Re-defining the role of Shiatsu
in Pregnancy, Birth and Babyhood

Courses for: Midwives, Doulas and Birth Educators Shiatsu Practitioners Massage Therapists Infant Massage Instructors CPD Individual Support for Parents during Pregnancy and Birth

Suzanne Yates, is a Shiatsu practitioner and teacher based in Bristol, England who has focused a lot of her work since 1989, in the field of pregnancy, birth and babyhood. She runs, with her partner, Chris Wilkinson, Homeopath and Yoga teacher, "Well Mother" which offers a whole package of support for women and their partners. In this article she makes a case for exploring our attitudes to pregnancy and birth, as well as evaluating the role of Shiatsu at this time.   As a lot of my work is in the field of “Midwifery and complementary therapies”. I find it somewhat concerning that Shiatsu does not have such a high profile as some of the other therapies - particularly yoga, acupuncture, homeopathy, reflexology, massage and aromatherapy. I have decided to extend my work, which up until fairly recently has been primarily working with parents and babies, to working much more with midwives and NHS health professionals, shiatsu practitioners and other holistic therapists. I hope through this article to stimulate more discussion on the role of Shiatsu and consideration of the vital part it can play in women's, and their partner's lives. I think pregnancy is often an area which is seen as something separate, rather than as a natural part of many women's lives. It is ideally a healthy movement from womanhood to motherhood, which offers much potential for change, growth and personal development. Yet by many it can be viewed with anxiety, as times of change often are. I think Shiatsu practitioners are as guilty of doing this as anyone else. I do wonder how many Shiatsu practitioners are anxious in some way of working with women through their pregnancies and births, and perhaps err on the side of donning kid gloves. I find it interesting that in the core curriculum, points contra-indicated during pregnancy are highlighted as a separate topic. I also wonder how much we have unconsciously absorbed many of the attitudes linked in with the Western medical approach to birth. More than any other time of our lives, even the most alternative people have some contact with the NHS during their pregnancy. It is indeed illegal to give birth without a midwife present. Yet although the Western approach does have a lot to offer, it has in my opinion one fundamental flaw. That is that the very nature of the care it provides tends to undermine the confidence of the mother and the partner in listening to and acting on their own wisdom, and that of their baby. Although now, since the publication of the government report "Changing Childbirth" in 1993, women are, supposedly, the experts, and their knowledge is acknowledged to be as valid as any obstetricians, the whole system of care is by its very nature disempowering. This is really what I see one of the crucial roles for Shiatsu. Shiatsu by its very essence enables people to be more connected with their own energy and during pregnancy with the energy of their baby, in a very direct and accessible way. In this sense it can be one of the most powerful therapies for women and their partners at this time, particularly if the Shiatsu session itself is complemented with tools for the woman to continue exploring and deepening this connection with her body and her baby. The underlying belief which informs all my work with pregnant women is that ultimately they know their bodies and babies better than anyone else. As practitioners we need to be aware of any of our own anxieties which may interfere with us empowering women to contact their wisdom. We also need to be aware of any influences which inhibit the mother being in contact with her wisdom. Yes, there are the situations we are familiar with, of people not eating well and living lives which disconnect them from their bodies. Yet we also need to be acutely aware of how Western maternity care powerfully undermines that trust a woman has in her body, at a time in which she is particularly sensitive and vulnerable. The first part of the maternity package is to go along and have a scan. This used to be done routinely at 16 weeks, but now often seems to be happening earlier and earlier, even at 8 weeks. The scan is when ultrasound is passed over the baby in the womb, with the rationale being to determine the age of the baby. It can often pick up what are called "gross anomalies" i.e. major physical problems. But often the ones it picks up are so serious that the baby would probably die in utero anyway. Women usually want to have a scan to "check the baby is all right", but it can not offer this reassurance. Scans have never been shown to be that dangerous, but they have never been proven to be particularly safe either. It is entirely possible that they may cause subtle neurological damage to the child. It is difficult to prove this because the kind of research that would pick up this problem is not available. From an Oriental perspective, seeing the development of the baby in the womb as mirroring the evolution of humanity from the water state to the earth state, each day represents 100 million biological years of evolution. Exposure to ultrasound for any amount of time,( the minimum exposure time would be a few minutes ranging up to half an hour), would obviously affect the baby in some way. Research is now beginning to show, surprise, surprise, that the baby is distressed by the contact with ultrasound waves. The WHO has argued that there is no medical justification for routine scans. But the number continues to grow. Scans, I feel, exemplify the Western approach to birth. If there is a test, a measurement, that doesn't appear to be unsafe, do it, get more information. Yet the value of the information needs to be considered. More information does not necessarily mean better care - often the reverse can be the case. Routine fetal heart monitoring in labour has led to a higher number of unnecessary Caesareans. More information has led to the situation today where obstetricians and medical professionals hold power and women have given up their knowledge. Routine ultrasound scanning undermines the woman's relationship with her baby. Often women say to me that the pregnancy becomes more real when they see the picture of their baby on the screen. Unconsciously, they are absorbing the attitude that someone else needs to validate their pregnancy, that they are not able to be in touch or trust in their own inner sense of the baby and their own knowledge of their pregnancy. This then affects their whole attitude throughout their whole pregnancy and during the birth of their child. They value obstetrical judgements over their own inner knowledge. Some women are aware of how this relationship has been undermined and make comments like "I left my baby behind in the gynaecologist's office". Women are extremely sensitive during pregnancy and comments by health professionals such as "your baby is too big", "your baby is too small", "What if your baby stops breathing and you're at home" introduce anxiety and powerfully undermine their confidence in their own ability and knowledge. I am always amazed how normally articulate women, used to standing up for themselves, come out with comments such as " well, we have to trust in what the obstetricians say, they know best" rather than being able to see that different obstetricians have often diametrically opposed opinions. Working in this field we do need to be reasonably informed about the differing opinions within the world of maternity services, so we can help women put the information they are given in a broader context. On the other hand there are many exciting developments in maternity services. I serve on the Avon Maternity Services Liaison Committee which is a multi-disciplinary committee made up of obstetricians, paediatricians, midwifery managers, health visitors, midwives from the local trusts and lay representatives . One of our current areas of discussion is the role of complementary therapies in maternity services. Some NHS trusts offer some complementary therapies. There is a midwife acupuncturist at Plymouth, an aromatherapist at Peterborough and John Radcliffe in Oxford has been using Aromatherapy on the delivery suite for some time. There is beginning to be some awareness of the part that complementary therapies can play. There is a journal of "Complementary therapies in nursing and midwifery" and the book "Complementary for pregnancy and childbirth" edited by D. Tiran and S. Mack, to which Elise Johnson contributed the chapter on Shiatsu. I hope that we will be able to get Shiatsu accepted as a vital part of midwifery care, particularly during labour. Some of us are already familiar with attending births and maybe using specific points and techniques. I myself have also taught many birth partners Shiatsu for labour, including fathers and midwives. I regularly run, with my partner Chris Wilkinson, Birth Preparation Days, of which Shiatsu is a crucial element. I am always surprised how much people can take on after even a few hours tuition. I particularly encourage people to get a feel of "Shiatsu touch", as well as teaching the points and areas which can be of use. We guide them to relate to their partner's body in the "Shiatsu" way, getting some feel for energy and how it changes when working with points. I'd like to share with you now a little of how I came to be involved in this field, and how I have developed my work to what I am doing now, which goes beyond my training as a Shiatsu practitioner. My real interest in Shiatsu and pregnancy began during my first pregnancy in 1989/90. I had only recently (1988) graduated from the Healing Shiatsu Education Centre and was beginning to assist Sonia Moriceau on the 3 year diploma course. I'd worked on a few pregnant women, but very carefully, unsure of the strength of the new born baby in the womb, armoured by precautions, "avoid work in the first trimester ", "don't stimulate these points in the second trimester" and so on. I hadn't planned on being pregnant, and initially wasn't sure whether I wanted to be. So, while on the course, I worked quite intensely on my spleen meridian and especially SP6 as well as other contraindicated points. I carried on with my meditation and exercises, quite vigorously, but my daughter hung on in there. I gradually became aware of the resilience of the spirit within me. I firmly believe now that connecting with the energy of the mother we are not able to cause harm. I usually am guided away from the contraindicated points, but occasionally surprise myself by working on "contraindicated" points or areas, although I'd say never with firm pressure and usually working more ethereally than with direct physical pressure. During this pregnancy, I began quite detailed personal study of the kind of exercises that were appropriate for me. I was initially quite cautious, once I decided that I did want to be pregnant, but gradually became more confident in my body's and baby's strength. I went to study ante and post natal exercise and baby massage with Elizabeth Noble at the Maternal and Child Health Centre in Boston, USA. My partner is a Yoga teacher and with his support, I gradually developed my own system of exercises for pregnancy and postnatally. I was never drawn to training as an active birth teacher as I felt their training was too yoga based and I wanted to include more meridian work. When my daughter was 3 months old in September 1990, I began teaching weekly ante and post natal classes, which I have been doing ever since. I continue to develop my exercises, learning continually from the women who attend my classes and through my second pregnancy in 1995. I include variations on makkho exercises, more yoga type work for strengthening the back, quite a lot of work on physically toning the abdomen and pelvic floor muscles, as well as a lot of breathing and contacting energy kind of work, especially including an awareness of the baby, whether in the womb or already born. I find these weekly classes complement Shiatsu sessions. If people come for Shiatsu as well, then I can tailor the exercises to support the meridian work done in the session. I have also been surprised by how quickly, even sometimes after attending just one class, many women gain relief from physiological symptoms like backache, tiredness, varicose veins, rib flare, swelling, simply by attending these classes, without the support of the Shiatsu session. Antenatally some of the work in the weekly classes is to prepare women for labour through connecting with their energy and exploring birth positions and movements and breathing. I developed the Birth Preparation days with Chris, my partner, by drawing together our joint work and also through our experience with the birth of our daughter Rosa Lia. We had decided we wanted Rosa to be born at home and in 1990, pre Changing Childbirth times, this was not supported by the NHS. I was indeed quite horrified by the way the community midwife, every time I went for a visit, tried to undermine my confidence, putting forward negative viewpoints of women and birth constantly. In the end my waters broke, I didn't go into labour and they wanted to induce me. Chris and I meditated and communicated with the spirit of our daughter, She seemed fine and we still intuitively felt that we all wanted her to be born at home. I showed Chris the Shiatsu points for induction and he worked them vigorously. It still took a couple of days for me to go into labour. For me it was LV3 which did it. I was definitely feeling quite angry by then. Once I'd gone into labour, Chris worked mainly the sacral points and labour progressed smoothly and quickly. The lessons for me of this birth, were that a partner is able to support a woman in labour with Shiatsu without being a Shiatsu practitioner. Over the 7 years we have been teaching these workshops, we have witnessed many other partners give support with Shiatsu. I think one of the best times was when I had a class full of obstetricians and later they came back to me enthusiastic about the effectiveness of the Shiatsu. By the time I gave birth to our son Bram Delaney, also at home in 1995, the midwives didn't need to be convinced of the value of Shiatsu and our approach to birth. It's been one of the highpoints of my work and life, that they did nothing at the birth, and it was my body and my hands alone which brought Bram into the world. I have also developed Shiatsu for babies. I find it is better to teach the parents to massage their babies, although sometimes with ill babies I'll work directly on them and then teach the parents specific techniques. Postnatally, especially in the first 6 months, I find it is important to be able to offer home visits, as mothers focus exclusively on their babies' needs, at the expense of their own. I also find it is important to be able to be adaptable and to include the baby in the session if necessary. I've given some lovely sessions where the baby has been lying on the mother's belly, even feeding. The baby is not really separate from the mother in this early period. Many cultures see the first 9 months of a baby's life as a transition period, when although out of the womb, s/he is still strongly interconnected with the mother. I hope this gives you some inspiration for expanding your work with pregnant women. There are many other ways which we can link in with other approaches and disciplines, which fall outside the Western medical model. As my partner is a Homeopath, I have become aware of the value of Homeopathy, particularly in the first year of a baby's life. I have realised that there is a definite lack of written material on these approaches to pregnancy, birth, and babyhood, particularly from a Shiatsu perspective. Ohashi's book is good in as far as it goes, but is very limited in scope. I am currently researching a book to fill this gap. A big part of it is drawing on stories of women and their partners who were able to contact their own wisdom of birth, as well as those who were swept along by medical technology. I have developed a questionnaire to help me gather these stories, so maybe some of you practitioners out there who have had children (it doesn't matter when or how) would like to fill in a questionnaire for me. Or maybe you have clients who have had interesting experiences. I also feel that more training is needed for Shiatsu practitioners in these areas; in particular a good knowledge of how the NHS system works and its approach; a practical understanding of other approaches, such as exercise, baby massage, work with partners, understanding needs and issues at this time; as well as a more thorough and in depth understanding of Shiatsu during this period. I will be running a one year diploma course for Shiatsu practitioners starting in 1999 in Bristol "Well Mother; Shiatsu and holistic care for pregnancy, birth and baby hood". I will be running 2 introductory weekends in 1998 one in July and one in September. If you are interested in more information on this course, please send for a prospectus. I look forward to hearing from the many of you out there, who I am sure work with pregnant women, and raising the profile of Shiatsu in this field. You can e-mail me at the bottom of the page. A few useful references; Marsden Wagner "Pursuing the Birth Machine" Ohashi " Shiatsu for Pregnancy and Birth" D.Tiran and S. Mack (editors) "Complementary therapies for pregnancy and childbirth" E. Noble "Essential Exercises for the Childbearing Year", "Primal Connections" Copyright © Suzanne Yates December 1997

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