrhoids, varicose veins, heartburn, hiatal hernias, frequent urination, constipation, trouble sleeping, edema in ankles and legs, carpal tunnel, stress to heart

Massage:  same as in 2nd trimester

Treatment plan:  Decrease stress to postural muscles - adductors, legs, hips, low back.  Decrease edema. Increase relaxation.




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