The physical and emotional toll of pregnancy can be overwhelming, and
one in five women will experience perinatal anxiety or depression. It's a statistic that's driving research into therapeutic interventions that may reduce this distress.
In recent years, massage during pregnancy has become more mainstream, no longer limited to women seeking alternative therapies. Instead, it's widely accepted as a legitimate way to ease the pain of labour and reduce stress in the lead up to delivery.
Recent research by Southern Cross University has demonstrated the safety, feasibility and benefits of partner-applied relaxation massage.
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Associate Professor Romy Lauche, Deputy Director of Research at the National Centre for Naturopathic Medicine, Southern Cross University, says perinatal anxiety is not only a challenge for pregnant women but also their partners and families and may impact maternal or infant mortality.
"New parents often report feelings of insecurity and lack of confidence in the efficacy of self-care activities.
"Through the partner delivered massage, our participants regained feelings of control and autonomy – which are key drivers in maintaining positive psychological health and reducing the need for clinical or pharmacological interventions," says Ms Lauche.
Women weren't the only ones to benefit from partner-delivered massage; partners also reported significant gains.
"Generally, many men feel on the outside to their partner's pregnancy, and inadequately prepared to support them during this crucial time.
"An intervention as simple as relaxation massage, however, provided them with the skills they needed to be a calming influence on their partners' anxiety."
Belinda Joyce, midwife and author of Survive and Enjoy Your Baby, says the study is a simple concept that has the potential to improve women's perinatal mental health.
"I love that it brought couples together and gave them a special time to talk and discuss their concerns freely. A feeling that they were in this together as a team.
"The massage gives the partner a concrete way to support the pregnant mother, which can then benefit in labour and beyond.
"Men are often left out of the pregnancy, birth and early parenting of their babies, and this gives them an opportunity to be more involved.
"It's also free and available to the majority of pregnant mothers whose partners are willing to help," says Ms Joyce.
Massage during labour
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Cochrane review of massage for pain relief during labour demonstrates that massage during labour decreases pain and anxiety and increases satisfaction with birth.
Despite the quality of evidence in the review, as it's impossible to blind people to whether or not they're receiving a massage, it's still an attractive therapy, explains Ms Joyce.
"In light of the potential benefits of massage, and the fact that there doesn't seem to be any evidence of harm, massage should be an available option for all people during labour for pain relief.
"Massage stimulates the release of endorphins. The lower back is most often massaged, but any massage will be helpful; be guided by the labouring mother and her needs."
Massage of the scalp is also relaxing, as is the use of labour blends of essential oils which allow hands to glide more freely, says Ms Joyce.
"Midwives are generally well skilled at massage and can help guide the support person."
Endorphins are at their highest levels in women who feel relaxed, safe and calm during labour, explains Ms Joyce.
"During labour, endorphins rise as pain increases, and we can optimise this natural endorphin release by keeping the labouring mother comfortable, calm and feeling safe.
"Women will actually feel less pain and many report feeling 'high' during labour and even in the early days after birth.
"By minimising fear and the associated adrenaline release, which can slow or even stop labour, we can enhance a mother's own endorphins."
The adrenaline release is most apparent when labouring women present at the hospital and their labour stops suddenly, only to return when they're feeling comfortable, says Ms Joyce.
"Massage is one of the tools that assists with this process."
Tips for partners on massage for pregnancy and labour
Always be guided by your partner's reaction to the massage. It's about relaxation, not therapy or treatment.
Practise techniques in the last few months of pregnancy discover your partner's preferences. This is also great for her relaxation during pregnancy. No need to take a formal course; you can watch massage videos online.
Using massage oil will enhance the experience, most edible oils will work - sweet almond oil is nice!
Only use specific labour blends of oil to massage during labour. These may have essential oils that encourage uterine contractions, which are not safe if not yet full term.
You can massage different areas of the body, such as hands, feet, back, neck, scalp.
Some women think they will want to use massage during labour but then don't want to be touched. Don't take this personally as it's quite common. Just being there and listening is more important than you will ever know!