Postpartum is the time after you give birth. Generally it is considered as the first year, however it lasts much longer then that, as the body never gets back to 100% of its original state. And depending on how the birth went, as well as the type of birth, can effect your healing time afterwords.
Massage can be received immediately after you have given birth, but depending on if there were any complications, that will be what determines where you can be massaged as well as what positions you can be in. If you had no complications with a vaginal birth, the only restriction that you will have is being fully face down during your massage, within the first 24 hours after giving birth, possibly a bit longer. The only reason for this, is your muscles will still be tired from the overuse of pushing, which can make the muscles too weak to be able to get up off of the table, or to be able to turn over onto your back. This is even if you feel fine, and able to walk around right away. You might not even notice that the muscles are that tired, until you have been lying down for a certain amount of time. Sort of like after you had a major work out and you only feel it the next day.
If you’ve had a difficult birth, or a cesarean birth, also known as a C-section, there are a few more restrictions and modifications that will have to be done, but is still allowed. But there is a pretty good chance that if either of these have happened, you will most likely not feel up for going to a massage clinic right away, to be able to get a massage anyways. If you have a therapist that is willing to travel to you, you will be able to have a massage then, and only in the areas you feel comfortable with having massaged. You will more then likely be kept in a reclined position, to make you more comfortable in general, rather then trying to get you laying down on a massage table.
Another thing to remember is right after giving birth, there is a huge change in all of your hormones, which can cause you to experience all types of emotions. Sometimes this can become overwhelming, and by having a massage, even if it is only on your arms, or your back, by either a Registered Massage Therapist to anyone in your support group, can ease and calm you, allowing you to be able to adjust more easily to your new hormone levels.
Here are a few things that can be treated by using massage, after giving birth: breast tenderness, from either being engorged or blocked milk ducts; helping the ribs and diaphragm go back to their original position; correcting posture; urinary incontinence; prolapse; scar tissue healing, and much more.
For both incontinence and prolapses, they cannot be treated with massage alone, as the main treatment for it is preformed by a pelvic physiotherapist. They will work directly onto the pelvic floor, but any other areas of the body that directly affect the pelvic floor, like the diaphragm, abdominals and multifidus (tiny back muscles along the spine) can be worked on by a massage therapist to help correct both of these conditions. Depending on the severity, they can be fixed with these two types of therapies working together, along with some at home exercises. Unfortunately if you have a severe prolapse, you will have to go in for surgery to have it corrected.
Scars
The reason why some clients may need treatment on a scar is after they have had a cesarean delivery. This type of scar can also cause mothers to have a change in their posture due to scar tissue build up forcing other tissues to have a restricted movement, as a form of protecting the area. Unfortunately, this type of scar does need to heal for some time. Usually this is approximately 6 weeks, but some may need a bit longer, or may heal faster then this time frame. This would depend on how painful the area is, as well as how willing the new mother is with having the area touched, as some may be more self conscious of the area then they were before.
For the treatment of the scar tissue, most of it is direct pressure on the area, starting with the most outer portions of the scar. These types of techniques can include skin rolling, and other fascial techniques, fascia being the tissue the surrounds muscles and organs. Other techniques used to help with scar tissue, is also taking care of surrounding muscles to keep them from pulling on the area, this includes doing trigger point therapy (treatment of active knots) in the abdominal muscles, diaphragm (the muscle that helps with breathing, that is located just under the rib cage), pelvic muscles and hip flexors. When working on all the surrounding muscles, they can be worked on carefully before that 6 week mark, as long as the therapist is careful not to pull on the scar itself.
Unfortunately, when having a vaginal birth, if you had a tear in the perineum, massage isn’t able to help you. This is considered as an area that is outside our scope of practice, and you will have to see your OBGYN or family doctor to find ways to help you heal faster, or to decrease your chances of having another tear if you decide to have another child in the future.
Breast Massage
Another condition that can also be treated with massage that can be quite common, is swollen, tender or blocked milk ducts in the breast tissue. For this treatment you will never have both breasts exposed, only one at a time and it will only be the one that is being treated at that time. The nipple is never touched during this massage, and once the first breast is finished being worked on, it will be covered back up with a sheet or towel, then the other breast will be uncovered. This type of treatment uses both cool and warm cloths as well as the use of lymphatic drainage. These can help with relieving pain as well as any excess swelling within the tissues. The lymphatic drainage can help with the milk duct blockages as well, with the manual pumping portion being used as it can force what is blocking the milk duct through to the areola. The only time that this treatment isn’t able to be done is when there is an infection, in which case you have to go to a doctor and get antibiotics until the infection has been treated. After you have been cleared of the infection you can book your massage.
As for all other ailments, especially after the 6 week mark if you have had a cesarean delivery, will be the same as it would be before you were pregnant. This also includes positioning, as long as it is comfortable, and to stay within your pain tolerance.