C h e c k o u t A B M P P o c k e t P a t h o l o g y a t w w w. a b m p . c o m / a b m p - p o c k e t - p a t h o l o g y - a p p . 59
from skilled massage therapy, beginning
with reducing the negative effects of
this stress-saturated pandemic.
Editor's note: Portions of this article are
excerpted from the third edition of Pre- and
Perinatal Massage Therapy by Carole
Osborne, Michele Kolakowski, and David M.
Lobenstine. Projected publication is December
2020/January 2021 by Handspring Publishing.
Notes
1. Associated Bodywork & Massage Professionals,
"COVID-19 Updates for the Massage Profession,"
accessed July 2020, www.abmp.com/covid-updates.
2. Occupational Safety and Health Administration,
"Guidance on Preparing Workplaces for
COVID-19," accessed July 2020, www.osha.
gov/Publications/OSHA3990.pdf.
3. National Institutes of Health, "Special Considerations
in Pregnancy and Post-Delivery," accessed July
2020, www.covid19treatmentguidelines.nih.gov/
special-populations/pregnancy-and-post-delivery.
4. Centers for Disease Control and Prevention,
"Considerations for Inpatient Obstetric Healthcare
Settings," accessed July 2020, www.cdc.
gov/coronavirus/2019-ncov/hcp/inpatient-
obstetric-healthcare-guidance.html.
5. Evidence Based Birth, "Coronavirus COVID-19/
Evidence Based Birth Resource Page," accessed
July 2020, www.evidencebasedbirth.com/covid19.
6. American College of Obstetricians and
Gynecologists, "Coronavirus (COVID-19),
Pregnancy, and Breastfeeding: A Message for
Patients," accessed July 2020, www.acog.org/
Recommended Blood-Clotting Guidelines
For clients who have had COVID-19
and are seeking massage, these are
my best recommendations.
• Most conservative—wait at least
three months for any massage
• Less conservative—wait at least
three months for any massage of
the legs or lower abdomen
• Least conservative—but still probably safe
for most within the three-month after-
phase: strict adherence to leg massage
limitations and guidelines, summarized
in Image 5. Most importantly, work
superficially (light oil and pressure) on
the medial side of the entire leg and
into the inguinal area. In addition,
be cautious anywhere else major
arteries and veins reside, including
the neck and axilla, and be judicious
about using deep pressure there.
If you do not understand fully the
underlying physiological mechanisms
and these guidelines, I urge you to delay
working with pregnant and postpartum
clients until you further educate yourself.
CAN MASSAGE THERAPY
SAFELY HELP?
Absolutely! Despite all these increased
precautions and limitations, expectant and
postpartum clients may find great relief
The following articles fully articulate these concerns as they affect massage therapy in
general, and it is critical you understand this information. Read all of them prior to working
with pregnant and postpartum clients while COVID-19 is still spreading as part of your "first,
do no harm" imperative.
• Article—"COVID-19-Related Coagulopathy: Blood Clotting Through Thick and Thin" by
Ruth Werner, www.massageandbodyworkdigital.com/i/1256819-july-august-2020/34
• Blog—"COVID-Related Coagulopathy, Take 3: A Conversation with a Hematologist" by
Ruth Werner, www.abmp.com/updates/blog-posts/covid-related-coagulopathy-take-3-
conversation-hematologist
• Blog—"Ready to Dive Back In?" by Ruth Werner, www.abmp.com/updates/blog-posts/
ready-dive-back
• Interim Guidance—"The WSMTA's Interim Guidance on Practice Guidelines,"
www.mywsmta.org/resources/Documents/COVID%2019/WSMTA's%20Interim%20
Guidance%20on%20Practice%20Guidelines.pdf
patient-resources/faqs/pregnancy/coronavirus-
pregnancy-and-breastfeeding#How%20does%20
COVID19%20affect%20pregnant%20women.
7. Midwives Alliance North America,
accessed July 2020, www.mana.org.
8. P. Dashraath et al., "Coronavirus Disease 2019
(COVID-19) Pandemic and Pregnancy," American
Journal of Obstetrics and Gynecology 222,
no. 6 (June 2020): 521–31, www.ajog.org/
article/S0002-9378(20)30343-4/fulltext.
9. Susan Ricci, Essentials of Maternity, Newborn, and
Women's Health Nursing, 4th ed. (Baltimore: Wolters
Kluwer Health/Lippincott Williams & Wilkins, 2017).
10. R. Silver et al., "Prospective Evaluation of Maternal
Sleep Position Through 30 Weeks of Gestation
and Adverse Pregnancy Outcomes," Obstetrics &
Gynecology 134, no. 4 (October 2019): 667–76,
https://doi.org/10.1097/AOG.0000000000003458.
11. E. Shanes et al., "Placental Pathology in COVID-19,"
American Journal of Clinical Pathology 154, no. 1
(July 2020), https://doi.org/10.1093/ajcp/aqaa089.
12. P. Devis and M. G. Knuttinen, "Deep Venous
Thrombosis in Pregnancy: Incidence, Pathogenesis and
Endovascular Management," Cardiovascular Diagnosis
and Therapy 7 (December 2017): S309–S319,
www.ncbi.nlm.nih.gov/pmc/articles/PMC5778511.
13. T. Callahan and A. Caughey, Obstetrics
and Gynecology (Baltimore: Lippincott
Williams & Wilkins, 2007).
Carole Osborne is a pioneer of therapeutic
massage and bodywork for childbearing. Her
Pre- and Perinatal Massage Therapy book and
courses have paved the way for more than
5,000 therapists working with this population.
For almost 50 years, Osborne has been in
private practice in a variety of settings and has
been honored by numerous organizations in
the field. The third edition of her book will be
published in December 2020, with coauthors
Michele Kolakowski and David M. Lobenstine.
