Hannah did one of my early shiatsu practitioner courses, but I still feel her project on the importance of shiatsu for the baby in the womb is still very relevant.

Shiatsu with the Pre-birth Baby
by Hannah Mackay, shiatsu practitioner

Contents
Introduction
Connection and separation of mother and baby
Developmental changes during pregnancy
Reasons for working with the pre-birth baby using shiatsu
Shiatsu: A softer way of welcoming the baby
Working with a pre-birth baby with health problems
Focusing on the baby’s needs
Changing the baby’s position, especially in breech presentation
Working with the baby in the birth process
Connecting with the baby to understand more about the mother’s symptoms
Ways to work with the energy of the pre-birth baby
Being sensitive in working with the baby
Working with intention
Making a connection with the baby
Working points on the mother’s meridian system to affect the baby’s energy
Using cranio-sacral holding techniques
Using points on the baby’s body through direct work and visualisation
Conclusion
References

Introduction

Women coming to shiatsu during pregnancy may be looking for different things from their treatments. These may include general well-being and relaxation, help with specific physical problems which may or may not be associated with pregnancy, work on emotional issues, preparation for the birth, or help adjusting to motherhood and role changes.

When working with pregnant women, we should also be aware that we are working with pre-birth babies. Therefore, in addition to the aspects of the shiatsu treatment in which we focus on the mother’s needs, we may well want to pay some attention to the needs of the baby. As with any shiatsu client, pre-birth babies will differ in their needs and personalities. There will variation in how easy it will be to connect with different babies; we will need to work at a level appropriate to the individual baby; and we will need to try different approaches to get a connection.

In this project, I will be exploring some of the ways in which I have worked with pre-birth babies in shiatsu sessions. I will consider how focusing on the pre-birth baby can be helpful; and discuss ways to work with the baby’s energy. I will be using case study examples throughout the project. First I will consider some more theoretical issues about separation and connection of the mother and baby before birth; and issues concerning the baby’s development during the pregnancy.

Connection and separation of mother and baby

Before birth, the mother and baby are interconnected, and also separate. For example, in Western physiological terms, mother and baby have separate bloodstreams, and so the baby can have a different blood group from the mother without an immune response being triggered. However, the bloodstreams of mother and baby are also connected, through the placenta. Substances (such as nutrients, oxygen, hormones, and drugs) pass from the mother’s blood through the placenta into the baby’s blood, or from the baby’s blood into the mother’s (waste products, carbon dioxide) (Kitzinger, 1997, p70).

A similar process may operate on an energetic level. Energetically the mother and baby are connected before birth. This connection gradually subsides over time, but seems to be there for at least several months after the birth (based on our experience in Suzanne’s parent and baby clinic), and may actually remain throughout life. As well as this connection, there is a separation, a distinct quality or flavour to the baby’s individual energy that may be discerned even quite early in pregnancy.

The energetic connection between mother and baby means that the mother’s meridian system can be used to work with the mother’s energy, and also with the energy of the baby.
Working to rebalance the energy of the mother will affect the baby, and working with the baby will affect the mother. Therefore, if we focus the treatment where it is most needed, it should be beneficial for both mother and baby.

The distinct quality of the energies of mother and baby mean that as shiatsu practitioners we should be able to focus on either mother or baby, if we choose to. As energy follows intention, we can focus our shiatsu diagnosis or treatment using our intention. Pooley (2001) suggests that the shiatsu practitioner can sense the vibrational level where the client needs the most work – for example, a diagnosis of Large Intestine kyo could indicate that work is needed on breathing out, letting go emotionally, clearing mental clutter or working on issues of life and death. This sensing of where the work is needed, is also applicable to working with mother and baby during pregnancy. Working on the meridians of the mother’s body, or diagnosing from the hara or back, can be focused towards the energy system of the mother or the baby.

Developmental changes during pregnancy

A vast amount of physical development of the baby occurs during pregnancy – he or she changes from a single fertilised egg to a human being capable of surviving in the outside world. The different energy functions and meridians of the baby develop at different times during gestation. Each month is said to correspond to a particular function, although there are different schemes for the order of development. During treatments, the shiatsu practitioner may be aware of the energy function developing at the time of the treatment.

In addition, the nature of the relationship between mother, baby and the outside world will change during the course of the pregnancy. Before birth, the baby’s means of communicating with the world is through the medium of the mother’s body. The first trimester is a time where the focus is more internal, and it may be less appropriate to intervene from the outside (Ridolfi & Franzen, 1996). For the shiatsu practitioner, in the early months it may be more difficult to connect with the baby, as the baby has less of an energetic relationship with the outside world (for example, there is no visual indication of the baby at this stage). It may be that working with the baby is appropriate during these early months for some individuals. I feel that it is important to be responsive to the baby-client and not impose or push for a connection at this stage.

The Heart Protector and Triple Heater energy of the baby only begin to operate after birth, when the baby begins to interact directly with the world without the protective function of the mother. However, as the baby in the uterus grows nearer to the time of birth, he or she does begin to have more direct connection with the world beyond the mother. For example, Kitzinger (1997) states that babies may be startled by noises from the outside world from 17 weeks gestation, and that definite movement can usually be felt from 18 weeks (for a first baby). The baby can recognise its mother’s voice from 28 weeks. Connecting with the pre-birth baby in shiatsu sessions is likely to become easier as the pregnancy progresses, and the baby is more aware of the outside world. In general, shiatsu work directly with the baby becomes more appropriate in the later stages of pregnancy.

Reasons for working with the pre-birth baby using shiatsu

Shiatsu: A softer way of welcoming the baby

Currently, the common use of ultrasound scans means that the baby’s first meeting with the outside world will often be through the medium of high pitched sounds waves and electronic equipment. Many women find it difficult to really believe that they are pregnant, or make a connection with their baby, until they have seen their scan. This use of scanning makes the relationship between mother and baby much more externalised than it might be otherwise, although some people feel that it may help parents to bond with their baby. The reason for carrying out a scan is to make a judgement about the baby, and whether it is developing normally. This right/wrong, normal/abnormal focus may also carry across to the baby, and is not the most accepting way of making early contact with a new life.

In shiatsu sessions, we may be able to give the mother a more internalised way of relating to her baby. We can also establish a human, energetic contact between shiatsu practitioner and baby, which can be a softer way of communicating in these early stages of life. Connecting with the baby, and talking to the woman about her baby, can help to encourage bonding and discussion about the parent-child relationship. This can help support the mother-baby relationship before birth, and help to flag up issues relevant once the baby has been born.

Case example 1: Discussing the baby’s energy with the mother to make the connection with the baby more real.

A came for a shiatsu treatment at 35 weeks pregnant. She was generally in good health, but was feeling scattered, having recently moved to a new city. She was also feeling tired and a bit anxious about the birth. I noticed that she didn’t talk about the baby at all during our initial consultation.

A’s back diagnosis indicated Spleen jitsu and Lung kyo; and I was very aware of the Lung back diagnostic area when connecting into the baby towards the end of the treatment. A’s signs and symptoms also indicated Lung imbalance (waking at 3 a.m. unable to sleep again for a couple of hours; getting out of breath on the stairs; more colds during the pregnancy, and a sore throat for 3 months). When I connected with the baby, I could sense similarities with A’s energy, and also differences; I was aware that the baby’s energy was more Yang and active than the mother’s. After the session, I mentioned this to A, and she became much more animated and alive. She said she was aware of how the baby felt very different from her, and we discussed this. I felt that this conversation may have helped A to increase her connection with her baby, and to trust her feelings about the baby. This increased connection, and a sense of being both similar and different, would be likely to support the Lung energy for mother and baby (exchange across borders).

Case example 2: picking up on the nature of the baby’s energy to discuss relationship/parenting issues with the mother

B came for shiatsu 5 weeks before her baby was due. In connecting with her baby, I was aware that it seemed very Yang, moving around a lot. Later in the treatment, I had the impression that the baby did not find it easy to stop moving, or to reach a still point. I knew that the baby’s father had been hyper-active when he was a baby, and I was concerned that this baby could be following in that family pattern. During the session, I found that working the Bl, SI and LI Yu points were effective in calming the baby, and reducing its level of movement. I also found a meditative, Yin approach to holding the hara was effective in calming the baby. In talking to B afterwards, I told her that I had felt that the baby liked a lot of movement. She had mentioned at the beginning of the session that the baby had been waking her up 4 or 5 times a night. She then linked this to the baby’s active-ness, saying that the baby woke her wanting her to move around, and B seemed to be irritated with this situation. This led into a discussion about how to deal with this. I felt that it could be useful to focus on calming the baby when it woke her at night, rather than getting annoyed with it. This would apply both before and after the birth. B found it useful to think about interacting with the baby in a different way.

Working with a pre-birth baby with health problems

There may be specific occasions where medical opinion, or information obtained through complementary health care approaches, suggests problems in the health of the pre-birth baby. Obviously in this case, it is useful to focus on the baby.

Case example 3: Working with a baby diagnosed with problems

C had been coming for shiatsu throughout her pregnancy, mainly for treatment of severe sickness. At around 24 weeks pregnant, she had a scan which showed abnormalities of the baby’s heart and kidneys. At the time she came for a shiatsu, she did not know what the implications of these abnormalities were, but she was aware that they might make the pregnancy unviable, and she might consider a termination. My intentions in the session were twofold – to support the baby and its potential to heal its problems; and to prepare it for possible death. My focus was mainly with the baby during the session.

I initially found it quite difficult to connect with the baby. After some gentle holding and working with the Ht-Ut meridian, I made some connection. Visualising the baby, and working physically through the mother’s belly, I was strongly aware of points on the baby’s body; Ht7 and Kidney Yu points; it was as if the baby were presenting these points to me. I held these points for some time (I may have been in physical connection, or it may have been only a visualised connection). I then focused again on working with the baby through the mother’s meridian system. I worked with the sacral groove points to stimulate the baby; and worked SI Yu point, which seemed to open a channel of communication to the baby. I felt that working this point increased the baby’s will to live. Maintaining the communication connection with the baby, I was intuitively aware of points on the mother’s meridian system which would be useful to work – Bl16 helped to open Qi into the baby, and Bl24 was a gentle support for the baby. Holding the cranial base increased movement of the baby. It seemed easy to follow the pathways for the treatment, which the baby was indicating to me, once I had made a connection.

Making a deep connection with the baby’s spirit at the end of the session, I focused on allowing that it would be good to be in the world, and also good to go if necessary. There was a sense of increased well-being and happiness at the end of the session. I felt that the baby’s energy was still other-worldly, and not very solid.

C was very relaxed at the end of the session; I felt that focusing in a positive way on the baby (rather than as a medicalised ‘problem’), I had also allowed C a sense of peace. Working with the baby’s needs seemed to bring the mother what she needed as well.

C had a miscarriage several weeks later, after a number of conflicting medical views about what was happening with her baby.

Focusing on the baby’s needs

At times it may be useful to focus directly on the baby’s needs, particularly where aspects of the mother’s lifestyle or energetic state may be difficult for the baby to cope with.

Case example 4: Working to reduce the effects of maternal stress and medication use.

D came for shiatsu at 32 weeks pregnant. She has a long-term history of depression, and has been using anti-depressant medication for 15 years. During pregnancy, she had changed her medication to one that is safer for the foetus. She was feeling quite depressed when she first came for treatment, but by the 3rd session her mood had improved. When D is feeling depressed, her Zen Shiatsu diagnosis tends to include Lu or LI.

In the first session, the baby was slow to connect with me. His energy felt calm and not very ‘vocal’. D liked the feeling of my connection with him. In the second session, I felt that the baby was cross and stuck. I visualised working LI on his arms to release some of the stuckness. The stuckness felt toxic, like an inability to eliminate waste from his system (not something I’ve been aware of in any other baby I’ve worked with). I felt that this might relate to the build-up of anti-depressant medication in his system, or possibly the impact of negative emotional energy from his mother.

I did not focus much on the baby in the 3rd session, but in the 4th session, I was aware that his connection to the outside world felt very muffled – as if it were difficult to hear him. I felt that the baby’s energy was very separated from his mother’s, and that his energy was not coming through to affect the overall mother-baby energy field. Perhaps the boundary between mother and baby was too fixed, relating to the long term Metal imbalance. I felt that this may have been a direct consequence of the medication being used by D, or her energetic pattern of finding it hard to connect through her depression. I also thought that she might be keeping separate in order not to damage him, through exposure to the medication or her own emotional state. I felt that it was appropriate to allow more connection from the baby into the mother-baby field, but without pushing it.

I worked quite a bit on Kid and the Kidney-Uterus meridian in this 4th session (Kid kyo in back diagnosis). There was more allowance of the baby’s energy to affect the mother-baby energetic field at the end of the session. By the following week, the baby’s energy felt much bigger and he was more responsive to direct connection and to the shiatsu work.

Changing the baby’s position, especially in breech presentation

Working with the baby directly will often be appropriate when he or she is in breech presentation (bottom down). Kitzinger (1997) suggests that it is most appropriate to turn a breech baby between 36 and 39 weeks gestation – earlier than this, and the baby is likely to turn back again. Shiatsu can help to turn the baby, using suggestion, holding and points (Bl67). Working energetically with the baby may help to encourage him or her to remain in cephalic position.

Working with the baby in the birth process

It may be useful to work with the baby in encouraging the birth process to start and in supporting the baby during the birth. A shiatsu practitioner may pick up on whether the baby is experiencing anxiety during the birth, or whether it is simply energised. Focusing on the baby could, therefore, inform the best course of action during a difficult labour, in conjunction with medical information. If drug interventions are to be used, shiatsu can help prepare the baby beforehand, by moving him or her energetically towards the effects of that drug. This may avoid some of the shock felt by the baby during the birth process.

If the baby is overdue, shiatsu can be helpful in stimulating the birth process to start. Lateness may be a reflection of the mother’s energy, but the baby may also be blocking the birth beginning. It may be necessary to work with the baby’s physical position, or more emotional/energetic reasons for the baby’s lack of readiness to be born.

Case example 5: Picking up on reasons for the birth process not starting

E came for a shiatsu session when her baby was 10 days past the due date, hoping to start labour. She mentioned that her baby had been in breech position until quite late in the pregnancy, but was now close to the optimal birth position, with the head halfway engaged. She said that the baby was quite active. E had been experiencing mild period-type pain for 3 weeks, which had been stronger over the past 3 days.
E seemed quite relaxed and well grounded in her body. I was not aware of any particular block to her labour beginning, within her energy system. When I focused into the baby, holding at hara and back, I was aware that the baby’s head was not presenting straight down the birth canal. The side of the top of the head, rather than the crown, was presenting. This may have been linked to the fact that the baby had been in breech position; perhaps it had not found it easy to get into the right position. It felt to me that this aspect of the baby’s positioning was hindering the beginning of labour, rather than the mother’s energy (in contrast to other mothers/babies with whom I have worked).
In the shiatsu session, I worked the major birth induction points (GB21, Sp6, LI4, Liv3). Liv3 seemed to have the most effect on the baby, making it move quite a lot, whereas Sp6 and GB21 were more noticeable for E. As I felt that the baby needed to be the focus of work, I suggested to E that she should use Liv3 after the session.

Towards the end of the session, I used a simple holding technique to connect with the baby, to help it to change position. I encouraged the baby to move superior, to release its head from the birth canal, and then allowed a slight turn of the head, before moving down again. I was fairly sure that I had been successful in enabling the baby to move, and E felt that the baby moved a lot during this holding phase. I suggested that E should do some squatting to help the baby move down in this more optimal position.

Case example 6: Preparing the baby for induction of birth

F came for a shiatsu session when her baby was 8 days past its due date. She had not had any particular problems during her pregnancy. She was expecting to have the birth induced later on the day of her shiatsu session, as there was a concern that the baby was large, and F was fairly small. I used a simple connection with the baby, holding on the hara and back, after I had done some shiatsu for F. The baby seemed very comfortable, and relaxed (whereas F was more nervous). As the birth would begin that day, I felt that this level of relaxation was not the best state for the baby to be in, as the drugs used for induction would be a shock to its system. For the remainder of the session, I therefore maintained an intention to wake up the baby, and prepare it for birth. It felt appropriate to use quite vigorous shiatsu to move the Qi in F’s legs and hips, to achieve this intention. By the end of the session F was feeling very relaxed, and the baby was noticeably more lively. F noticed, and remarked that the baby was showing more movement. I had the sense that the baby was feeling the slight discomfort or ‘itch’ which acts as a catalyst to the baby to move it into the birth process.

Connecting with the baby to understand more about the mother’s symptoms

In working primarily with the mother’s symptoms, focusing on the baby can help shed light on what is going on, as in the example below.

Case example 7: picking up the influence of the energetic/elemental nature of the baby in working with the mother’s symptoms

G had been coming for shiatsu regularly before she was pregnant, and had been for six sessions during her pregnancy. I had also worked with her husband, and they had been to see me together for a birth preparation session. G came for a shiatsu treatment a couple of weeks before her baby was due to be born, suffering from pain in the pubic symphysis. She had identified the problem, and had stopped yoga and swimming, to stop the symptoms getting worse.

In connecting with the baby, I was aware that the baby’s energy at this time felt very much more like her father’s than her mother’s. The father is a very Woody person; creative, full of ideas, and a lot of Yang energy, prone to some stagnation problems. G, in contrast, is very calm, and tends towards depletion in the Water element, with some stagnation in the Metal element. It felt to me that the problems around the pubic symphysis related to the vibrant, large energy of the baby, which made it feel energetically too big for G’s body to hold in. The treatment focused mainly on working around the pubic bone, which was quite kyo, to support her body in containing the baby’s different energy.

Ways to work with the energy of the pre-birth baby

In this section, I will review techniques or approaches to working with the energy of the pre-birth baby. Many of these techniques have already been described in case examples in the previous section.

Being sensitive in working with the baby
Case example 8: anxiety over my contact with the baby

H came for a shiatsu session in the second trimester of her pregnancy, to address pain in the right side of her pelvis, and sciatica. During the session, I was aware that she was not finding it easy to relax, or to let go physically (for example in stretches). Towards the end of the session, with H lying in supine, I connected into the energy of the baby, holding on her hara. H said to me afterwards that she had been worried whilst I was doing this, as she thought that I might press on her stomach.

This comment made me aware that I should let pregnant women know that I am connecting with the baby, and that I am not going to press hard on the belly. This may be particularly important when the session is mainly focused on a physical symptom the mother is suffering; earlier in the pregnancy when the mother may be less aware of the baby; or when the mother is generally more anxious. Otherwise, the physical act of holding on the belly may make the mother feel anxious; and the fact of making connection with the baby may feel strange.

Working with intention

Connecting with the mother’s hara or back, intention can be used to focus either on the mother or the baby. This connection can be general, allowing a sense of the energy of mother and baby to arise through the hand contact. Alternatively, the connection can be through a hara or back diagnosis. Repeating a hara diagnosis holding the intention of 1). the mother, 2). the baby, or 3). the combination of mother and baby, can produce different results, and indicate different priorities. This information can then be used to structure the shiatsu treatment.

Case example 9: Variation in Zen diagnoses for mother and baby

When I worked with B (described in Case example 2), I compared a back diagnosis focused on her, with one focused on the baby. These diagnoses indicated TH kyo, Sp jitsu for B, and GB jitsu, Sp kyo for the baby. This suggested that there was a dynamic between mother and baby, based around the Spleen energy. I knew that B had had some bleeding earlier in the pregnancy, and she ended up giving birth 2 weeks early. It may be that her Spleen energy was being stretched by trying to hold up the pregnancy and retain her Blood (jitsu), and so not as much Spleen energy was available for support and nourishment of the baby (kyo). I worked with the Spleen meridian in the arms and torso in the session.

Making a connection with the baby

Sometimes, it may be difficult to connect with the baby’s energy. This may indicate that it is more important to focus first on the mother; perhaps her need for shiatsu treatment is greater. It may be easier to connect with the baby later in the treatment, when the mother has relaxed. Or it may be that it is not necessary or appropriate to work with the baby during this session.
I have found that holding the SI Yu points can often open a channel of communication between me and the baby. This makes it easier to connect with the baby’s energy, in subsequent holding at the hara.


Case example 10: finding it difficult to pick up on the baby’s needs

I went to treat J when she was about 32 weeks pregnant. She was feeling quite stressed, trying to get work finished before going on maternity leave, and having had some protein in her urine. I used several hara/back diagnoses during the treatment, to see how J. and her baby’s energy changed over the session. I did not find it easy to pick up on diagnoses specifically relating to the baby. Initially, I got a hara diagnosis of Liv jitsu, St kyo. J (who is a shiatsu practitioner) felt this probably related to her, but I felt it related to both J and the baby. After some work, I returned to the hara; diagnostically the focus on J vs. baby did not indicate many differences, except that Sp was jitsu in the mother-focused, but not in the baby-focused palpation. Using SI Yu points did increase the sense of connection to the baby, but I was not aware of anything needed particularly by the baby. I was more aware that she wanted her mother to have the treatment she needed. The only sense I had of a particular need from the baby’s perspective, was when holding at the end of the treatment, I was aware of her wanting increased Ht connection from her mother.

I felt that my difficulty in picking up on the baby’s needs in this treatment, reflected the dynamics of what was going on for J and her baby. J was stressed, and I felt that she was ready for shiatsu treatment. The baby only wanted more connection from her mother – this was something I could not provide for her, except through working to calm and de-stress her mother. Therefore, not much came through from the baby directly to me.

Working points on the mother’s meridian system to affect the baby’s energy

In working with pregnant women, I have been interested in whether particular points tend to affect the baby. For example, Bladder 67 is said to affect the baby by making him/her move, and so is useful in turning babies which are in breech presentation. I have seen the following as evidence of ‘effects’: increased or decreased movement; the mother’s impression of specific effects; and my own impressions. I have noticed a variety of points/meridians affect different babies (Liv3, Bl67, Kid1, Kid10, Spleen meridian in the lower leg). However, the only point that I have noticed having a consistent effect is SI Yu point, which almost always increases my connection to the baby. For me, this has seemed more consistent than Bl67, which has not always had a discernible impact. The position of the SI Yu point, near the top of the sacrum, is close to the location of the baby; and the influence of SI on the Blood in the hara (Beresford-Cooke, 1996, p157) also suggests its importance in feeding the baby during pregnancy. These may be reasons for the point’s usefulness.

Using cranio-sacral holding techniques

Simple holding techniques, as used in cranio-sacral therapy, can be used to allow information to come from the baby. Following movement can help to move the baby into a better position for birth (see Case Example 5).

Using points on the baby’s body through direct work and visualisation

During the final weeks of the pregnancy, it may be possible to work directly with points on the baby’s body. If the baby is in a position with the spine anterior, the Yu points are easily felt and accessed. Working these points may have a beneficial impact as they are access points to all the energy functions of the body – and are often worked in any shiatsu client. Earlier in the pregnancy, or if other points are to be worked, the practitioner will need to use visualisation and the direction of intention to work points, as it will not be possible to feel them accurately on the physical body (see Case Examples 3 and 4).

Conclusion

I have very much enjoyed working with pre-birth babies in the shiatsu sessions I have given to pregnant women. One of the more difficult aspects of this work can be the lack of feedback direct from the client, when he or she is a pre-birth baby. After birth, when working with babies we can, at least, use visual indicators such as colouring and movement. When working with pre-birth babies, we have to rely on reports from the mother and our own felt sense to tell us what we should work, and whether a treatment has had an effect.

I have felt that shiatsu for the pre-birth baby has had an impact on the clients I have seen. This can usually be seen by changes in the mother’s state, often including a very deep sense of relaxation. It seems that working with a focus on the baby often also gives the mother what she needs. Changes can also be seen in the baby’s state, such as position or amount of movement. Working with pre-birth babies is also helping me to trust my own feelings of the work that is necessary, and the effects shiatsu is having. And it’s great fun!

References

Beresford-Cooke, C. (1996). Shiatsu Theory and Practice, Churchill Livingstone.
Kitzinger, S. (1997). The new pregnancy and childbirth, Penguin.
Pooley, N. (2001). The different vibrational levels of the meridians. Shiatsu Society News, 79, 21.
Ridolfi, R. & Franzen, S. (1996). Shiatsu for women. Thorsons.

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