Issue link: https://www.massageandbodyworkdigital.com/i/1299745
vessels to dilate or contract to either increase pressure, or to manipulate the myocardial mechanism to increase the heart and stroke volume. This process enhances the blood flow to muscles, enabling them to function at a heightened level for self-preservation. 20 It is when this process doesn't normalize, that the body can become prone to disease. Complications that arise due to hypertension are the leading cause of US infant and maternal mortality rates across all races. Common complications include: • Preeclampsia—a condition of pregnancy that includes high blood pressure, usually presenting around the 20th week of pregnancy (or after birth) and indicates that the liver and kidneys are not working normally. Preeclampsia is the cause of 15 percent of premature births. • Premature birth—babies born before 37 weeks. • Low birth weight—often a result of premature birth, low birth weight refers to babies that weigh less than 5 pounds, 8 ounces. • Placental abruption—when the placenta partially separates from the wall of the uterus before birth, often resulting in growth problems, premature birth, and stillbirth. • HELLP syndrome—a serious pregnancy complication that affects the blood and liver due to breakdown of red blood cells that carry oxygen from the lungs to the rest of the body, elevated liver enzymes that can be an indication of liver problems, or low platelets— tiny fragments of blood cells that help form clots to stop bleeding. 21 Stress and Blood Pressure During Pregnancy A 2008 study of 170 pregnant white and African-American women looked to see whether there were racial differences associated with stress and blood pressure, including the combined effects on infant birth weight. 22 Many measures and parameters were put into place, including the general societal percentage of hypertension among Black versus white American women. The study took into account both systolic blood pressure (SBP) and diastolic blood pressure (DBP) measurements and how each number was affected based on the combination of stressors for both African-American and white women on study entry. Results found that both elevated SBP and DBP were associated with stress for African-American pregnant women but not white American women. When looking at elevated stress and blood pressure as separate influences on birth weight, though, it was noted that white women had higher birth weights. When looking at birth weight and high stress levels, DBP had a negative association. These results indicated that the higher the DBP, the greater the predictor of the lowest birth weight. The research also noted that Black American women are twice as likely to suffer from the combination of higher stress and DBP than white American women, or any other racial groups. It was concluded that racism was a "uniquely salient psychosocial stressor." 23 Differentiating Physiological from Racial Stress Two separate studies focused on differentiating physiological stress from racial stress among pregnant women to see if there was an effect on birth outcomes in weight and gestational age. "Very Low Birthweight in African American Infants: The Role of Maternal Exposure to Interpersonal Racial Discrimination" (2004) looked at 312 Black women over a three-year period to identify any mitigating factors to determine why some Black women suffered preterm deliveries resulting in very low birth weight for their babies, on average 3.3 pounds, while others were able to carry their babies to full terms with an average weight of 5.5 pounds or greater. Researchers concluded that the frequency of perceived encounters of racism over the span of the woman's lifetime "constitutes an independent risk factor for preterm delivery" resulting in very low birth weight. 24 "Racial Differences in Birth Outcomes: The Role of General, Pregnancy, and Racism Stress" (2008) included a sample of 51 pregnant African-American women and 73 pregnant non-Hispanic white women, with both groups holding a college degree or higher and earning a higher income than the general population of their corresponding groups. The results indicated that Black Americans had a less favorable birth outcome than the non-Hispanic whites. 25 Although there were earlier studies on perceived racism, the researchers claimed that (to their knowledge) no research had been done that focused on a lifetime of perceived racism experienced—or vicariously experienced—from childhood through to adulthood. 26 These studies concluded that this lifelong struggle created an "independent risk factor for preterm delivery" and could be used to predict birth weight in African-Americans once the medical and sociodemographic risk factors had been considered. 27 MASSAGE AND STRESS REDUCTION Reliable double-blind studies on the efficacy of massage are rare due to the complexities of attributing cause and effect to human touch. Studies that do exist tend to use a small sample size, and very few look at ethnic race and the use of complementary and alternative medicine. No studies, to date, focus specifically on the effects of massage and racial stress. Smaller studies suggest, however, that massage has a real and measurable impact on our overall parasympathetic systems by increasing relaxation, lowering blood pressure, and calming the central nervous system. Some notable studies to consider in this area include: Stress Relief with Trigger Point Therapy A 2002 study was conducted to look at trigger point therapy on the head and shoulder area in healthy clients. Researchers wanted to assess areas that were easily accessible to nurses to incorporate into their normal care protocol. The study was conducted on 30 healthy individuals (both male and female; all about the same age), at similar overall emotional and physical states. Measurements taken before and after trigger point therapy showed an increased parasympathetic 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 . 77