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Our hospital has 40 midwives trained in reflexology, a 40-hour certificate course on reflexology and uses in midwifery practice endorsed by our midwifery national body (ACMI). This accounts for one-quarter of the total midwifery staff.
Our teacher was Susanne Enzer, a retired midwife and reflexologist, originally from England and now living in Australia. Susanne facilitates seminars, workshops and the accredited course "Maternity Reflexology." She is also the co-author of "Maternity Reflexology: a guide for reflexologist" (1997) and author of "Reflexology: a tool for midwives" (2000).
Reflexology is a therapeutic system of pressure-oriented massage to feet, hands or ears in the belief that all organs and glands have corresponding reflex points to the body. Reflexology elicits painful or tender areas with actual or potential disorder. It is a gentle, nonthreatening, noninvasive effective therapy. It has the potential to balance and maintain equilibrium, relax and increase vitality, and balance energy and move blockages.
A complementary therapies working party (3 midwives, 1 pharmacist, 1 midwifery childbirth educator) forged a policy which has been accepted by the hospital ethics committee to practice reflexology at work.
We use reflexology in our antenatal clinics and midwife clinics for various discomforts of pregnancy like leg and ankle odema, constipation, anxiety, and prolonged pregnancy. In childbirth, reflexology is useful to help enhance contractions, increase relaxation, retained placenta. Postnatally, reflexology can assist after epidural, forcep or LSCS and urinary retention. Difficulties relating to breastfeeding can be helped with reflexology. Also, with exhaustion, postnatal depression. There are few contraindications- severe PE, APH, severe PPH.
We are conducting a randomised single-blind controlled trial on the effect of reflexology on foot and ankle oedema in late pregnancy (over 32 weeks pregnancy). All women who met the criteria and are attending the clinics are invited to participate in the trial. The women are randomised (after informed consent obtained) into one of the three groups: normal pregnancy visit (control), relaxation reflexology (placebo,) or lymphatic drainage reflexology (treatment). The sessions are 15-20 minutes at least once a week. The information gathered are pre- and post-treatment measurements of ankle and instep, and blood pressure.
The women answer a questionnaire at each session about comfort, changes in mood/feelings, and changes in relationship with midwife. The study commenced in August 1999 and is due for completion in August 2001. Unfortunately we will fall short of the 120 women needed as we have had only 80 women enrolled. The difficulty of the study is the midwives do not always have the time to give the reflexology as it is within work time and there is no research assistant.
In a separate part of the trial, 12 women were treated with lymphatic drainage reflexology and refused randomisation but wanted reflexology. The characteristics of the women were mostly primigravidas (91.6%), 24-39 years old (mean of 30 years), at 33-39 weeks gestation (mean of 37.5 weeks). The results show all measurements decreased after lymphatic drainage reflexology. The women's blood pressure decreased (42%), increased (21%) and/or remained unchanged (35%).
On a scale of 0 to 5, The women found a decrease in stress, tension, anxiety, pain, tiredness, discomfort and irritability. The majority felt "very relaxed" or "relaxed" during and after the reflexology. Most noticed a difference in their feet after the reflexology: "more movement," "not as tight," "less swelling." Additional comments made by the women included "more at ease with midwives," "feel better about myself," and "relaxed whole body."
Although this sample is small, the many midwives have had similar comments from women receiving reflexology. It demonstrates that reflexology has a place in midwifery practice.
- L.M.
