Circles of Healing: The Complete Guide to Healing With Massage & Yoga

By Wendy Hammarstrom

Now, perhaps more than ever before, we need simple ways to help each other in this troubled and increasingly complex world. All those facing physical, mental, and emotional challenges, along with their caregivers, are the inspiration for this book.

Circles of Healing is a must-read for every bodyworker, new and seasoned, as well as yoga teachers and students, medical professionals, veteran advocates, hospice workers, first responders, and the vast numbers of us who are caregivers by profession or within our families.

By using the techniques and reading the case histories and personal stories in the book, bodyworkers, movement instructors and others can expand their area of practice and discover the unexpected joy of working with varied populations.

• Language: English
• Publisher: Wendy Hammarstrom
• Release date: Aug 24, 2019
• ISBN: 9780996046824

Book preview

Circles of Healing

The Complete Guide to Healing

With Massage & Yoga

For Caregivers, Practitioners, Students & Clients

By Gwen Wendy Hammarstrom, BFA, LMT

Special thanks to Alice Iwasa.

Without her this book would not have taken form.

Mandala Art by Gwen Hammarstrom, unless otherwise indicated

Cover design by Gina Marie, gm Studios

Photos are by the author, with some help from models Marina Braff,

Alicia Gonzales, Megan Ceriale, Sylvia Cruz and Daniel Factor.

Neither the author nor the publisher takes responsibility for any effects, which may be produced as a result of following any treatments or suggestions given in this book.

It is my hope that this information will benefit you and those you care for.

Names of students and clients are fictitious.

Copyright 2012 by Gwen Hammarstrom

All rights reserved.

No part of this book may be reproduced, scanned, or distributed in any printed or electronic form without permission from the author.

ISBN 9781480259003

Dedicated to Four Generations of Writers & Teachers

My grandmother, Helen Manatt Bissell

My mother and me, Mt. Washington, New Hampshire, 1959

My mother, Helen Hammarstrom

My aunt, Marian Siegeltuch

My aunt, Faith Bissell

My cousin, Susie Bissell

My daughter, Marina Pesha Hammarstrom Braff

For their love of travel and exploring what is new to them;

for their insatiable intellectual curiosity and their willingness to share what they learn via the written or spoken word;

and for their voices, which they have never managed to keep quiet.

About the Cover

The Tree of Life on the cover is bearing circular or mandala fruits, each representing a chapter in this book. Mandala is a Sanskrit word for circle or wheel, or beginnings with no ends. The variations of patterns are endless, but each has a specific center, and concentric rings that emanate from that center. Some people believe that creating mandalas is making order out of disorder.

Focusing on the mandala’s midpoint can bring us to a place of physical and emotional equilibrium, as does using the self-care techniques described in this book, such as conscious breathing, movement, and giving and receiving healing touch. Psychotherapist Carl Jung thought of making mandalas as an opportunity for processing feelings and events, for self-exploration and for healing. He said that a mandala symbolizes "a safe refuge of inner reconciliation and wholeness," and believed the mandala is the ultimate symbol of well-being and wholeness.

The circle with a center pattern is the basic structure of nature, from the smallest molecule to the seeming endless Milky Way galaxy. Flowers, rings found in tree trunks, snowflakes, sand dollars, tree fungi, stars and planets surround us, as do the conceptual circles of family, friends and community.

This book encompasses the circle of time as well, beginning with the unborn child in the circle of the womb, and ending with the spirit leaving the body and becoming part of an ever-changing energy.

The Circle has healing power. In the Circle, we are all equal. When in the Circle, no one is in front of you. No one is behind you. No one is above you. No one is below you. The Sacred Circle is designed to create unity. The Hoop of Life is also a circle. On this hoop there is a place for every species, every race, every tree and every plant. It is this completeness of Life that must be respected in order to bring about health on this planet."

~Dave Chief, Oglala Lakota, Sun Dancer and Elder

Table of Contents

Preface

Introduction

SECTION ONE: CARING FOR MOTHERS AND INFANTS

CHAPTER 1: EARLY MOTHERHOOD, FROM PREGNANCY TO CHILDBIRTH

First Trimester Pregnancy Massage

Second Trimester Massage Techniques

Third Trimester Massage Techniques

Contraindications and Cautions

Beneficial Exercises for Pregnant Women

The Pelvic Floor – Important Information for Your Female Clients

The Experience of Childbirth

CHAPTER 2: INFANT MASSAGE & THE EXTENDED FAMILY

Favorite Baby Massage Techniques

Exercises for Mommy and Baby

Body Mechanics for Mom

Vulnerable Babies in the NICU (Neo-Natal Intensive Care Unit)

Babies Have Deep Emotions Too

Husbands, Fathers, Partners and the Extended Family

Teen Touch

CHAPTER 3: PARTNER MASSAGE AND STRETCHING

SECTION TWO: ACQUIRED CHRONIC CONDITIONS: EASING THE BURDEN OF SEVERE ILLNESS AND TRAUMA

My Father – The Old Bryn and the New Bryn

CHAPTER 4: HEALING THE WOUNDED: WORKING WITH TRAUMA AND POST TRAUMATIC STRESS SYNDROME

Has Your Client Experienced Trauma?

How Do Body Therapies Work?

Victims of the Road

Concussion

Helping the Helpers

Helpers Helping Themselves

Veterans of All Wars Need Hands-On Therapy to Help Heal their Wounds

Where to Find Help

Benefits of Massage Therapy

CHAPTER 5: MASSAGE, YOGA AND BREATHING FOR PEOPLE WITH CANCER

How to Work with a Cancer Patient

Lymphadema and a Cautionary Note

Therapeutic Touch is Widely Accepted by Mainstream Medicine

Yogic Breathing

Mudras ~ Yoga of the Hands

Restoring Your Body with Yoga Poses

CHAPTER 6: THE CHALLENGE OF ADDICTION

Yoga and Movement at the Half Way House

First Stage of Class

Second Stage of Class

Third Stage of Class

Suggestions for an Outdoor Class

Breathing and Visualization Exercises

CHAPTER 7: HOW WE CAN HELP STROKE VICTIMS

For the Bodyworker and Caregiver

For the Client

Heart Health

CHAPTER 7A: HANDS ON WITH PARKINSON’S DISEASE: CAUSES AND CASE STUDIES

SECTION THREE: BODYWORK FOR SPECIAL PEOPLE

CHAPTER 8: WORKING WITH DISABLED INDIVIDUALS

Important Guidelines

CHAPTER 9: WORKING WITH CHALLENGED INDIVIDUALS IN AN INSTITUTIONAL SETTING

Uncrossing Wires

Poses that Ease the Students into the Movement Phase of Class

Yoga Props

Sample Class Format

Balancing Techniques for Self- Care

Movements and Yoga Poses For Staff Working with Disabled Clients and Others

Guide One: Yoga and Self- Care in a Chair

Guide Two: Using Voices and Movement for Self-Expression

CHAPTER 10: WORKING ONE ON ONE WITH DISABLED CLIENTS

SECTION FOUR-MIDLIFE AND BEYOND

CHAPTER 11: HELPING WOMEN IN TRANSITION – MIDLIFE MUSINGS

Bodywork for the Midlife Woman

Aromatherapy

Bodywork for the Endocrine System

Chakra Chart

Reflexology Chart

What your Clients can do for Themselves: Wisdom from Women Who Have Been Through It

The One Exercise all Women Should Do

Remember to Dance!

CHAPTER 12: AGING WITH GRACE AT ANY AGE

Working and Living with Elders

Geriatric Massage and Healing Touch for Seniors

My Personal Introduction to Yoga

A Typical Class for Midlife Students and Others

Yoga Practice One: Salutation to the Sun

Yoga Practice Two

CHAPTER 13: POLARITY THERAPY

Background – The Founding of Polarity Therapy by Dr. Randolph Stone

The Squat

CHAPTER 14: PROVIDING LOVE AND COMFORT TO THE DYING

SECTION FIVE - MASSAGE FOR OUR ANIMALS - THE FOUR LEGGEDS, TWO-LEGGEDS AND NO-LEGGEDS

All Animals Benefit from Caring Touch

Benefits of Animal Massage

How to Tell If the Massage is Being Well Received

Linda Tellington-Jones and Joyce the Python

SECTION SIX – SELF-CARE, TAKING CARE OF THE CAREGIVER

Keeping Up with the Physical Demands of Your Profession

Start Your Day: Salutation to the Sun

During Your Work Day

After York Work Day – Taking Care of Your Feet

Restoring Yourself

Exercises for Your Back

Beyond Your Body: How to Center Yourself

Hara Self-Massage

Standing Tall: Alexander Technique

CONCLUSION

APPENDIX

Yoga for Specific Conditions

Poses and Holds, Chapter by Chapter

Where to Find the Yoga Poses and Exercises in the Book

Assessing your Inner Motivations as a Practitioner

Developing your Awareness through Practice and Attention

Resources for the Practitioner

Schools and Systems of Bodywork

Bodywork and Holistic Organizations

Bodywork and Holistic Publications

Resources for Specific Chapters and Clients

Bibliography

About the Author

Notes

Preface

In this book, Wendy brings together her years of experience as a massage therapist, dancer, and yoga teacher to show you how to help people with special needs.

Professional therapists will value this book as a reference to working with unusual and challenging kinds of clients. Beginning bodyworkers will find it inspirational and instructive. And anyone with an interest in, or in a position to, help others with healing touch will appreciate the potential it has in a world gone mad with pills and prescriptions.

Let’s be clear from the beginning: any person can, at one or another time in their life, be a person with special needs.

From birth to death, we all go through times when we are out of the mainstream, vulnerable, possibly ill or disabled, and in need of TLC (tender loving care). Some individuals live a whole lifetime as a special needs person; nearly all of us fall into that category at some point.

This book addresses the ways healing touch and movement can bring ease, comfort, and in some cases complete recovery from seemingly intractable physical challenges.

Included with each chapter are exercises and techniques that you can use with your clients and even to help yourself. All of them are simple to perform, enjoyable to do, and most importantly, effective.

This volume is a book you will want to return to again and again as you encounter people whose cases are a little bit different and require a creative approach. Let Wendy’s words of wisdom guide and inspire you in your own practice.

April 2010

Alice Iwasa

Harvard, Massachusetts

MY DEEPEST THANKS TO:

Alice Iwasa, for her tireless contributions including editing, research, organization, format, writing, re-writing and for 'pulling it all together' into a cohesive form.

Thanks also to Gina Marie, gm Studios, for cover tree design, editing, layout and publication contributions; Risa Gettler, Calligrapher, for creative design, formatting, ongoing support, artistry and inspiration; Katie Malin, Digital artist, for her computer expertise.

Lurena Hay Miller, my teaching partner at day centers for the physically and mentally challenged; Jacquie Maroun, PT, my teaching partner for Massage and Movement for the Childbearing Years at Long Beach Community Hospital and elsewhere in California; Debbie Blaine, supervisor, Fred Tam, staff leader, and the loving and hardworking coaches at Cole Vocational Services.

Editors: Jennifer Adrian, Beth Lutz, Carol Gaskin, for their support and insights, and Carol Malin, for her editing, wise counsel, and marketing savvy; Karol Strelecki, my high school English teacher, for his sense of humor, inspiration, support, and editorial observations, forty years ago and today; and Allen Kates, Lurena Hay Miller, Mary Louise Muller, Dorothy Lebowitz, Holly Whittlesey Whiteside, Deb Reich, and Laurel Nicholson for their feedback and suggestions; and Roland Behny & Marilyn Spooner for their inspiration and support.

My models: Marina Hammarstrom Braff, Alicia Gonzalez, Megan Ceriale, Silvia Cruz and Daniel and Danny Factor, Morgan Vuilleney and Emily Lozano, ten year old Tyler Donnelly and five year old Trevor Donnelly, William Irwin, Risa Gettler, Kathleen Patrician, Amber Bramley and her baby Nova Ramsey; Lurena Hay Miller, Susan Lerner-Greenbaum, HHP, and her client, Elena LaManna, Kelly Smith, clients at Cole Vocational Services in Riverside County, CA, and Korrie’s Pilates Place in Wildomar, California.

Pam Clarkson, Illustration, NICU Neonatal Perinatal Programs, University of New Mexico, Albuquerque; Maruti Siedman, author of A Guide to Polarity Therapy, for the use of his Acu-points foot illustration; Robin Wooley, chakra and salutation to the sun illustration; Deborah Boardman, Steve Hebden, and Stan Sadowski, Philadelphia photographers; Agent Jay Whiten of the Best Buy Geek Squad in Menifee, CA; and Lyndsi and Lisa K. Reisman for graphic art and layout assistance and the Reference staff at the Escondido, California library.

Mary Debus, for her inspiration, generosity and gift of my first computer; Jill McCubbin-Clare, Acupuncturist and yoga instructor for her Ontario, Canada residence by the lake, where I began to write; yoga teacher Judy Kyle, Mercedes Martine, Acupuncturist, and Susie Masard, yoga teacher for their unwavering support; the Polarity Therapy group who at one time ran the Murrieta Hot Springs retreat; and clients, students, dancers and artists who have taught me and helped me grow throughout our work together.

Special thanks to my animal friends for their love and for always being around me.

And special thanks to my daughter, Marina Braff, for her sharp mind, never-ending help, patience, love and understanding.

Introduction

The greatest sense in our body is our touch sense.

It is probably the chief sense in the process of sleeping and waking;

it gives us our knowledge of depth or thickness and form; we feel, we love and hate, are touching and touched, through the touch corpuscles of our skin.

~ J. Lionel Taylor, The Stages of Human Life

Everybody knows that therapeutic massage feels good, can be relaxing, and has some value in helping muscles heal. For most people, especially those who have not experienced a massage or other bodywork at the hands of a skilled therapist, this is as far as it goes.

Yet massage is so much more than just a relaxing rubdown. Ask any of the clients featured in this book, and you will hear that unexpected benefits and even seemingly impossible results come from the healing power of touch. The human body is designed to be healthy. Drugs can only treat the chemical aspects of an imbalance in a person, often creating other imbalances along the way.

Bodywork, a term, which refers to massage, and other forms of hands-on healing such as polarity and acupressure and yoga, on the other hand, restores the natural energetic pathways that lead the body, and the whole human, back into equilibrium. Even when a person is disabled, chronically sick, or terminally ill, they can find balance and harmony within themselves through the gift of healing touch and the restorative poses of yoga.

In my practice, the most common complaints are headaches, arthritis, jaw (TMJ) pain, irritable bowel syndrome, fatigue, and insomnia. Other ailments include back, neck, and foot problems. A vast number of clients come to me because they endure chronic pain or are stressed and need to relax. Many are women who are facing the challenges of hormonal shifts and life changes. Clients dealing with everyday stresses, who choose massage over a pill.

On the more challenging side, I have worked with clients with physical motor problems, cancer and AIDs, diabetes, joint replacement, ALS or Lou Gehrig’s disease, chronic fatigue syndrome, heart disease, brain injuries and diseases, and many other conditions, some diagnosed and some not. Some clients walk with canes and walkers, some are on crutches, in wheelchairs, or stretchers, and some are missing a limb. I am moved by their courage as they search for the best path to take back to wellness.

No matter who the client is or what is their problem, I never see them as a diagnosis. It is more than just a body I am working on. It is layers of emotions, memories, fears, joys and concerns- it is a life - I am working with. Although I know much about muscles and the physical structure, and I teach it, often it is not what I am focusing on in the session. I work with my eyes closed, by feel, in my right brain and not my left brain. At times I am in the alpha state. I like to think I contact clients on a soul level, that is, we are all equal and we all have an inner light (including animals - down to the ants).

Of course the ability to do this has developed over the thirty-six years I have been in practice. Behind what seems to be instinctive is much training, experience, and knowledge of how the human body works.

As a novice bodyworker in the 1970s I spent an inordinate amount of time wondering if my clients were enjoying and benefiting from the work - almost to the point of not giving a good massage. Yet the more experienced and confident I became, the less it was an ego-centered process. Rather it started to be more a meditative and spiritual practice. Now I am ready to share what I have learned with you.

One special area of my practice has been working with people who are disabled or challenged in unusually difficult ways. As a consultant for the mentally and emotionally challenged, I have come to know and work personally with people who suffer from depression (mild and severe), panic disorder, post-traumatic stress syndrome, agoraphobia, obsessive compulsive disorder, alcoholism and other addictions. Some clients have had schizophrenia, bipolar disorder, severe mental retardation, Down’s syndrome, and autism.

I believe healing touch is an overlooked modality for many people with these diseases. All those facing physical, mental and emotional challenges, and their caregivers, are the inspiration for this book. The vulnerability of these special clients, with their courage, warmth, wisdom and magnanimous spirit continues to inspire me.

Those who are new to the field of bodywork will learn about the variety of paths they can follow. By using the techniques and reading the case histories and personal stories in this book, seasoned bodyworkers and movement instructors can expand their area of practice and discover the unexpected joy of working with these populations. In addition, this book can help all care givers who are not specifically bodyworkers, such as psychotherapists, hospice workers, home health care workers, physicians, rescue workers, nurses, teachers and others to discover new ways to use touch and movement to help their clients as well as themselves. Now, perhaps more than ever before, we need simple ways to help each other in this troubled and increasingly complex world.

Water flows over these hands.

May I use them skillfully

to preserve this precious planet.

~ Thich Nhat Hanh

Nurture the mother, who nurtures the child, who nurtures the world.

Section one

Caring for mothers and infants

When a woman becomes pregnant, she becomes part of the population of clients who need to be treated with special attention, due to the ever-changing nature of her state as she goes through pregnancy. Knowing how your client’s body is changing and how to address it will make your sessions easier and more effective.

Physiological and structural stresses, and emotional ups and downs, are all part of her preparation for motherhood. The following chapter is a compendium of techniques and resources for a bodyworker or a yoga teacher who has pregnant clients. It takes you all the way from early pregnancy through childbirth. In it you will learn ways to adjust your techniques trimester by trimester, good yoga poses for pregnancy, and what to avoid. A thorough discussion of labor is included.

Also in this section is a chapter on infant massage. Massaging babies can be one of the most rewarding aspects of doing bodywork. In hospitals, massage work with premature infants is increasingly appreciated. You will get to read a moving story about one woman’s experience in the neo-natal unit with a distressed and vulnerable baby girl.

You will also learn some specific techniques of infant massage. Parents who are taught to massage their babies bond more strongly and become more attuned to the moods and needs of their little ones. As a bodyworker you can treat both mother and child, and you can empower the mother to have a more positive experience with her baby at home.

This section is helpful for anyone who lives or works with pregnant women, from bodyworkers and movement instructors, to nurses, coaches and living partners.

The moment a child is born, the mother is also born.

She never existed before.

The woman existed, but the mother, never.

A mother is something absolutely new.

~Rajneesh

Chapter One

Early Motherhood, From Pregnancy to Childbirth

Mothering the Mothers

As I write this chapter, my daughter, my first infant massage recipient and first infant yoga student, has left home to attend college. Being a mother has been a large part of who I am for the last eighteen years, and that will always be part of my identity. I will always be a mother. However, it was not always so.

After twenty years of being a dancer, an artist, and a caregiver via bodywork, the thought of having a baby was worrying, even terrifying to me. As a forty-year-old first-time mother, could I physically and emotionally manage such a major change? After several pregnancies that ended early I shared the worldwide women’s fear of yet another loss. But on a cold Philadelphia November day, I realized my daughter was meant to be.

Receiving massages as a pregnant woman

During the first trimester of my pregnancy, as I was adapting to my pending motherhood, I felt physically fragile and over-sensitive, insisted on light pressure when receiving a massage, and even (unnecessarily) shunned Shiatsu from my favorite healer. After that period of time deeper massage felt okay, but my growing tummy was problematic for several reasons. It made my back hurt! When the abdomen stretches to accommodate the uterus this expansion stretches the rectus sheath¹ and oblique muscles forward and down, dragging and pulling the connective tissues of the thorax,² shoulders, throat and head.

Receiving massage throughout that time helped relieve stress on my tired, weight-bearing joints, including the sacroiliac and hip joint, and alleviated neck and back pain caused by muscle imbalances and weakness. Of particular concern were the upper and inter-scapular back muscles and the thoracic-lumbar junction. Massage helped my circulation and energy, especially when I was too fatigued to exercise. The herbal massage oils were soothing, and the time off from day-to-day concerns was a treat. I could let myself be pampered and send loving energy to the baby growing inside me, and I could let go of anxiety surrounding my pregnant state. Partly because I was receiving consistent bodywork, I was able to massage others for several hours a day up to my last month of pregnancy.

As I was learning about pregnancy massage I attracted pre-natal clients. One of my clients reported relief from low back pain and sciatica, another got relief from edema of her ankles, and several who had trouble sleeping in the last trimester found massage helped their bodies recoup. (The benefit of one hour of massage equals several hours of sleep.)

Women from their third month onward are discouraged from lying on their back, due to the pressure the baby puts on the mother's vena cava (the vein near the vertebral column that brings the blood back up into the heart from the lower extremities and the pelvic area.) Therefore, after the first trimester most pregnant women receive massage lying on their sides with pillows and bolsters supporting them, or with one giant body pillow to fill up the empty spaces needing support in their side-lying position. (They sleep that way too.) Massage tables built for a pregnant woman, with a large opening for the belly to rest in, are available and some women prefer to sit on a massage table with pillows supporting them from behind at a forty-five degree angle.

After my daughter had been born, in Long Beach, CA in 1993, I joined forces with physical therapist Jacquie Maroun, also a mother from our support group, Moms Helping Moms. Together we created a seminar called Massage and Movement for Pregnancy and Beyond. We taught this course to the staff at Long Beach Community Hospital and held several other workshops for parents before my family moved to Murrieta. Teaching this class felt especially important because I frequently heard from bodyworkers, novice and seasoned alike, that they avoid massaging pregnant women, in spite of the availability of excellent bodywork classes for pregnancy and beyond, and in spite of proof of the beneficial effects of pregnancy massage.

Information to share with students

Pregnancy Massage

Reduces strain on muscles of the lower back, abdomen and shoulders

Increases muscle tone

Decreases muscular tension

Facilitates the reduction of edema and controls varicosities

Improves posture and alignment

Relieves insomnia.

Reduces the effects of stress hormones circulating in the blood for both mother and baby.

Increases general circulation for mother and baby. Baby's oxygen and nutrients are maximized as a result of increased blood flow.

Decreases fear and anxiety in the mother and baby.

Emotionally supports mother, which is especially helpful for single mothers.

Helps mother accept her changing body.

Can help prepare mother for an easier delivery.

Remind mom to drink extra water after receiving massage.

Different stages of pregnancy require different approaches. We roughly divide pregnancy into three trimesters, as you see by the guidelines below. But each woman experiences pregnancy differently, and bodily changes vary widely. The best guide for what is comfortable and healing will be your client. Pay close attention to her responses, and listen to what she is telling you. She is the expert regarding her own body.

First Trimester Pregnancy Massage

Use deep melting strokes as you and client breathe into each area. This can be used for all phases of pregnancy and labor as desired by client.

Pay special attention to masseter, temporalis, levator scapulae muscles, hand and finger flexors, toe flexors, inner thigh, lower back and buttocks. Mother learns where her tension is and how to release it with outside help, as well as on her own.

Masseter muscle area

Temporalis muscle hold

Use effleurage strokes and acupressure for tired feet and legs.

Hold acupressure points at inner wrist and suggest that she wear nautical wristbands for nausea.

Second Trimester Massage Techniques

Use side lying position or a supported prone position. Keep mother’s hips level and use four pillows: one to support the arm that is draped over, one for the side of the neck and head, and two to support the bent upper leg to minimize lumbar strain. Some women like to have a small pillow to support their belly, or one in between their breasts. For some mothers you will want to use an extra-large sheet for their comfort.

To alleviate edema, effleurage legs and feet, and arms and hands towards torso. But avoid working on area of pitting edema.³ If you notice this, your client should be referred back to her healthcare provider immediately.

For headaches, use an occipital hold and apply gentle traction.

For calf cramps, press on acupressure point, Bladder 57, at the base of the gastrocnemius (the calf muscle), with thumb, knuckles or heel of hand.

For sciatica, apply palm pressure down the mid-line of the back of the leg.

Place fingers or hands on intercostals to help free up ribcage and to encourage mother to breathe fully. Apply gentle pressure while she breathes into your fingertips.

Third Trimester Massage Techniques

Do gentle swooshing nerve strokes from sides of belly toward navel and up and off body. This is also helpful for relaxing during contractions.

Continue to encourage mom to develop awareness of areas of chronic tension and learn ways to release them, which will be useful during labor and throughout years of mothering (and on!).

CONTRAINDICATIONS AND CAUTIONS

If your client informs you of any of the first three conditions, she should see her obstetrician or midwife or practitioner as soon as possible. The following can be signs of problems with the pregnancy, and should be evaluated in case special treatment or precautions are necessary.

A noticed decrease in fetal movement over a 24-hour period

Pain in the abdomen (unlike pressure felt in the latter months) or anywhere in the body

Vaginal bleeding or discharge

Diarrhea

Proximity to the site of a bruise, varicose vein or a scar. This probably doesn’t require a medical evaluation, but don’t massage these areas.

Domestic abuse

One condition you, as a practitioner, should be alert to, is domestic abuse. Your client may not willingly inform you if she is having problems at home. However, many pregnant women suffer abuse, in numbers that are large enough to concern the Centers for Disease Control, which report that at least four to eight percent of pregnant women—that's over 300,000 per year—report suffering abuse during pregnancy.⁴ It’s prevalent enough to be considered a problem from a public health standpoint. If you detect such an issue with a client, let her know that there are resources in your area, and on the Internet, which she can turn to for help. The information in the footnotes is an excellent place to start.

Movement and Yoga throughout Pregnancy

When I first met with my Philadelphia midwife, David Jennings, I was concerned that I would have to change my lifestyle. Since my yoga helped keep me well and centered I was worried that he might tell me to stop doing it, especially headstands, which I had been doing for years. He reassured me, saying, "If you have been doing headstands all along, no need to stop now. But if you haven't been doing them, don't start now". That is the advice I got consistently regarding practicing yoga. Another important