interacting within the perinatal healthcare system

1

Interacting Within the

Perinatal Healthcare System

Webinar #5 of Growing a Prenatal Massage Therapy Practice

Carole Osborne

Carole Osborne

•Author

•Course developer

•Instructor

•National Teacher of the Year

•Therapist

In this Webinar You Will Learn

• Who are typical providers?

• Why you might want to

connect with them

• Elements of letters &

forms

• Patient privacy regulations

• Relevant research on

prenatal massage benefits

• Collecting objective data

• Insights from Michele

Kolakowski, a hospital-

based prenatal MT expert

2

Questions to Consider

1. What are the benefits of high quality communications between MTs

and the providers of healthcare and other professional services for

expectant women?

2. According to professional standards, and legal requirements in many

cases, what type of form must you have completed and signed by your

client in order to interact with her other providers?

3. In what circumstances is a maternity healthcare provider’s approval

recommended when an MT works with a pregnant woman?

4. In what circumstances is a prescription from a maternity healthcare

provider approval needed for prenatal massage therapy?

5. What types of benefits for prenatal MT has preliminary data indicated

might be verified by research?

6. What benefits did the Moyers 2004 meta-analysis of many MT studies

document?

7. What benefits of prenatal massage seem to be suggested by studies on

pregnant and post-surgical rats?

Types of Maternity Healthcare Providers

Midwives: In the US, direct

entry & nurse midwives Obstetricians

Nurses

In obstetrical offices In hospitals: antepartum,

labor & delivery, &

postpartum

3

Childbirth Educators

Other Providers

Doulas/Labor Assistants Diagnostic Technicians

Mental Health

• Peer counselors

• Professionals who are

preventing, treating &

minimizing negative

effects of perinatal mood

disorders : Counselors,

social workers,

psychotherapists &

psychiatrists

4

Other Providers Treating Musculoskeletal Pain

Physical Therapists &

Trainers Chiropractors

Collaborative Trends

• Utilization of MT in

healthcare increased 20%

in 2012

• Increased referrals by

healthcare providers

• Prenatal MT thriving : spas,

medical & midwifery

practices, wellness centers,

women’s health centers,

hospitals

• Inclusion in complementary

and alternative medicine

(CAM) along with

midwifery care

5

Treatment Benefits of Good Interaction

MT to

Provider

Provider

to MT

Increases effectiveness of care

Provides further information

Secures guidance on medical issues

Produces more individualized application of precautions &

contraindications

Business Benefits of Good Interaction

Demonstrates medical necessity,

functional outcomes & cost efficiency

Offers marketing & networking for your

practice

Informs & educates providers about MT

Provides some evidence of due

diligence if liability questions develop

MT to

Provider

Provider to MT

If woman’s pregnancy

is high risk

If medical complications develop

or

notice signs of complications

If you or client has concerns about your

massage therapy or her pregnancy health

When requested by other healthcare

providers who submit proper forms

When to communicate

6

Foundations for Productive Communication

• Maternity MT knowledge and

experience

• Ability to speak their language

• Respect for other providers

• Maintenance of scope of practice

and other ethical concerns (refer

to webinar #3)

• Established pathways for

communication

Communication Media

Communication Types

Introductory letters to establish relationships and referrals

Reports

• Initial

• Progress

Permissions

• Release forms

• Permission to consult

Personal letters

Individualized communications

Prescriptions

Give permission

Set safety guidelines

7

Privacy Issues

Heath Insurance Portability

and Accountability Act (HIPPA)

Electronic submissions and security

From Hands Heal, 4e, Diana Thompson, used with permission of Lippincott, Williams and Wilkins

8

Consent or Release of/ Request for

Information

�Client’s name

�Therapist’s name

�Address and phone

�Name of person to whom information may

be given

�Type of information

�Time frame of release

�Signed, dated, and on file


Healthcare Providers’ Approval for MT

� Client name

� Client date of birth

� Your complete contact information

� Reason for communication

� Action requested

� Print of provider’s name, title, date

� Provider’s signature

9

Basic Providers’ Approval (Release)To: Maternity Healthcare Providers

Re: Release for Therapeutic Massage During Pregnancy/Postpartum

Your patient, ________________________________, has requested prenatal therapeutic massage. Therapeutic massage

during pregnancy is provided as adjunctive health care.

It is our policy to work with a woman only if her maternity healthcare provider has reviewed this request

with her. In addition, if her pregnancy is high risk, or she has experienced any complications or

contraindicated conditions, we require a written release from her healthcare provider stating any specific

limitations or precautions that you feel to be appropriate.

Please verify your clearance of this request by your signature below. This verification can be modified or

withdrawn at any time should your patient’s health status change. I welcome this opportunity to work

with you in providing prenatal care to your patient. Thank you for your time and assistance.

Patient’s pregnancy is: ____normal progression ____complications ____high risk

Specific limitations or precautions:

You may contact me directly for clarification or concerns regarding this patient. Yes No

Signature: _______________________________ MD DO Midwife Date: _______________________

Please print your name:_______________________________________________________

Office phone:_______________________________ (fax):___________________________ email: ____________________________________

Date:To:From: Michele Kolakowski, RMT at Sanctuary Healing Arts, LLCColorado State Registration # MT-1805, Certified Maternity Massage Therapist

Your Patient _______________________________________ Date of Birth ____/_____/_____has requested prenatal/postpartum massage therapy as a complement to your medical care. In the case of high-risk condition or complications, it is my policy to have the patient’s prenatal/postpartum care provider review this request before massage therapy services are provided. With excellentcommunication between the patient and her care providers, massage therapy and patient positioning can be safely adapted to best meet the patient’s needs.

As indicated below, I have secured this patient’s written permission to consult with you regarding herhealth and treatment. I, ________________________________, give Michele Kolakowski RMT, permission to consult with my prenatal/postpartum care provider regarding my health and treatment.Patient Signature _______________________________________ Date _______________

Please verify your approval or disapproval of this request for massage therapy and indicate any concerns, precautions or limitations for her massage therapy treatments below.Patient’s Diagnosis ______________________________________________________________Massage therapy is (check one) � approved � not approvedIf massage therapy is approved, please list any concerns, precautions or modifications for her massage therapy treatments.__________________________________________________________________________________________________________________________________________________________� Please check if you want to receive this patient’s massage therapy progress notes and provide yourpreferred mailing address or email address _____________________________________________________________________________________

Care Provider’s Name (print) _________________________________ Date _______________Care Provider’s Signature ____________________________________

Michele Kolakowski , Licensed Massage Therapist and Certified Birth Doula (DONA)Sanctuary Healing Arts, LLC 2138 River Walk Lane Longmont, Colorado 80504303.570.7942sanctuaryhealingarts.com [email protected]

Prescriptions

� MT’s Contact info

� Patient’s name, DOB

� Date

� Referring provider’s diagnosis

� Frequency, duration & goals

� Medically necessary treatment plan

� Precautions & contraindications

� Referring provider’s contact info

10


Reports to Providers

• Initial report to

summarize

important findings

• Progress reports

including session

SOAP notes (see

webinar #3 this

series for examples)


11

Calgary Maternity Massage Therapy

Client Treatment Form

Name:

__________________________________________________________

Date

Notes

Date

Notes

Used with permission of Linda Hickey, RMT


In the Spa Setting

• Maximum info in the

minimal time allotment re

pregnancy: week of

pregnancy, if any

complications or high risk

conditions are present,

what the client’s goals or

needs are

• If incomplete information,

then may want to limit

goals to relaxation as

determining risk factors or

complications developing

is difficult

12

Research Pertinent to

Prenatal Massage Therapy

Massage Therapy

Obstetrics

Midwifery

Doula

Nursing

Physical therapy

Chiropractic

Sociology

Most Massage Therapy Research

Few replications

Small sample

size

Outdated

Relevant Massage Therapy Research

Massaged group of pregnant

women had less back and leg

pain

And lower levels of reported

anxiety /stress & hormones

in saliva

Similar results with depressed second trimester women

13

Relevant

Massage

Therapy

Research

Daily acupressure to PC-6 on

forearms may reduce nausea


• Slow stroke back

massage may help

reduce BP & heart rate

• Massage by partner

may decrease pain &

reduce depression,

anxiety & anger in

both


Meta-analysis of massage

research found that a

course of massage therapy

reduced trait anxiety and

depression

Magnitude of effect similar to

psychotherapy

Also less pain perception

Moyer CA, Rounds J, Hannum JW.

14

Stress in Pregnancy

• Conflicting data on

correlation between

stress, prematurity & low-

birth weight

• Some correlations with

ADD from animal studies

• Early prenatal stress may

be more detrimental than

that which occurs closer to

term

• steadier BP, pulse, and respiratory rates

• regular blood flow to uterus, placenta and fetus

• healthier immune system, emotional states, and responses to stressful stimuli

• feels less fearful and anxious

Improves Maternal

Physiological Balance

• had 1/3 fewer prenatal complications

• shorter labors with fewer complicationsStressed women with support

systems

Stress Reduction/Relaxation

Massage Studies –Stress-Relaxation

• Moyer meta-analysis on prior slide

• Meta-analysis by MT Research Foundation: “Single

treatment reductions in salivary cortisol and heart rate…

some evidence for a positive effect on diastolic blood

pressure…lacks the necessary scientific rigor to provide a

definitive understanding of the effect massage therapy has

on many physiological variables associated with stress.”

• TRI: Sexually abused women receiving weekly 30 min.

massages: less depressed and anxious

15

Oxytocin

Hormone of calm, love and nurturing

Other

Bodywork

Studies

• Improved breathing

through correcting

restrictive postural

deviations and improving

neck, abdomen and chest

mobility

• Improved musculo-skeletal

functioning

• Less intense pain, and

decrease in quality of pain

Classic Animal Studies on Skin Stimulation

• Stroked rats stronger

& smarter

• Post-surgically

improved outcomes

for petted rats

• Pups of gentled rats

improved health &

growth for lifetime

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Skin Stimulation for Healthier Offspring

Collared pregnant rats

unable to lick were

• Inferior mothers

• Bore more sickly

litters

• Had decrease

mammary & placental

development

“appropriate, meaningful touch of pregnant

and laboring women leads to touching babies

in meaningful, effective, and caring ways”

Rubin, 1963, 1975, 1984

Collecting Data

• Subjective reports:

drawings, pain &/or

activity scales

• Questionnaires

• Visual and Palpable

Observations

• Range of Motion chart

• See earlier health report

examples from Thompson

17

Case Reports Needed

Welcome, Michele Kolakowski, RMT (CO)

• Former Program Supervisor for

Longmont United Hospital's

Health Center of Integrative

Therapies, Longmont, CO.

• Sanctuary- Hands On Healing

Arts for Women, Longmont, CO

• Birth Doula

• Infant Massage Instructor

• Former curriculum developer &

instructor with Boulder College

of Massage Therapy, Cortiva

Institute

• Instructor of Pre- and Perinatal

Massage Therapy

COMPETENCY STATEMENT: The Postpartum Massage Thera py pilot program will provide massage for the postp artum and ante-partum patients at The Center for Childbirth. Massage Ther apist must be licensed and exhibit specialized knowl edge in the techniques and skills appropriate for this population.

RATING1=Novice: Unfamiliar/ never done; 2=Advanced Beginner: Performs w/ supervision; 3=Competent: Performs w/ min. or no supervision; 4=Proficient: Performs independently; 5=Expert: Can teach/mentor othersCOMPETENCY VALIDATION METHODS D=Demonstrates Competency (Psychomotor) V=Verbal Competency W=Written Competency MR= Medical Record Review (Documentation)

PERFORMANCE CRITERIADescribe contraindications to receiving Postpartum massage: W

Identify foot reflexology points to remedy postpartum symptoms: D

Demonstrate appropriate positioning for postpartum massage: D

Semi-sitting in bed Side-lying Supine Birth Ball

Demonstrate appropriate techniques for cesarean delivery mothers: D

Demonstrate techniques for reducing edema in a Postpartum patient: D

Describe how to adapt treatment in special circumstances: WCesareanDiastis RectiSymphysis pubis separationHip dysplasiaEpidural or IV site conditions

Demonstrate appropriate documentation of massage therapy treatment in e-summit: D

Overall Rating: ________________

Initials & Signatures of ALL Preceptors/Educators/Trainers

Adapted from and used with permission of

Longmont Hospital

18

LONGMONT UNITED HOSPITAL POLICY/PROCEDUREDepartment: Health Center of Integrated Therapies P olicy # Birthplace Massage Therapy 01SUBJECT: Massage Therapy Standing Physician Order f or All Birthplace InpatientsEffective Date: 1/99 Revised Date: 3/09 Reviewed: (Reviewed and approved at 3/12/09 OB-GYN Medical Staff Meeting)

PURPOSE:Longmont United Hospital’s BirthPlace recognizes the importance of skillful, caring touch for its patients and provides massage therapy to patients as a part of their care. This meets JCAHO requirements for non-pharmacological pain relief and supports Longmont United Hospital’s Planetree Designation with the use of complementary therapies and the creation of healthy communities.POLICY:Longmont United Hospital Massage Therapists, with permission and a standing order from the OB-GYN Medical Staff and input from the BirthPlace Nursing Staff, provide massage therapy to all BirthPlace patients who request this service.PROCEDURE:Each complimentary massage therapy treatment is up to 30 minutes which includes time for the Massage Therapist to talk with the patient, to design and provide a treatment that addresses the patient’s needs and to obtain pre- and post treatment 0-10 pain ratings from the patient. The Massage Therapist encourages the patient’s communication and feedback about the patient’s comfort during the treatment and appropriately adapts pressure and movement with the patient’s current pain medication(s). The Massage Therapist follows standard universal precautions and hand hygiene protocols, and uses hypoallergenic massage therapy lotion. Patients are appropriately positioned in bed in supine position and/or lateral recumbent position (the latter using the “log roll” with abdominal pillow support especially in cases of Cesarean section, tubal ligation or hysterectomy) or seated in a chair. All massage therapy techniques that meet the patient’s requests are appropriate with the exception of the following contraindicated techniques:· No circulatory massage therapy techniques with patients who are febrile or have hypertensive disorder. (Noncirculatory techniques that stimulate a parasympathetic nervous system response are indicated.)· No direct massage therapy techniques on IV injection sites in the hand or forearm, as well as epidural and spinal sites and the related bruising or hematoma during the acute stage due to pain and presence of thrombi. (After 48 hours and in the sub acute stage, gentle massage therapy techniques around these sites are indicated.)· No direct massage therapy technique on abdominal incisions after Cesarean section, tubal ligation or hysterectomy until the skin has healed. (A progression of massage therapy techniques to treat scar tissue is indicated once the skin is closed.)· In the first 8-10 weeks postpartum, no deep tissue or percussion massage therapy techniques in the lower abdomen, inguinal region and medial aspect of the legs (femoral triangle and length of saphenous vein) due to increased blood clotting activity especially after Cesarean section, tubal ligation, or hysterectomy which further increase the risk of DVT and thromboembolism.· No abdominal techniques that move the rectus abdominal muscle laterally or put strain on the linea alba, especially in cases of rectus diastasis.

The Massage Therapist documents the treatment in the patient’s medical record progress notes including pre- and post treatment 0-10 pain ratings and reports any notable or adverse finding to the patient’s nurse. Patients may request and pay for a longer or additional massage therapy treatments payable to the Health Center of Integrated Therapies. (See Current HCIT Fee Schedule for rates.) Patients who are unable to receive massage therapy during their inpatient stay may receive a BirthPlace/HCIT 1 hour massage therapy gift certificate. Gift Certificates may also be used for service recovery at the BirthPlace Director’s discretion.

Longmont United Hospital Massage Therapists are LUH employees with State of Colorado Massage Therapy Registration. Massage Therapists are scheduled at BirthPlace 7 days a week, 365 days a year 0900-1230. The LUH Massage Therapist Job Description states that advanced maternity massage therapy training is preferred for BirthPlace Massage Therapists. In addition, all BirthPlace Massage Therapist complete an annual competency test.

Used with kind permission of Longmont United Hospital's Health Center of Integrated Therapies.

Hospital Communications Flowchart

Massage therapy performed

Therapists’ observations

Notation in chart or to nurse/doctor

Nurse/doctor follows up, makes diagnosis, treatment plan

Client Benefits of Good Collaborations

• Client perception of

teamwork amongst their

healthcare professionals

• Increased sense of safety

especially with

complications & high risk

conditions

• Lower stress = better

outcomes.

19

Advice for Improved Communications

• Develop confidence, humility &

conciseness

• “Think on your feet."

• "I need some time to consider

that…research that… I'll follow

up" and then follow up.

• Know your scope of practice &

stay within.

• No ego-based communication.

• Work as a team for the good of

the patients.

Advice for Improving Communication

• Encourage patients to talk

with their care providers

about their experience

with CAM.

• Don't “carry a big stick."

• Wait for the right timing

when they come to you for

more collaboration.

• Be patient for things to

develop.

Advice for Improved Communications

• Find common ground.

• Ask for their ideas.

• Make educational

presentations.

• Join interdisciplinary

panel discussions.

• Bring lunch to medical

office.

• Know who are your "fans"

& ask for their support.

• Let patients lead.

20

Additional Advice

• Be curious and willing to learn.

• Have your “elevator speeches"

ready.

• Stay up on the current research.

• Value your personal experience.

• Ask for others to share their

experience with you

• Avoid putting more demands on

medical staff time unless they

offer their time.

• Go to their office managers.

• Get health care professionals on

your table!

Collaboration Grows Referral Network

• Childbirth Educators

• Midwives

• Doulas

• Yoga & exercise

teachers

• Psychotherapists

• Lactation consultants

• Prenatal

photographers

• Domestic violence

hotlines

• WICC

• Social services

agencies

• Substance abuse

treatment centers

Thank you, Michele Kolakowski, RMT (CO)

• Former Program Supervisor for

Longmont United Hospital's

Health Center of Integrative

Therapies, Longmont, CO.

• Sanctuary- Hands On Healing

Arts for Women, Longmont, CO

• Birth Doula

• Infant Massage Instructor

• Former curriculum developer &

instructor with Boulder College

of Massage Therapy, Cortiva

Institute

• Instructor of Pre- and Perinatal

Massage Therapy

21

Growing a Prenatal MT Practice Webinar

1. Trimester Developments & Women’s Prenatal

Needs – recorded 3/12/13

2. Making Nurturing Spaces for Moms and

Babies –recorded 3/19/13

3. Prenatal Massage Therapy Practicalities-

recorded 3/21/13

4. Relaxing Prenatal Massage Sessions

recorded 3/26/13

5. Interacting Within the Perinatal Healthcare

System

6. Marketing a “Mommies R Us” MT Practice

Pregnancy 101 Series Pre-recorded

1. Fostering a Healthy Pregnancy

2. Cardiovascular Adaptations

3. Respiratory and Digestive System

4. Musculoskeletal Adaptations-back & pelvis

5. Musculoskeletal Adaptations-other areas

6. Practice-Based Decision Making*(Each available individually except #6 only available if purchase all 6 webinars. Studying in all 6 webinars highly

recommended for a more complete understanding.)

*most applications to this webinar

New

Class!

22

Certification in Pre- and Perinatal Massage Therapy

Distinguish yourself and develop the prenatal practice of your

dreams by earning THE maternity massage certification

many hospitals & employers require.

Practice and receive personalized feedback in:

• deep tissue

• passive movement

• neuromuscular

• reflexive

• positional release

• Plus other somatic methods modified to support

pregnancy, laboring and postpartum women

“ You made the techniques from your book so clear,

exciting, and easy for me to use immediately. The

instructor and assistants’ enthusiasm and expertise

was phenomenal. “

For schedule & more info: www.bodytherapyeducation.com

Carole Osborne’s Prenatal and Deep Tissue Massage Training

Further Information and Training

1. Benefits of Prenatal and Perinatal Massage Therapy

2. General Guidelines, Precautions, and Contraindications

3. Client Positioning, Draping, Body Mechanics, and Other Practical Considerations

4. Trimester Recommendations and Techniques

5. Massage Therapy as Labor Support

6. Postpartum Perspectives and Techniques

7. Clients with Special Needs

8. Business Considerations

9. Profiles of Maternity Massage Therapists

214 pgs; 90 minutes of technique videos

Free Educational Videos

Carole’s videos are at

www.bodytherapyassociates.com/videos.php or YouTube

• Peripartum Pelvic Pain

• Advantages of Sidelying

• Tips for Sidelying Positioning

• Secure SL Draping

• SL Body Mechanics

• Massage of the Legs

• Rhythmic Deep Tissue for Neck

Oakworks Educational Videos at www.massagetables.com/videos/educational-series.asp

� Smooth Moves Between Side-Lying and Semi-Reclining Position

� Adapting a General Massage for Sidelying

� Breast Draping for Side Lying Massage

� Contrasting Pillows and the Side Lying Positioning System

� Side Lying Approach to Piriformis Syndrome

� Top 10 Tips for Great Side Lying Positioning

23

Terms of Participation for

Growing a Prenatal Practice Webinars

� I realize that the health and well-being of my clients and their offspring are influenced by my understanding and application of this material; therefore, I am committed to the conscientious study and thorough absorption of the information presented in this webinar.

� I understand that this webinar offers reliable, yet limited education in prenatal massage therapy. I understand that it does NOT include labor, postpartum, or any clinical or hands-on instruction or evaluation; therefore, this is NOT a certification program.

� I agree not to represent myself directly or by implication in marketing activities or any communications to clients or others that I am certified, endorsed, or authorized by the Benjamin Institute or by Carole Osborne, Body Therapy Education, or any other agency to practice or teach prenatal massage therapy on the basis of participation in this webinar.

� I recognize that, on the basis of this webinar, I am especially not prepared to work with those women whose pregnancies are complicated by medical conditions or a higher risk of complications developing; therefore, I will refer these individuals to others more thoroughly educated and certified in this specialization.

� The safety and health of the expectant woman and her child (children) are my foremost concern; therefore, I will seek guidance from her prenatal healthcare provider prior to providing services.

� If I have any doubt as to the prudence of any somatic practices for my pregnant client, I will refrain from such procedures and seek guidance from her prenatal healthcare provider regarding her care.

� I agree to conduct my practice of prenatal massage therapy in accordance with the ethical and legal guidelines of the organizations to which I belong or by which I am licensed or registered.

This Webinar’s References

•Belluomini J, Litt R, Lee K, et al. Acupressure for nausea and vomiting of pregnancy: a randomized, blinded

study. Obstet Gynecol 1994;84:245.

•Cooper R, Goldenberg R, Das A, et al. The pre-term prediction study: Maternal stress is associated with

spontaneous preterm birth at less than thirty-five weeks gestation. Am J Obstet Gynecol 1996;175:1286–1292.

•Field T, Hernandez-Reif M, Hart S, et al. Pregnant women benefit from massage therapy. J Psychos Obstet

Gynecol 1999;20:31–38.

•Field, T., Hernandez-Reif, M., Hart, S., Quintino, O., Drose, L., Field, T., Kuhn, C., & Schanberg, S. (1997). Sexual

abuse effects are lessened by massage therapy. Journal of Bodywork and Movement Therapies, 1, 65-69.

•Field, T., Figueiredo, B., Hernandez-Reif, M., Diego, M., Deeds, O. & Ascencio, A. (2008). Massage therapy

reduces pain in pregnant women, alleviates prenatal depression in both parents and improves their

relationships. Journal of Bodywork & Movement Therapies, 12, 146-150.

• Glynn L, Schetter C, Wadhwa P, et al. Pregnancy affects appraisal of negative life events. J Psychos Res

2004;56:47–52.

•Hetherington S. A controlled study of the effect of prepared childbirth classes on obstetric outcomes. Birth

2007;17(2):86–90.

•Hobel C and Colhane J. Role of Psychosocial and Nutritional Stress on Poor Pregnancy Outcome. J. Nutr.

133:1709S–1717S, May 2003.

•Kozhimannil KB, Avery MD, Terrell CA. Recent trends in clinicians providing care to pregnant women in the

United States. JMidwifery Womens Health 2012 Sep-Oct;57(5):433-8. doi: 10.1111/j.1542-2011.2012.00171.x.

•Meaney MJ, Aitken DH, Sharma S, et al. Neonatal handling alters adreno-cortical negative feedback sensitivity

and hippocampal type II glucocor-ticoid receptor binding in the rat. Neuroendocrinology 1989;50:597–604.

•Menard MB. Making Sense of Research (2nd ed). Toronto: Curties-Overzet Publications, 2010.

• Meek, S. S. (1993).Effects of slow stroke back massage on relaxation in hospice clients. Journal of Nursing

Scholarship, 25, 17-21.

•

References Continued•Moyer C, Rounds J, Hannum J. A meta-analysis of massage therapy research. Psychol Bull 2004;130:3–18.

•Moyer, C, et al. Does massage therapy reduce cortisol? A comprehensive quantitative review. Journal of

Bodywork & Movement Therapies (2011)15:3-14.

•Nuckolls K, Kaplan BH, Cassel J. Psychosocial assets, life crises and the prognosis of pregnancy. Am J Epidemiol

1972;95:431

•Pryde M. Effectiveness of massage therapy for subacute low-back pain. A randomized controlled trial. Can

Med Assoc J 2000;162(13):1815–1820.

•Roth LL, Rosenblatt JS. Mammary glands of pregnant rats: development stimulated by licking. Science

1996;264:1403–1404.

•Rubin R. Maternal Identity and the Maternal Experience. New York: Springer Publishing, 1984.

•Rubin R. Maternal tasks in pregnancy. Matern Child Nurs J 1975;4:143–153.

•Rubin R. Maternal touch. Nurs Outlook 1963:11:828–831.

•Ruegamer B, Benjamin. Growth, food, utilization, and thyroid activity in the albino rat as a function of extra

handling. Science 1954;120:184–185.

•Thompson D. Hands Heal: Communication, Documentation, and Insurance Billing for Manual Therapists,

Fourth Edition, Baltimore: Lippincott, Williams, and Wilkins, 2012.

•Wadhwa P, Culhane J, Rauh V. Stress, infection and preterm birth: a biobehavioral perspective. Paediatr

Perinat Epidemiol 15;2:17–29.

•Werntoft, E., & Dykes, A.K. (2001). Effect of acupressure on nausea and vomiting during pregnancy. A

randomized, placebo-controlled, pilot study. The Journal of Reproductive Medicine, 46, 835-839.

•Witt PL, MacKinnon J. Trager psychophysical integration: a method to improve chest mobility of patients with

chronic lung disease. Phys Ther 1986;66:214–217.

• http://www.naturaltouchmarketing.com/HBMN-hospital-massage/HBMNHome.php

• http://nccam.nih.gov/health/whatiscam. Accessed March 21, 2013.

• http://accahc.org/

24

Resources And Acknowledgments

• Hartley and Jones, HIPPAA Plain and Simple: A compliance Guide for Health Care

Professionals. AMA, 2004.

• http://www.hhslgov/ HIPPAA updates from U.S. Department of Health and

Human Services

• http://www.naturaltouchmarketing.com/HBMN-hospital-

massage/HBMNHome.php

• http://www.amtamassage.org/uploads/cms/documents/hospitalsembracema

ssage.pdf

• https://sohnen-moe.com/clickcart/?app=ecom&ns=prodshow&ref=HS001

• https://Info.massagetherapyfoundation.org/portals/170998/docs/mtf-

physician-ebook.pdf

• Montagu A. Touching: The Human Significance of the Skin. New York:Harper &

Row, 1978.

• Thompson D. Hands Heal. Figures used with permission of Lippincott,

Williams, and Wilkins

• Forms from Longmont United Hospital's Health Center of Integrated

Therapies, used with kind permission.

Thank you! Questions?

Carole Osborne’s Prenatal and Deep Tissue Massage Training

Dr. Ben BenjaminUnraveling the Mystery Series:

• Low Back Pain

• Cervical Pain• Shoulder Pain• Knee Pain• Ankle Pain• Hip & Thigh Pain

We b i n a rs Ava i l a b l e O n De m a n d

Whitney Lowe• Orthopedic Approaches to Upper

Body Disorders

• Orthopedic Approaches to

Lumbo-Pelvic Pain

Tom Myers• Anatomy Trains:

Clinical Applications of

Myofascial Meridians• Beyond Good Posture

Tracy Walton• Massage in Cancer Care• Cardiovascular

Conditions & Massage• Hospital-Based Mssage

Carole Osborne• Pregnancy Massage 101

And Many More…

All Webinars Available at www.BenBenjamin.com

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interacting within the perinatal healthcare system

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