Explore the significant hormonal changes that occur during pregnancy and how reflexology can support the maternity journey.
Source – Reflexions; Winter 2023 – Written by Kate Mullis
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Pregnancy is a time of significant hormonal change as the body prepares to support, nurture and accommodate the developing foetus. Hormonal changes start after conception and ultimately affect every body system. In nonpathological pregnancies, these changes resolve with minimal residual effect. Various hormones are responsible for several physiological changes, so it’s important to be aware of these and mindful of some pregnancy changes that may indicate abnormal adaptions.
Human chorionic gonadotropin hormone (hCG): This hormone is only produced during pregnancy by the trophoblast cells surrounding the developing embryo, which then go on to form the placenta. HCG is detected in the urine 7-9 days after fertilisation, and the amount in the bloodstream doubles every 2-3 days as the pregnancy progresses, peaking around the 6-8th week of pregnancy. This rise in hCG may play a part in nausea and vomiting often linked to pregnancy in the first trimester.
Human placental lactogen (hPL): Also known as human chorionic somatomammotropin, is produced by the placenta during pregnancy. It can be viewed as a type of ‘growth hormone’ that helps to promote the development of the mammary glands in preparation for lactation and is thought to assist with regulating the mother’s metabolism by increasing nutrient levels in the blood, making them available for use by the foetus.
Progesterone: During the first few weeks of pregnancy,
the corpus luteum produces progesterone to maintain
the pregnancy by increasing the blood flow to the uterus,
stimulating glands in the endometrium to sustain the
embryo through the production of nutrients, and
encouraging the growth of existing blood vessels,
helping to establish the placenta.
Progesterone levels generally rise throughout pregnancy,
preventing early lactation and the womb muscles from
contracting until labour commences.
Oestrogen: Oestriol (the oestrogen
produced in pregnancy) levels increase
steadily until birth and are responsible for
stimulating, controlling and maintaining the
production of other pregnancy hormones,
which includes the correct functioning of
the placenta as well as the development of
many foetal organs such as the kidneys,
liver and lungs. Along with progesterone,
oestriol promotes the growth of the
mother’s breast tissue in preparation for
lactation.
High levels of circulating oestrogens and
progesterone can cause some undesirable
side effects, particularly as they act on the
brain, resulting in mood swings.
Oxytocin: Helps to stimulate uterine
contractions in labour and childbirth and to
stimulate contractions of breast tissue to
aid in lactation after childbirth. It also acts
as a chemical messenger in the brain,
playing an important role in parent-infant
bonding, trust, recognition and other
emotions.
Prolactin: Is one of the hormones that
helps milk production after birth, but it also
has over 300 other functions in the body.
Relaxin: Secreted by the corpus luteum in the ovary and detectable by week 7-10. Relaxin acts on the mother’s ligaments to allow the baby to develop, with the effects mainly concentrated around the pelvic region. Levels are highest in the third trimester of pregnancy, where they regulate the mother’s cardiovascular and renal systems and support the birthing process, as well as back and pelvic pain.
Tips for good hormone balance in pregnancy:
Maintaining optimal hormone balance during pregnancy is vital for maternal and foetal health. Prioritise a nutrientrich diet with ample proteins, whole grains, and fruits while managing sugar intake.
- Engage in regular, pregnancyappropriate exercise to support insulin sensitivity and overall wellbeing.
- Prioritise stress reduction techniques like meditation, gentle yoga and reflexology to stabilise cortisol levels. Ensure sufficient sleep to aid hormone regulation.
- Stay hydrated and follow the healthcare provider’s guidelines for prenatal vitamins.
- Seek regular prenatal care to monitor hormone levels and address any imbalances promptly.
How can reflexology help support maternity clients:
Promoting the use of reflexology for maternity clients’ needs to be done following the ASA guidelines. We can promote reflexology’s benefits in helping with relaxation, mood improvement, aiding sleep and relief of tension. While these sound rather vague and general, each can profoundly affect how an individual feels and their overall sense of wellbeing. If we choose to use research in our promotion, we need to quote the exact source and present this as factual rather than promotional information.
As reflexologists, we also need to be aware of our professional boundaries, knowing when and when not to treat and when to refer to the midwife or doctor. We must ensure client comfort and safety whilst helping reduce stress and easing pregnancy-related symptoms. More importantly, the reflexology session is a perfect time for mum to focus on herself and her growing baby.
Current research evidence suggests that reflexology has a significant effect on the pain and duration of labour as well as anxiety, and below are the outcomes of several randomised control trials (RCT) and other pilot studies for complaints common to pregnancy.
Research findings that support the use of reflexology in pregnancy:
Fatigue: An RCT investigated the effect of fatigue in pregnant women and concluded that reflexology had a positive effect in relieving fatigue experienced by this client group (1)
Sleep Quality: High-risk pregnant women who received reflexology were found to have a significant improvement in sleep quality assessed by the Sleep Condition Indicator Scale. (2)
Ankle and foot Oedema: Lymphatic reflexology techniques and periods of rest have been found to have a nonsignificant oedema-relieving effect. Lymphatic reflexology was the preferred therapy (from the women’s point of view), with significant increase in symptom relief (3)
Low back and/or pelvic pain (LBPP): A pilot RCT concluded that reflexology may help manage pregnancy-LBPP – but further trials would be needed to confirm this (4). Another pilot RCT analysing the release of salivary cortisol and beta-endorphin suggested that reflexology may have acted to reduce pain, disrupting the cycle of pain and stress (5)
Duration of labour: Numerous studies have measured the duration of labour to evaluate the efficacy of reflexology. One study found that the length of the first, second and third stages of labour was significantly lower in the reflexology group compared to the support group (6) A further four studies showed the same significant difference and effect in the active phase, transition phase, the second stage and the third stage compared with the control group. (7 – 10)
References:
- Shobeiri F, Manoucheri B, Parsa P, Roshanaei G. Effects of Counselling and Sole Reflexology on Fatigue in Pregnant
Women: A Randomized Clinical Trial. J Clin Diagn Res. 2017 Jun;11(6):QC01-QC04. - Nasiri M, Ranjkesh F, Mafi M, Senmar M, Hosseinigolafshani SZ, The effect of foot reflexology on sleep quality among high
risk pregnant women: a randomized controlled trial, Sleep Hypn. (2019) - Mollart L, Single-blind trial addressing the differential effects of two reflexology techniques versus rest, on ankle and foot
oedema in late pregnancy, Compl. Ther. Nurs. Midwifery 9 (4) (2003) 203–208 - Close C, Sinclair M, Cullough JM, Liddle D, Hughes C. A pilot randomised controlled trial (RCT) investigating the
effectiveness of reflexology for managing pregnancy low back and/or pelvic pain. Complement Ther Clin Pract. 2016 May;
23:117-24 - McCullough JEM, Liddle SD, Close C, Sinclair M, Hughes CM. Reflexology: A randomised controlled trial investigating the
effects on beta-endorphin, cortisol and pregnancy related stress. Complement Ther Clin Pract. 2018 May; 31:76-84. - Dolatian M, Hasanpour A, Montazeri S, Heshmat R, Majd HA, The effect of reflexology on pain intensity and duration of
labor on primiparas, Iran. Red Crescent Med. J. 13 (2011) 5. - McCullough JEM, Close C, Liddle SD, Sinclair M, Hughes CM, A pilot randomised controlled trial exploring the effects of
antenatal reflexology on labour outcomes, Midwifery 55 (2017) 137–144. - Semra AC, Incedal I, The effect of reflexology on labor pain, anxiety, labor duration, and birth satisfaction in primiparous
pregnant women: a randomized controlled trial, Health Care Women Int. 42 (4–6) (2020) 710–725, - Jameei-Moghaddam M, Goljaryan S, Mohammad Alizadeh, Charandabi S, Taghavi S, Mirghafourvand M, Effect of plantar
reflexology on labor pain and childbirth experience: a randomized controlled clinical trial, J. Obstet. Gynaecol. Res. 47 (6)
(2021) 2082–2092, - Kaplan E, Çevik S, The effect of guided imagery and reflexology on pain intensity, duration of labor and birth satisfaction
in primiparas: randomized controlled trial, Health Care Women Int. 42 (4–6) (2021) 691–709
