Maternity reflexology conference by Gill Thomson

Gill Thomson, practising midwife, health visitor, and therapist, provides a personal account of her experience at the first International Conference on Maternity Reflexology My fellow trainer, Jenni Grant, and I travelled to Israel in October 2009

to attend the first international Maternity Reflexology conference. The conference had been organised by Mauricio (Moshe) Kruchik who wished to bring together some of the leading speakers in the maternity reflexology field to share and impart their wisdom and experiences with fellow reflexologists holding a shared interest. Moshe is the president of the Israeli forum of reflexology. He is a reflexologist, doula, childbirth educator and maternity reflexology trainer. A doula (pronounced ‘doola’) is a Greek word meaning ‘woman servant or caregiver’, which now refers to an experienced practitioner who offers emotional and practical support to a woman (or couple) before, during and after childbirth.1 We were excited to be attending this conference, and were pleased to be able to offer support to our colleague, Lyndall Mollatt, who was travelling to Israel from Australia to speak and facilitate one of the workshops on the third day. Lyndall, Jenni and I are all midwives and reflexologists, who are authentic trainers of Susanne Enzer’s Maternity Reflexology courses worldwide. The conference was beautifully orchestrated. Moshe advertised all across the globe, and approximately 120 delegates came from all over, including Denmark, Spain, Holland, Greece, Australia, Hungary, Slovenia, Israel and UK. There were 10 attendants from England and Scotland, which, even with my poor arithmetic, is around 10 per cent of the audience and made us proud. The conference ran from Sunday to Tuesday, with Saturday being Israeli Sabbath and holiday. We all arrived for the first day and were greeted with name badges stating our name, nationality, and individual

homeland flag. Conference manuals were filled with the timetable, a list of planned speakers, and a summary of each seminar. We also received headphones for translation, as the conference was in Hebrew, and the translators were excellent to the point of being almost instant with their translation. There were only a couple of times where we were ‘lost in translation’, which was when the delegates asked questions without the microphone so that the translator could not hear the question. My most memorable moment of the translators was when one was translating for a speaker who was talking about being a doula at a stillbirth (which is when the baby has died in the womb prior to birth). This was naturally very emotional and as the translator was repeating the words of the speaker, she was brought to tears by the words she was translating to us. The whole conference membership couldn’t help but join her in shedding tears. Moshe opened the conference, and the conference began very patriotically with the Israeli National Anthem, while the audience stood to mark respect for the vision that was now a reality for Moshe.

During the two-day conference, the speakers worked through the various stages of maternity reflexology: • Reflexology for preconception and sub-fertility • Reflexology for pregnancy • Reflexology for labour • Reflexology for puerperium • Reflexology and the newborn The programme had a good systematic approach and kept the delegate informed as they travelled through the wonders of fertility, pregnancy and birthing. Generally, the lectures included a demonstration via a camera that was projected onto the conference screen, which helped highlight areas of therapy that each individual lecturer had found effective in their sphere of expertise. This was an effective way to reinforce learning, as often visual learning can be the most powerful.2 Reflexology for preconception and sub-fertility There were three main speakers on this subject who looked at reflexology for pre-conception and sub-fertility, as well as incorporating many other therapies into their discussions: Shirley Tidhar from Israel, Frank Berger from Denmark, Nili Noam from Israel, and Aniko Kotroczo from Hungary (was scheduled but did not present) Shirley Tidhar, discussed In Vitro Fertilisation (IVF) and hormonal influences. Frank Berger provided an explanation of the energies of the five elements in the Taoist philosophy, which looks at the effects of the seasons and the elements, such as fire, earth, metal, water and wood, upon fertility. The energy cycles show us how our energies operate through the different phases of our life and during the different seasons. Nili Noam talked about the mind/body connection and discussed the chakra systems,3 which consider the mind and body as one, and described how the effects of chakra blockages can reflect on the body, and of course, the feet. Aniko Kotroczo, who looks at nutritional effects upon fertility such as vitamins and diet, was illustrated in the conference manual. Reflexology for pregnancy There were five excellent speakers for the reflexology and pregnancy part of the conference: Hanna Almagor from Israel, Moshe Kruchik from Israel, Irit Landau from Israel, Teresa Huelga from Spain, and Lyndall Mollatt from Australia. Hanna Almagor, a nurse, reflexologist and educator, discussed various topics including: the hormonal responses of the body during pregnancy; massive changes that may lead to the minor disorders of pregnancy; and the safety of using reflexology in the first trimester of pregnancy. We know the last topic is controversial, and Hanna projected a lot of her personal thoughts and observations into her discussion, which appeared to make it ‘safe’. I, however, think we must work with research-based evidence, not personal. Although Hanna encouraged reflexologists to work with ease within the first trimester, for UK reflexologists, I would encourage you check with your insurance company before working on pregnant clients in the first trimester. This may depend on whether you have undergone maternity reflexology training. Moshe’s presentation spanned the nine months of pregnancy and beyond. He has developed, and sells, good visual aids on pregnancy, the three trimesters, and many of the pregnancy disorders. Many disorders are very normal and should be treated as such, but there are a few pregnancy conditions that can be life-threatening to mother and baby, and reflexologists need to be aware of these. Moshe has written books4 on the subject and is obviously very passionate about his work.

Irit Landau, a reflexologist and doula who specialises in Bach flower remedies, talked well about the pain/fear/adrenaline production cycle, and how these destructive elements can have massive effects on labouring/birthing women. This was a very interesting seminar and she returned the following day for a workshop. The first day ended with a surprise: a lovely Spanish midwife called Teresa Huelga, who teaches belly dancing to women she works with, performing a lovely dance that had us all mesmerised. Theresa explained that belly dancing is a great exercise that encourages dancers to dissociate their body parts, allowing fluidity and unlocking. As a physical exercise, it improves circulation, helps correct bad postural habits, protects the lumbar posture, and is good for relieving tension. Pregnant women who rock their baby with hip movements are often able to feel the strongest maternal energies within. All attendants were encouraged to stand and ‘swivel our hips’, copying the moves, which effectively helped to move the body fluid that had accumulated while sitting during the conference all day! After finishing the first day, Teresa Huelga, who completed her midwifery training in Ireland, started the conference on the second day and was one of my favourite speakers. This young midwife’s presentation, ‘An experience in Malawi’, involved a powerful pictorial on Africa, maternity and reflexology. Explaining how she spent two weeks in Malawi working alongside an English midwife, Teresa depicted a lovely account of women having babies in Africa. She talked about the lack of facilities and provisions, and how birth and death are normal parts of the midwife’s work, before going on to talk about how she introduced reflexology to birthing women. I gained a lovely taste of the African life, which made me want to gather my Pinnards5 and hands, and hot foot out there. Lyndall Mollart, a practising midwife and maternity reflexology trainer in Australia, worked alongside Susanne Enzer when she was developing The Maternity Reflexology training in Australia,6 and teaches midwives and reflexologists in Australia and Japan. Lyndall discussed pregnancy oedema, ‘issues in the tissues’, referencing her published single blind randomised controlled trial on foot oedema in late pregnancy in a metaphysical perspective. She describes the non-randomised group, and how there was a significant decrease in both ankle measurements after receiving lymphatic drainage therapy.7 8 Reflexology in birthing Sivan Ofiri, an Israeli doula and birth educator, gave a very emotionally provoking seminar on attending a stillbirth, which I mentioned earlier when I discussed the translation service. For many, this would have been the first insight in the sadder part of the maternity field, which, although Sivan shared in a very calm, serene way, brought the whole audience - men included - to tears. Sivan is setting up a wonderful project in Israel to have a register of doulas who will volunteer to support the births of those devastated couples that have had to experience sudden termination or stillbirth. Cheryl Cole, a British community midwife who has undergone training in the UK with Moshe and attends women in labour, discussed her ‘bag of tricks’ that aid women through natural childbirth with the support of reflexology. Cheryl discussed home birthing in her area of Plymouth. She talked about leaving things alone when all is working well, but how reflexology comes into its own when things slow down or become out of control emotionally. At the end of her seminar, Cheryl amusingly demonstrated with a ‘labouring’ Lyndall on her hands and knees (no better position), how to access areas on the feet, such as the pituitary gland, uterus, acupressure points, etc. She referenced her presentation well.

We are given the opportunity to hear Moshe again, who spoke this time on the effectiveness and benefits of reflexology during labour. Demonstrating to the audience the different areas to work on the feet, including spinal reflexes, hypothalamus, uterus, and bowel, Moshe explains the reasoning behind the manoeuvres. There was lots of stimulation and hooking in with positive intent to mother and feet: endocrine system, oedema, placenta, with questions answered accordingly. Rita Zatelman, a nurse, midwife and reflexologist in Israel, who also uses other therapeutic approaches such as aromatherapy, Bach flowers and massage, focused on such issues as emotional processes; the client’s personality and beliefs; cultural and social associations; support networks; self expectations; family expectations, etc. Discussing how therapists can help change a woman’s thoughts, especially when giving reflexology in the third trimester, Rita discussed the possibility of helping the client develop positive thoughts by discussing fears and shaping new images. This was very powerful and so very true to me, as listening skills and positive reinforcements are a large part of our role as reflexologists. Reflexology for puerperium Mireia Marco, a Spanish midwife and reflexologist who trained in Birmingham, was another of my highlights. These young Spanish midwives are truly inspiring- they are our future and are being excellent ambassadors. Discussing reflexology in the postnatal period, she discussed the main problems, such as mastitis (inflammation of the milk ducts), haemorrhoids (piles), anxieties/fears, pain, etc, and she also gave a glimpse of what reflexology can do for new mothers. Her presentation was very good: she used balloons to demonstrate engorgement of the breasts, the problems with breast feeding,9 and how reflexology can help these conditions. She also used case studies to support her talk. Reflexology and the Newborn Iris Yossef, a midwife who trained in South Africa, was the final speaker. Currently living in Israel where she has studied complementary therapies, including reflexology, Iris specialises in working with children in a clinic setting. A video was shown of work within the clinic, and although unfortunately a lot of this was lost with translation, we were able to follow the pictures though. Iris showed ‘before’ and ‘after’ photos of therapies, went through childhood conditions, and discussed how to work them through the feet. Diet and lifestyle were also explored. Workshops On the morning of the third day, there were two workshops each, which both covered the theory behind the subject and were followed by practical demonstrations: Reflexology treatment after pregnancy loss Lyndall Mollart discussed the sensitive issue of miscarriage: the causes, how they present, management, and some of the reasons behind the condition, including hormonal deficiency, blood disorders, anatomical abnormalities, chromosomal abnormalities, infection and unknown causes. Talking about the physical and emotional impact of miscarriage upon the women and their partners, Lyndall discussed post-miscarriage treatments, such as diet, exercise, supplements and reflexology. She raised the issue of major imbalances to the endocrine system, before talking about and demonstrating endocrine balancing therapy. This technique is taught on Susanne Enzer’s Maternity Reflexology course,10 and has been shown to be very effective during loss, fertility, pregnancy, and the postnatal period. Indeed, it can be used at any stage in life with both male and female clients. Practical

hands-on work supported the teaching, during which Moshe - the client - fell asleep and snored throughout his endocrine balancing! Truly relaxing. Reflexology treatment that may help improve male sperm and female infertility Frank Berger’s talk about the energies of the five elements in the Taoist philosophy looked at the effects of the seasons and the elements, such as fire, earth, metal, water and wood, upon fertility. The energy cycles show us how our energies operate through the different phases of our life, and how they operate during the different seasons. These may have a massive effect on fertility, both male and female.11 I did not attend Frank’s seminar but the feedback was good with reflexology enhancing therapies. This was the end of the conference, apart from a Bach flower workshop in the afternoon, which we did not attend. Instead, Lyndall, Jenni and myself went to the beach by our hotel and watched the sunset as it slipped into the sea - a truly fitting end to the Israel experience.

Author’s summary In Israel (and many other countries), this may be the first leap forward for maternity reflexology by helping reflexologists to treat pregnant women - always alongside medical practitioners - with appropriate care. My only constructive criticism would be that during the conference the importance of working together with main caretakers was not highlighted enough. This does scare me somewhat for, as a practising midwife, I am continually emphasising to training maternity reflexologists that if they find any ‘red flag’ complaints or conditions, not to treat the client until the main caretakers have provided permission to continue. A key role of the maternity reflexologist is to signpost the client back to the primary caretaker earlier if

any issues are suspected that should not wait for the woman to attend her routine appointment. This may be several weeks

away. They may treat and relieve but they a) could make the condition worse (or change), for example, severe oedema, whereby encouraging the fluid out of the cells into the circulation will result in an immediate rise in the blood pressure, which could be very dangerous/fatal to mother and baby, or, b) they could screen a potential problem.

Photo: Gill Thomson, Lyndall Mollart, Jenni Grant: Authentic Susanne Enzer Maternity Reflexology trainers

Pregnancy and maternity reflexology is my world and my language. I have been a midwife for over 25 years and am as passionate now as I was when I started back in the 1980s. During these two and half decades, I have witnessed massive changes within the midwifery world. Although some are for the better, I am sad to say that I believe many are for the worse, especially the frequency of (or should I say lack thereof) routine antenatal visits to the midwife or doctor.12 Midwife means ‘with woman’, but there are less midwives despite an increasing amount of work. Indeed, the hospital where I work in Slough, Berkshire, has reported a 30 per cent rise in births over the last year with the changing population and EU immigration.13 However, reflexology and maternity reflexology is becoming much more widely recognised and gaining worldwide popularity. In my view, reflexologists play a very important role in caring for maternity clients before, during, and after pregnancy. Maternity reflexologists will often see women more often than midwives, who are seeing pregnant women much less than they used a few years ago.14 They will also generally have longer consultations and more time with that pregnant woman at each visit, and within a relaxing environment, can educate, reassure and primarily ‘listen’ to any fears and anxieties the pregnant woman may have. They can be so valuable at picking up deviations from the normal and I see their role to signpost these to primary caretakers as invaluable. For these very reasons, I feel passionate about reflexologists needing post-registration training before they work on pregnant feet. S/he needs updated research-based knowledge so that they can then feel confident within the maternity field. My final word is that we need to have a UK Maternity Reflexology conference. We have some wonderful experts in this field, who I have both studied with and on, including such great therapist/educators as Susanne Enzer, Lena Chandler, Christine Roscoe, Denise Tiran, etc. I am training along with these (to name a few) other maternity reflexologist educators continually in the UK, and indeed Moshe has been part of the training of many of our colleagues and peers. We are all sharing and working with the same intent: to make safe, well-informed, research-based, empowering, maternity reflexologist practitioners. Safe, evidence-based, cautious, maternity reflexology will only bring admiration and respect to the reflexology profession as a whole. We are organising a maternity reflexology conference, which you will see information about below. Please email reflex4pregnancy@aol.com or visit www.maternity-reflexology.com

UK first

Maternity Reflexology Conference

6th & 7th November 2010

University of Reading, Park

House, Whiteknights, Reading, RG6 6AQ. UK

Making babies Fertility / Infertility

Carrying babies Pregnancy Reflexology and working with pregnant feet

Birthing babies

Birth and Birthing support from you the Reflexologist

Mothering babies Postnatal Reflexology care

International Maternity Reflexologists speakers including: Susanne Enzer, Denise Tiran,Lena Chandler, Lyndall Mollart , Gill

Thomson, Jenni Grant, Chris Roscoe , Cheryl Cole, Moshe Kruchik,

Teresa Huelga & Mireia Marcos Spanish Midwife/Reflexology therapists

For further information & booking forms

Visit www.maternity-reflexology.com

£250.00 for weekend including workshop

1 www.doula.org.uk/about doula

2 Visual learning. http://en.wikipedia.org/wiki/Visual_learning

3 Chakra definition www.wikipedia.com

4 Maternity Reflexology booklet .Compendium of the Maternity Reflexology Course with Moshe Kruchik

5 Pinnards. Explanation. www.radmid.demon.co.uk/pinard.htm

6 The Maternity Reflexology courses. www.maternityreflexology.com/materityreflexology.net

7 Mollart L.2003 Singleblind trial addressing the differential effects of two reflexology techniques versus rest on ankle and foot oedema

in late pregnancy.complementary therapies in Nursing and Midwifery 9:2038 8 Lymphatic drainage technique. S.Enzer. The Maternity Reflexology Manual.2004.p.

9 Lymphatic drainage technique. S.Enzer. The Maternity Reflexology Manual.2004.p.

10 Endocrine balancing technique. S Enzer. The Maternity Reflexology Manaul

11 Frank Berger. www.de5elementersklinik.dk. This is in Danish, but if you cut and paste in translate/google.com

12 NICE guidelines for antenatal care.www.nice.org.uk

13 Heatherwood and Wexham Park NHS Trust. Wexham St, Slough, Berks. SL14H

14 Maternity Reflexology booklet .Compendium of the Maternity Reflexology Course with Moshe Kruchik