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Postpartum Bodywork:
Advice for the Postpartum Massage Therapist
By Chula Gemignani
Instructor of Massage, Author, Bodyworker and Developer of
Dynamic Fascial Response™

In terms of bodywork and massage, what happens after the baby is born?

Every birth is so different but generally what I’ve experienced is that after birth there’s a time that my client will be retreating, adapting to their new life and bonding with their baby. If I wasn’t present at the birth then I make no assumption about what’s taken place. Rather than sending congratulations, I’ll send a message expressing curiosity in how my client is doing. This avoids any assumption that everything is well when there’s a possibility that there may have been complications. This way I’m sure to stay in rapport. I’ll let them know that I’m here for them when they need me for postpartum bodywork or a relaxing massage.

Once your client is ready to receive a massage they’ll invite you to a house call or will come into the office. If you don’t hear from them regarding postpartum massage, an email to them that educates on the benefits of postpartum massage with a coupon attached may be just what they need to ignite their attention towards self care once again.

How soon can I massage my client after birth?

As soon as your client is comfortable to receive it and there are no known complications.

Post Cesarean: Any abdominal massage or any core recruitment requires a wait until about 6-8 weeks when scar is healed and scar tissue is formed.

Why is postpartum bodywork necessary?

I can’t stress enough the importance of postpartum bodywork. Blending postural opening and balancing with relaxation massage is the key. The emotional load of new parenting, the lack of sleep, and the physical recovery as the body’s displaced muscles, organs and bones find their way back into place all will benefit from the integrating postpartum session.

How can I help my client’s improve their posture?

Anterior Unwinding of Repetitive Holding Patterns

The positions and activities of early parenting can be compromising to the body most of the day, every day creating repetitive holding patterns in the anterior (front) fascia. Looking down is one of the many gestures responsible for this. Forward head posture (FHP) is what causes neck and shoulder tension in new parents. Imagine the number of diaper changes, the amount of nursing hours, not to mention the hours gazing down in awe at this beautiful new arrival. And then there’s the weight of the breasts pulling the thoracic spine forward. The tension in the back of the neck and shoulders usually is coming from the constricted fascia in the front. According to Kapandji (Physiology of the Joints, Volume III), for every inch the head moves forwards, it gains 10 pounds in PSI weight. A normal 12 pound head can turn into a 32 pound head respectively. This gets translated to the muscles in the upper back and neck and they have to work much harder to keep the head (chin) from dropping onto the chest. FHP also forces the suboccipital muscles (they raise the chin) to remain in constant contraction, putting pressure on the 3 Suboccipital nerves.

This is why ventral and abdominal anterior unwinding is needed in massage for any new parent to help support good posture and to release neck and shoulder tension.

What should I expect during a postpartum session?
The client finally gets to lie on their belly and back or any position during their postpartum session. Their breasts may be sore and full of milk. A memory foam topper is helpful.

What do I do if my client leaks? MER Milk Ejection Reflex / Letdown (“Leaking”)
Breasts may leak breast milk during the session so provide a towel for your client to place under or over breasts whether lying prone or supine. The hormone oxytocin causes the milk ejection reflex (MER) or letdown.

If my client’s baby wants to nurse during the session, how do I accommodate a nursing baby? I always let them know that their baby is welcome to the session. Your client will appreciate this gesture of support. Ask them to bring someone to care for the baby if possible and inform them that if baby needs to nurse during the session it wont pose a problem because you can always switch to side-lying and still get a lot of bodywork done while their baby is nursing. Knowing this, you may want to save low back and hips for the last part of the massage just in case you find yourself working on a side-lying, nursing client. There is also the possibility that your client may not be ready to be separated from their baby at all and so you may have a fun and adventurous massage with a baby present. Think about adding a memory foam topper to your massage table for your clients comfort in side -lying positioning.

What positions are OK for postpartum massage? All positions are safe unless compromised circulation is present in which case you would use left side-lying.

Side-lying if breasts are sore (usually first few weeks) or if client needs to breast feed while in session.

Are there postpartum massage contraindications?
There are many warnings and contraindications and it’s important that you are certified in pregnancy massage or have learned those before proceeding with massage.

What if my client had a C-section? The importance of gentle and soft abdominal massage is crucial after a C section to help break up scar tissue. The surgeon’s cut may have been precise but scar tissue forms differently for everyone, sometimes irregularly and may even form adhesion over internal organs. Gentle massage will help break up those scar patterns so the client does not have unwanted back or pelvic pain. Adhesion can also prevent further pregnancies which is another reason to be sure to offer abdominal massage. There are time guidelines and contraindications for post C section massage that a massage therapist would learn in a certification course.

Is it OK to let my client talk during a session?

Emotional unwinding Your client has just gone through one of the biggest passages of their lives and will probably want to share with you their birth experience as you work. Allow for this unwinding with a listening ear. Eventually she will drop in to receiving and telling her story will help the process of letting go into the present moment. The more present they can be with themselves, the more present they can be for their baby.

What mechanical advice can I give my client?

Watch your posture, try not give yourself away.

When picking up child try not to bend over.  Instead, squat to pick up child, try a kegel and push feet into the floor to stand while engaging glutes.

Counter stretch whenever possible especially after long held positions like nursing.

Try not to favor one side.

Try slightly tucking chin to help improve suboccipital tension.

Take walks

Alternate sides when holding child.

Stay hydrated, set a timer on phone for water intake.

Sleep when baby sleeps.

Yoga, pilates, or joining a postpartum exercise class can help recruit the core when the client ready for that.
It’s good to encourage them but your client may not be ready, so be sensitive to their process and stay in rapport.

The next 5 Day Pregnancy Massage Certification in DFR Bodywork is
Feb. 15, 16, 17, 23, 24. Pre-registration discounts will expire after Jan 1, 2019. Class is limited in size and registration closes after 12 students are enrolled.
Visit DynamicFascialResponse.com to register
Email inquiries to: info@DynamicFascialResponse.com
Include Subject Header: “Winter Pregnancy Massage Certification ”

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Pregnancy Massage Certification Training in DFR™

Our next Pregnancy Massage Certification is coming up and here are what professional bodyworkers are saying about this dynamic, continued education training….

“Chula’s class gave me a well rounded understanding of prenatal massage and postnatal care. Her teaching style is organized, focused, and kind. She will wait until every last person is on the same page before moving on. I will continue to take every class she offers and encourage fellow body workers to do the same!”

“She was very patient and clear and very easy to pay attention to. Her enthusiasm for the subject was contagious”

“I really appreciate the book and all of the reference material that was provided”

“I loved all of the fascia techniques and Chula was very organized.”

“I have found this course invaluable, not just for being able to work with prenatal clients, but for returning to my bodywork roots and once more finding my voice with which to perform…”

“I feel much more confident and comfortable with the idea of working with prenatal clients”

“This course is amazing! It has made me more aware of my working posture and how to connect it”

“I feel confident and proud announcing that I do prenatal massage. The bonus is that a lot of what I learned can be used on my other clients”

“I like that Chula showed us the proper techniques and then allowed us to modify them to our specific style”


See dates and sign up for the next training by clicking this link. 
Class size is limited to 12.

Client Testimonials:
“Chula was such a helpful calming soothing presence during my pregnancy and at my birth! She worked with me prior to my birth multiple times, and her strong, skilled work helped my back stay out of pain, and my body adapt in a healthy way to the changes it was going through. At my birth, Chula’s talented touch and grounded nature helped me make it through the worst contractions and gave me rest and rejuvenation in between contractions. Her years of experience as a peri-natal therapist built trust, and her warmth and nurturing presence was a balm while I labored. She knew just where to apply pressure and how to work on my body to give the most support. Chula’s strength and stamina was amazing! In spite of a very long labor, Chula stayed by my side for several hours and continuously gave sustained deep work that made my experience easier. Chula’s presence provided more than massage therapy – she was counselor, unofficial doula, and even stayed after everyone else left to do the laundry and clean the house!
My husband also appreciated her calm, healing presence, and her respect of our space when we needed it. I highly recommend Chula as a perinatal and at birth therapist!”
“I was fortunate enough to find Chula as my prenatal massage therapist. I am also a bodyworker, and so appreciate a knowledgeable, effective bodyworker. Chula is not only both of those, but also very professional. Chula worked on me at the end of my first pregnancy, and so when i was pregnant again this last year, i couldn’t wait to call her again. I can’t begin to express the amount of gratitude I have for her! She helped me so much with extreme pains I experienced during my pregnancy. Her understanding of the body and her ability to apply that knowledge make her a wonderful therapist. Chula is also willing to unravel the layers that might be involved in the various discomforts of the physical body. She has listened to me share from my heart, and has offered empathetic and helpful reflections that enabled me to move through emotional blocks. Even now, after I’ve had my baby, I will use Chula to help me with an on-going hip injury. She provides thorough and effective bodywork, and is always willing to listen to my needs. She is an asset to our community!”

From an article published in the Nevada Union Newspaper 2017:
“I tried a few other massage therapists for prenatal massage, but Chula was above and beyond,” said Cameron McGowen of Nevada City, whose baby is due May 24. “Her table is set up in the most comfortable way and I always experience a lot of relief. It’s all in her training — a less experienced therapist would be a little nervous. She’s very adaptable. After all these years, she has so many tools on her belt.”

Please share event invite:

https://www.facebook.com/events/393451371109479/

See dates and sign up for the next training by clicking this link. 
Class size is limited to 12.

 

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Prenatal, At-Birth and Postpartum Massage Training

Five Day Prenatal, At-Birth and Postpartum Massage Training

DATES: Fri., Sat., Sun. Sept. 8th, 9th, 10th
Class continues for two more days at same location:
Sat Sept 23rd and Sun.Sept 24

EARN 40 NCBTMB APPROVED CEUs
Location:
Cedar Ridge Center
TIME: 9am-6pm [ EARN 40 CEU’s, class is approved by NCBTMB]
Price: $600 (Please see testimonials below)
Class is limited in size.
RESERVE: your place with a $150 Deposit
DISCOUNT: Early Bird Discount
$550 if Paid in full by AUG 1
$600 after AUG1
Material Fee: $25 to be collected day of class.

*REFUND POLICY: All payments are non-refundable and non-transferable

BONUS: Purchase this course and get $40 coupon off any of the following courses:

1) NECK/TMJ TREATMENT
https://www.facebook.com/events/1901958886745276
2) SHOULDER/CARPAL TUNNEL TREATMENT
https://www.facebook.com/events/1322951871146162/
3) LOW BACK/HIP SCIATICA AND SI JOINT TREATMENT
https://www.facebook.com/events/1568088979888340
4) WORKING ON CHILDREN WITH SCOLIOSIS
https://www.facebook.com/events/1246424452130448

CONTACT: Chula Gemignani chulagem@gmail.com

Chula Gemignani is vetted and approved for providing Continued Education Units by the National Certification Board For Therapeutic Massage and Bodywork.

Dynamic Fascial Response™ is healing modality created from Chula Gemignani’s years of experience. It is a blend of structural therapies and foundational philosophy that induce a ‘dialog’ of activation and response between the practitioner and the fascia/client body. The response in the fascia releases holding patterns in the fascial body and as a result, both physiological and emotional changes occur. This method resources and repurposes the stuck patterns and can heal trauma, relieve pain, improve posture and health and above all promote peace.

This bodywork may involve passive or active client participation.

Students who receive a minimum 24 hours in DFR courses and have video taped proof OR instructor approval of student’s proficiency of the material learned are free to use the terminology Dynamic Fascial Response™ for their work.

Feel free to share this invite widely however only professionals (massage therapists, doulas. midwives, chiropractors, physical therapists and nurses) will be accepted as students. Some exceptions may be considered like other manual therapists, etc.
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This FIVE day course will give you the confidence and knowledge of a specialist in prenatal massage. Student will be shown safe prenatal, at-birth and postpartum massage in an interactive group of professionals.

This class will consist of about
25% lecture and presentation
25% live demonstration of the material being covered
50% hands on practice of the material with fellow students.

A student handbook will be yours for future reference.

This class covers:
~ Prenatal massage safety and all contraindications.
~ Somatic healing techniques for overcoming emotional challenges
~ A structural approach will be taken to teach manual therapies for massaging your pre-natal, and postpartum client.
~ You will learn Dyamic Fascial Response™ massage techniques inspired by modlities including but not limited to: fascial release, structural integration, craniosacral therapy, lymphatic drainage, effective pin and stretch, resist and release, traction and compression techniques. All which will help your client ease through the various stages of the passage into motherhood.
~ At-birth massage techniques for a more easeful birth.
~ Up-to-date ethics concerns and solutions will be discussed for the prenatal massage therapist in the age of transgender rights.

Testing consists of short quizzes for each day covered which will be self-corrected and discussed as a class. A prenatal massage on your last day will act as your final exam.

“I’ll never forget the way it felt to massage a pregnant woman before I was a prenatal specialist. I do not want other therapists to feel as insecure or as unsure as I did. I want to keep mothers and babies safe and well cared for by responsible massage therapists. For this, I have created a practical student handbook, filled with illustrations and learning material that will facilitate this dynamic class of group and problem-solve learning, demonstrations, and upon completion, solid practitioners. “
~ Chula

Testimonials:
“Chula’s class gave me a well rounded understanding of prenatal massage and postnatal care. Her teaching style is organized, focused, and kind. She will wait until every last person is on the same page before moving on. I will continue to take every class she offers and encourage fellow body workers to do the same!”

“Chula is one of the best teachers I have ever had. This structural work is difficult for me but she made it much easier for me and was very patient and clear and very easy to pay attention to. Her enthusiasm for the subject was contagious”

“I really appreciate the book and all of the reference material that was provided”

“I loved all of the fascia techniques and Chula was very organized.”

BONUS!
This course is for treating the pregnant client however, there is a bonus. Most of the side-lying techniques that you will learn for solving low back and hip pain, will be appropriate for non-pregnant clients as well as the jaw release that you will be able to bring to any clients suffering from chronic headaches, TMJ, neck issues or pelvic issues. I was already a good bodyworker before I learned this material, but with it my work became great, my schedule full and word of mouth has helped my successful career grow even more rewarding. It is truly inspiring work that fuels my fire.

Upon completion of this course you will be a pregnancy massage specialist and will have a specialist’s confidence and 40 continued education hours. A certification of completion of hours will be mailed to you in a timely manner after this class is completed.

Contact me with question at chulagem@gmail.com.
Be sure to put PRENATAL CLASS in subject.
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Chula Linda Gemignani has been a bodyworker for 15 years+ and a prenatal specialist since 2009. She has helped many mothers bring healthy children into our community. Her unique style has sustained a thriving practice. She incorporates many modalities and is widely known for effective myofascial release and structural massage techniques. In addition to massage, Chula is a somatic specialist and offers Somatic NLP for those who wish to address behavioral and emotional patterns no longer serving their life.
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