Toledo Hospital nurses Marilyn Verhelst and Marjie Smith touch their patients in a way that medical technology cannot.
With gentle strokes, pressure, and manipulation of the body's soft tissues - and plenty of encouraging words - the two licensed massage therapists ease the pain and stress of women who are in labor, as well as those high-risk moms who have been hospitalized as they await labor and delivery.
And for the miracle of relief that the nurse/massage therapists deliver, some patients regard them as superwomen.
"I was in pain and Marjie was my hero," said Trisha Truman of Curtice a day after giving birth to her first child, Isaac. "I don't think I could have gotten through it without her."
Dawn Santchi, an RN from Swanton, experienced massage during labor for the first time when her third son, Carson, was born on March 9. "It was wonderful," she recalled. "I suggest them to everyone. It just calms you down."
Physicians are enthusiastic as well: "I think it's great and the patients love it," said Dr. Lillian Rayner, an OB/GYN who practices at Toledo Hospital. She said massage soothes fearful patients and aids labor, and "Anything that helps the labor helps the baby."
Massage therapy "is an up-and-coming modality of care," said Liz Jackowski, clinical director of inpatient women's services at Toledo Hospital. "It is a high-touch comfort measure, a way to relax."
The use of massage to comfort patients isn't new. It's been used informally in other areas at Toledo Hospital and by other hospitals. St. Vincent Mercy Medical Center, for example, offers free massages as
part of its services to women who have been hospitalized because of complications with their pregnancy, said spokesman Sarah Bednarski. In addition, perinatal education specialists at St. Vincent show new moms and dads how to do infant massage, which can facilitate parent-child bonding, calm the baby's nervous system, and result in more restful sleep.
And some private-practice licensed massage therapists, such as Mary Beth Tanner of West Toledo, occasionally are asked to meet a pregnant client at a hospital when labor starts.
However, Toledo Hospital believes it is the first in the area to staff nurse/massage therapists in labor and delivery. The service is free and optional, and has been used in 47 percent to 62 percent of deliveries each month since it was started. "We do not charge the patient; we do not bill it to insurance. It is part of our nursing comfort measures that we offer before and during labor," Mrs. Jackowski said.
The "Comfort Massage" program came about through the efforts of Kleia Luckner, administrative director of the hospital's Center for Women's Health, and the two LPNs. As Mrs. Verhelst and Mrs. Smith were studying on their own at the Northwest Academy of Massotherapy in Maumee, Ms. Luckner was pursuing the idea of adding massage to the services provided to obstetrics patients.
The program started last November. Still in the pilot stage, it has been a hit with patients, nurses, and doctors, Mrs. Jackowski said. "Everyone likes it."
Data are being collected to determine whether there is a correlation between massage and duration of labor, Mrs. Jackowski said.
But Mrs. Verhelst and Mrs. Smith say they don't need statistics to be convinced that they're making a difference, medically and emotionally.
Connecting physically with a patient establishes a bond, observed Mrs. Smith, who has been a nurse for 28 years. "A lot of times the patient will tell you whatever's bothering them. You're in their space and they're comfortable, and they'll just go ahead and say, 'I'm scared,' 'Am I going to throw up?,' 'Am I going to feel it?' Being nurses, we can answer their questions directly as well as provide the comfort of a massage."
Mrs. Verhelst, a nurse for 32 years, recalled a young woman who grabbed her arm and barked, "No! Don't leave!" as the baby began coming and Mrs. Verhelst had stepped aside for the delivery team and was turning to slip out of the room.
The therapists don't perform deep tissue massage on their patients, nor do they generally touch the tummy because monitors are attached there. For patients who are heading to the operating room for a Caesarean section, Mrs. Smith and Mrs. Verhelst do a light "healing touch" massage, usually on the patient's arms and hands, that's aimed at relaxation rather than facilitating labor.
For moms whose labor has been induced but whose contractions have slowed or stopped, the massage therapists work areas of the feet, ankles, and lower legs as a way to get things started again, Mrs. Verhelst said. "It triggers the uterus and the organs that control the uterus to work on their own, so our goal is to wake it up and have it work better on its own so we need less medication, we get a quicker delivery, and a more awake, happier baby," she explained.
The technique helped Holly Smith of Maumee, who gave birth at Toledo Hospital to her first child, Harrison, on Aug. 11. "When I was getting the massage my contractions were more regular and stronger, where they had been pretty irregular up until then," she said, adding that her husband, Wade, could see the change in the form of higher arcs on the monitor.
The massage also eased her nerves. "I ended up having a C-section because the baby was breech," Mrs. Smith said. "I was relaxed by the time I went in [to the operating room] because the massage had calmed me down."
Marjie Smith said another way to help move labor along using massage is to turn the patient on her side and gently rub her lower back and hips. That can relax and stretch the pelvis in such a way that the baby can move into position for delivery, she explained.
She also sometimes uses visualization to help her patients: As the woman is having a contraction, Mrs. Smith presses her hand in the area above the tailbone and instructs her to "Relax your body into the contraction and let it all come back to my hand."
For Mrs. Truman, the new mom from Curtice, that technique "helped me to really focus through the pain."
Even dads benefit, in an indirect way, through the presence of the nurse/massage therapist. "It was just a nice, relaxing voice," Gregg Truman said.
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