Postpartum anxiety is one of the most common complaints in the postpartum period, and has several negative consequences. It can delay or prevent the release of oxytocin, potentially interfering with breastfeeding. Anxiety may negatively influence the emotional bond between the mother and infant, leading lead to potential psychological problems in children. Additionally, postpartum anxiety is a very strong predictor of postpartum depression. Early treatment of postpartum anxiety may help reduce postpartum depression disorder.
Research on Massage in Postpartum Anxiety
Iranian researchers conducted a controlled clinical trial to test the efficacy of massage therapy on postpartum anxiety. The study consisted of 100 primiparous (first time) mothers with normal deliveries. Women were divided into two groups – a massage group and a control group. Members of both groups were similar in age, education, and the use of medication during labor. (Citation: Iran Red Crescent Med J. 2016 Aug; 18(8): e34270. )
Massage was chosen as a treatment due to its ability to decrease levels of cortisol, adrenaline, and noradrenalin. Massage also has other beneficial physiological effects, especially muscle relaxation. Relaxation in the postpartum period decreases the activity of the sympathetic nervous system. This can prevent postpartum depression, and it can also increase effective mother-infant attachment.
In the experimental group, slow-stroke back massage was performed for 20 minutes. The massage was described as follows:
“The mother was seated on the edge of the bed. Then, the researcher grasped the top of the mother’s shoulders with both hands and placed the thumbs of each hand just below the base of the skull, making tiny circular movements on the upper neck. In the next stage, the researcher placed the palm of one hand at the base of the skull and made a long and smooth stroke all the way down the patient’s spine to her waist. The second hand followed the first at the base of the skull and stroked down the spine as the first hand returned to the base of the skull. Next, the researcher placed her hands on either side of the mother’s neck under the mother’s ears and stroked down and over the mother’s collarbones with her thumbs just over the shoulder blades and repeated the motion several times. Then, she placed the thumb of each of her hands beside the spine, beginning with the shoulders, and moved the thumbs down the spine to the waist and repeated this movement several times. Finally, she completed the procedure by placing her palms on each side of the mother’s neck and making continuous, long, sweeping strokes down the neck, across each shoulder, and down the back near the spine and repeated the entire process several times.”
In the control group, a researcher sat with the mother for 20 minutes but performed no massage. Twenty minutes later, and again the following morning, the mothers completed anxiety questionnaires.
Prior to the massage, both groups had similar anxiety levels as shown in questionnaires. Immediately after the massage and the next morning, there was a significant difference in the anxiety scores. After receiving the massage, the anxiety level of the experimental group was significantly reduced. Research on mothers on the first day after labor, third day after labor, and second day after birth reported similar results. The level of anxiety in the control group did not change.
As a result of this study, it is recommended that midwives, nurses, or other caregivers use massage in the early days after labor to help the mother achieve relaxation.