Massage and Aromatherapy during all stages of pregnancy
I am sharing here my findings on why I can confidently suggest that a massage can be helpful at any stage of pregnancy, and how adding aromatherapy can really complement it. However one can have a perfectly relaxing treatment without it too.
When booking for a treatment, it is an experience that is for you, which you can shape as much or as little as you wish. But regardless of how much you voice, it will be in response to you beyond words, how you feel, where you ache or hold tension, and in the case of pregnancy massage, in full awareness of what goes on at the stage of pregnancy you are at, and what can be presenting for you as a result. What is comfort at one moment might not be at another, and having that adaptability promotes you feeling empowered and in tune with your own body. Receiving a massage doesn’t mean you have no say, however the hope is that trust is there enough for you just to relax and let go.
Aromatherapy in pregnancy:
Aromatherapy is a great addition to a massage treatment in pregnancy. I reduce the dilution to 2% or less; essential oils are powerful enough this way as senses are often heightened. This means that for a massage I am likely to use around 2 to 4 drops in total. To me, aromatherapy in a pregnancy massage is but a small part of the treatment, yet a very enhancing one. One that can make it richer, more complete, and really boost it.
I use essential oils (never ingested) to promote healing or provide relief and support. They do so primarily by either aiding relaxation or uplifting our mood. Additionally, they can help with constipation, with swelling, and in the event of congestion, flatulence or lowered immunity. They promote better sleep, better circulation, ease aches and calm the nervous system.
Oils that could lead to miscarriage are not used in Aromatherapy treatments, and those that are not recommended, there is no research that show threat without ingestion. A big majority are oils I tend to not use in any massage. I avoid all essential oils in massage in the first trimesters because I want to ease any worry, I am aware clinical research in pregnancy is limited. There are others I would only use topically, if If there is a sufficiently strong reason to use them such as to aid a specific reason late in pregnancy such as those used to promote labour. In my experience thus far this has mostly been the use of Clary sage, Jasmine or Sweet marjoram until near, on or past the due date. There has been a clinical trial with Clary sage during labour that has found it helpful as an analgesics to relax and to accelerate contractions (1) so this is the classic example of an oil contraindicated for pregnancy which is recommended in the later stages in support of it (2). Additionally to this the oil is seen as uplifting and tonic yet calming therefor perfect for this moments of needed clear strength.
I have been practicing aromatherapy for over 10 years and essential oils are companions in my practice however I take this extra caution and revise guidelines as I am aware mothers might worry or question the safety of a treatment.
I am aware that for the full therapeutic properties of essential oils to make a significant difference through absorption they need to be used regularly, however I use them confidently for the benefits of promoting wellbeing during a massage. During my practice so far, I have mostly focused on safe blends of treatments, however if asked about using oils outside of a massage, I can suggest some for compresses of for baths or to diffuse in a room for better sleep.
First trimester massage
During this time, the embryo is tiny and well protected inside the womb, however, still settling in place, the heart and brain are only just forming followed by the spine and all other organs and limbs. It can’t yet see of hear, but it is the beginning of the nervous system and perhaps the sense of touch, and shortly after, the nose is formed. People can’t tell yet that you are pregnant, however it is often one of the hardest times, as the whole biochemistry of the body changes, there can be a lot of fear, or doubt, as well as pressure to keep the news secret and perform as usual while the internal world re-shapes. You might go off food, crave for foods, experience nausea, feel emotional, feel tired or all of these. A lot of people avoid massage out of overwhelm, others out of not wanting anything to intervene or hinder the process of implantation and embryonic growth.
This time is all about what is understood in TCM as “ the embodiment of the corporeal soul”(3) and linked to the Earth element, and this is the energy around the establishing of the placenta, the embryo rooting in the uterus. The absence of the period means that blood is retained and the placenta begins to form. As the embryo is still implanting, focusing through nutrition, enough rest and good support mechanisms will help the mother hold that energy in the uterus for the baby to healthily form.
Supporting the mother, supports the baby, and during this time a massage is mostly focused on the power of holding, on touch, on grounding, and if appropriate, of connection. In a massage, releasing of tension plays a big part, this will help the mother cope, and there fore promote a healthy pregnancy. At this time I don’t use essential oils on the skin as it is a time of sensorial overload, but I might use some in the room if it seems suitable. Oils I might use in a diffused method are lavender, for overall relaxation, peppermint or ginger in case of nausea or dizziness.
Second trimester massage
The baby has grown and shaped all its organs and limbs, and by the end of it, it is believed it can hear, taste and see as well. It is understood in TCM that at this point its all about the foetus “connecting with the sovereign purpose of its existence”(4) and its destiny linking it to the element of fire, it is connected with the blood of the mother, igniting the growth of muscles and bones. Things often settle a little in terms of energy levels, nausea and sensitivities, the movements of the baby become apparent which can bring a lot of excitement. This is all often a relief, as it comes with some renewed energy, however on occasions in can create a disconnect. News are out, however life can carry on as normal. This leads to all the usual stressors of life that cause tension in the body, however the growth of the bump and the breasts, is a new thing to get used to. The increased relaxin allows now for the body to stretch to accommodate the baby and prepare for birth. This however can bring on heartburn, constipation, a weaker pelvic floor and impact on posture.
A massage at this stage helps to ease all those issues, address life tensions as well as provide a break. Allow for the mother to rest, tune into her self and connect with the baby and with the pregnancy. The support of the mother onwards is also a direct support to the foetus as well. Incorporating essential oils to the massage, is very safe and helps promote the ease of tensions, calm the mind and ground. In combination, it is a great reset that also promotes a healthy pregnancy. Typical oils I might use are Lavender, Black pepper, Roman chamomile or Mandarin for physical aches and constipation; Rose, Neroli, Frankincense or Petitgrain for relaxation and emotional support, and Patchouly, Vetiver or Sandalwood for grounding and support of all systems. However I am aware within this list there are cross overs of properties that are beneficial overall.
At this stage I am more likely to massage the bump, bringing in that connection with the baby, however I am careful to do so with with consent. I am also likely to discuss things to look out for in term of posture and exercise, that can benefit other stages of pregnancy and postnatally
Third trimester massage
At this stage the baby is fully developed and is mainly growing in size, hair and nails develop and organs are fully formed. In TCM it is talked about the support to the overall good flow of energy, especially linked to Wood element or “Hun”, as it is is about growth of new life, “organisation of events at the time of experience”(5). The foetus has less space to move inside the uterus and is finding their position. The anticipation begins, labour talks are more frequent and more monitoring of baby’s heart beat, of blood pressure, and of baby positioning might be taking place. This comes alongside more weight to carry, less space for the organs of the mom, more body pains, usually in the lower back, glutes or pelvis, possible oedema can develop, but also more excitement as the arrival is imminent. Hopefully also more relaxation as maternity leave will be either starting soon or might have started, and more nourishment as with labour comes the end of the pregnancy.
Some times if there have been other birth experiences that caused trauma, this can play out, causing worry and anxiety. There is often a need to balance listening to medical advice while still being able to listen to your self and stay in tune with your intuition. This is especially the case when going past the due date.
Massage as this stage offers a great relief to all the noise of it all without taking anything out of it. Is connecting with the pregnancy, with the baby and with one’s self in a more grounded way.
Ease of tensions all round helps the mom feel calmer through this process and provides some relief as well as offer support with self connection and calmness. There is generally a more downwards, approach to the session while also a lot of massage of the hands and feet to promote good fluid and energy flow. Often there is a lot of pressure on the lower back and glutes. Through different moves, positions and focused pressure strokes these can be alleviated. Aromatherapy can play a part as well, promoting calmness, and choosing oils that are known for promoting labour. My favourite oil to introduce at the later stages is Jasmine, thought said to promote contractions and relief pain during labour, in my sessions, I have introduced it for its amazingly uplifting scent, helping shift fears and anxieties while still being calming and nurturing promoting good sleep.
Regardless of what decision the mother makes at this stage about the labour, creating this space of meditation, introspection and relaxation the days before can support this transition, it is about her feeling empowered and aware as well as calm and relaxed, so although I am passionate about essential oils, I am also happy to not use them if that is what is preferred .
Aromatherapy during Labour:
Although the preparation includes having a detail plan of how we want things to go, we are also having to stay open to what comes. Here its all about being present and connected with you self. The use of essential oils in labour, I’d leave to who ever is supporting, however I would happily make a blend with the mother for a midwife, doula or partner to use on lower back massage or a warm compress, or suggest them to be used in an oil burner or diffuser.
In 2000, Burns & Blamey conducted a large observational study on over 8000 women during labour, over a 8 year period, reporting a reduction of anxiety and fear thanks to the use of aromatherapy, and the most chosen oils were Lavender and Frankincense (6). Clary sage and Chamomile having also been studied as helpful for relaxation. Peppermint and Lemon can be very uplifting as well as help with nausea, and for anxiety, Neroli or Jasmine are my choice followed by Ylang Ylang and Rose.
Some times things don’t go as planned though and weather one simply forgets in the moment to use oils or decides they can’t stand them, or things turn more medical, I see important to highlight the care and support received during the pregnancy, and remembering this as a way of accepting the immensity of the moment and staying with it. Which is one of the reasons having regular massages during pregnancy can be beneficial. And any oils or blends not used can always be used after as well.
Post Partum massage:
After labour comes another period of adaptation, while typically the body gets used to breastfeeding, the uterus starts contracting and reducing in size. Hormones change drastically as Oestrogen and Progesterone decrease rapidly followed by cortisol and slowly relaxin as well. Oxytocin and Prolactin increase helping the bonding process, however the reality of the life change is now apparent. Interrupted sleep and overall concern for the health of the baby, the physical sensation in the body of what it has gone through to deliver and how it has changed from before the baby and re-establishing new routines can be a lot physically, mentally and emotionally.
If there has been any complications or C section it is a period of additional rest and needed healing. This is medically identified as a 6 week period in which things return to place with the first 10 to 14 days being the most vulnerable to infections or blood loss. In other cultures this period is perceived as much longer: In Japan being 21 days and in TCM it is seen as a 4 month period called “Golden Month” in which the mother could either heal from any illnesses she might have had or contracting some for life. It is a time where there is a depletion of energies in the body, so rest and care are paramount. Providing the midwife has ok’ed a treatment, this massages are all about replenishment, closure and integration. They are adapted to meet mother and baby needs and if needed the baby can be there, however they are in support of the mother. In this period I still use a very low dilution of essential oils, and can use them diffused instead. I still advocate for them then as they can really help with any anxiety and relaxation. Oils I might use if so would be lavender or mandarin.
Aromatherapy for mental health support during pregnancy:
The role that essential oils play during a massage, is primarily through the impact they have on our central nervous system through smelling them. When choosing oils for someone, before blending, I will always check that they are happy with the smell. Essential oils are known for reducing stress and anxiety, this subsequently helps to resolve fears and ease overall tension In pregnancy and postpartum, this can help feel more in control, more clear headed, balance blood pressure and reduce the need for medications, before, during and after labour. Subsequently this can also promote a well oxygenated placenta, reduce the need of epidurals and success at breastfeeding, but also help to avoid or manage postnatal depression. They can do all this not as a one off sniff, but when used consistently or even better, as part of an overall series of sessions that support the holistic wellbeing of the mother. This can not replace the need for medical treatment or therapy when that is what is needed, but can support it and hopefully help prevent it.
I am aware that I have referred to mostly average pregnancies, and that there is a lot of nuisance when it comes to more rare situations and condition that can arise. I advise, always check with your midwife as to weather a massage is right for you at this time. If there is bleeding, severe abdominal pain or high blood pressure, or after birth if there are any signs of postpartum psychosis I wouldn’t proceed. However if other conditions might arise some modifications for the massage and where aromatherapy can still be of benefit.
I am writing this in part from my own experience as a mother but also with the memory of all the other mothers I have met and have had the honour of supporting in whatever capacity with pregnancy massage. I have trained to amplify my knowledge and confidence to be able to offer a variety of massage treatments to meet individual needs and with a heightened awareness of the basics of energetic bodywork on TCM vessels and other shiatsu points. Combining this with the use of essential oils and massage techniques old and new, I have had the joy of working with women from varied paths of life, each unique, each special.
Bibliography:
Salvatore Battaglia, The complete guide to Aromatherapy, Second edition, PG154-155-188-445-446-447-
IFPA Pregnancy and Lactation Guidelines 2024
In essence magazine, IFPA Vol 22 no 2 - 2024, pages 18/21. Lucille Casey and Sam Todd
Pregnancy and child birth, A holistic approach to massage and body work, Suzanne Yates. 2010 edition.
https://www.sciencedirect.com/science/article/pii/S0033318298713556#:~:text=Hormonal events in pregnancy and,term and declining at delivery.
Quotes and References:
(1) Holmes P. Clary sage. The international journal of Aromatherapy.1993; 5(1):15-17
(2) Burns E Blamey C. Soothing scents in childbirth, The international Journal of Aromatherapy 1998 (8)4:41-43
(3) Pregnancy and child birth, A holistic approach to massage and body work, Suzanne Yates, pg137, 6th paragraph
(4) Pregnancy and child birth, A holistic approach to massage and body work, Suzanne Yates, pg138, 1st paragraph
(5) Pregnancy and child birth, A holistic approach to massage and body work, Suzanne Yates, pg138, 6th paragraph
(6) E Burns C Blamey. The use of aromatherapy in intrapartum midwifery practice an observational study, March 2000Complementary Therapies in Nursing and Midwifery 6(1):33-4
