I recently saw a Facebook post on a reflexologists’ page, in which an obviously inexperienced therapist was querying why expectant mothers should not lie flat on their backs at 39 weeks’ gestation. Whilst it is worrying that she did not understand and possibly had not undertaken specific training on working with pregnant clients, the responses from her colleagues were even more worrying. Many (although not all) did not seem to appreciate the impact of supine hypotension on maternal and fetal oxygenation, nor did they fully understand safe positioning to avoid not only resulting dizziness and fainting but also how to avoid excess strain on the spinal muscles and ligaments and the symphysis pubis. Another post, a few days earlier, - of a type which I see frequently – was the group’s attempt to make a diagnosis from a photograph of a client’s feet. There were some extremely worrying comments, with therapists jumping to conclusions about possible medical conditions which they had “recognised” from the picture, with no other history available. Even more concerning were the comments about how reflexologists might actually treat this person, based on their so-called diagnosis.
As a midwife for over 40 years, a clinical reflex zone therapist for 35 years and having treated almost 6000 pregnant clients, I am alarmed by the attitudes of these practitioners, which showed little knowledge and understanding of the physiology and possible pathology of the client in question. I have no doubt at all that it is possible to examine the feet visually and via palpation, as well as taking into account the reactions of the client in terms of areas of tenderness and pain in relevant reflex zones on the feet. I have, myself, often seen or felt variations on the foot reflex zones that indicate changes in physiology or impending pathology, and my main interest in the therapy is its diagnostic potential. For example, I have undertaken formal research whilst at the University of Greenwich in the 1990s, to show that it is possible to predict stages of the menstrual cycle from an examination of the feet zones relating to the pituitary gland, ovaries, fallopian tubes and uterus – I have around a 70-75% success rate in so doing. I teach this in my courses for midwives and lead on to teaching how they can estimate the onset of labour, using the same theories.
However, a clinical diagnosis is achieved from a complete assessment of the client, including taking a comprehensive medical (and obstetric) history, ascertaining the current signs and symptoms, then a visual examination and thorough palpatory examination of the feet. Having drawn some conclusions, it is then essential to understand the physiopathology behind the assumed condition and to work out whether or not reflexology is an appropriate treatment to reduce the severity of symptoms, rather than resolving the condition. More often than not, medical conditions are a contraindication, even for a statutorily regulated health profession, and certainly for a reflexologist who is not a clinician. I am sure the injudicious attempt to work out what is happening and how reflexology may be able to help people with specific medical conditions arises from a compassionate but misplaced enthusiasm to help people.
If we want reflexology to be seen as a credible therapy with underpinning theory and evidence-based practice, practitioners MUST acknowledge the boundaries of their personal practice. These parameters may be different in different therapists due to their training and experience, but it is fundamental to professionalism to know when not to treat as much as it is essential to understand how to treat someone. This certainly applies to working with pregnant clients – and it is usually a post-registration training and qualification to be eligible to treat pregnant and newly-birthed women. For someone working with a client at 39 weeks of pregnancy and not to understand the most basic principle of positioning is obviously due to lack of, or poor, training and the fact that she was still about to treat the client is bordering on negligence. Further, I would assume that if she did not know this, she would certainly not be prepared to deal with any emergencies that might arise such as the woman having a rapid labour resulting in a precipitate birth whilst in the consulting room, or her waters breaking and the umbilical cord prolapsing.
The term “natural remedies” refers to herbal remedies, herbal teas, aromatherapy essential oils, homeopathic medicines, plus traditional (indigenous) medicines, whether sourced from plants, minerals or animals.
If a pregnant woman needs to change from her pre-pregnancy antidepressant, the popular alternative remedy, St. John's Wort may not be a safe alternative.
This herbal remedy works in a similar way to some antidepressants and can carry similar risks during pregnancy.
Always advise your clients to consult with their midwife or a qualified herbalist before considering St. John's Wort. (NB always midwife before doctor!!)
Keeping both mother and baby safe is always the top priority!
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Diagnosis and Professionalism in Reflexology
Guidelines On Herbal Remedies In Pregnancy
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