Jeda Boughton: Hi Dawn, welcome to BodaHealth Radio. I have been looking forward to this conversation and hearing a lot more about Fertility Massage. We have been working together for almost three years now?
Dawn Sells: Yes, at Christmas time it will be three years.
Jeda: At the beginning of this year (2015) you flew off to Ireland to study with Clare Blake, and we’ve been so busy that we haven’t had a chance to sit down and actually have a really good conversation about what it is that you’ve been doing. Obviously I know we have been working with the same patients, and I have come in and I have had a treatment with you, but I have had lots of little questions that I wanted to ask you, so this is great. Thanks for talking the time to hang out with me.
Dawn: No problem, thank you.
Jeda: How many years have you been an RMT?
Dawn: It will be 10 years in March, 2016.
Jeda: You have been a Massage Therapist for ten years--so after ten years of practice, I am curious about what drew you to study fertility massage?
Dawn: I have been interested in fertility for quite a while. I have had a focus on women’s reproductive health, and most of my continuing education courses have been in pregnancy and postpartum massage . I have always had an interest in fertility but I did not really know how exactly how I was going to work that into my practice until I started working at BodaHealth--when I started working with you, specifically--and we had patients in common that were trying to get pregnant. I started feeling that instead of giving a more general relaxation massage, which is in and of itself helpful, I wanted to get more specific with fertility. So I started researching how I could bring something new to the table at BodaHealth in terms of massage and fertility. As I was doing my research I discovered that there is not much happening in this field in Canada, and really in North America. That’s when I started putting my own treatment protocol together, based on my knowledge and research, but I really wanted to learn some more specific techniques.
Jeda: I remember all the work that you did, studying, looking into programs and where you could learn more, and what kind of techniques you can use.
Dawn: There is not much research. There have been very few studies done, I think because there are so many variables involved for patients who are trying to conceive. They’re usually receiving more than one type of treatment. I was hoping to find more research that would prove that certain types of hands-on techniques could help improve fertility, but that is still hopefully yet to come.
Jeda: It is pretty tough to do a study when you can’t do double blind trials too, that is one of the problems with acupuncture studies.
Dawn: So we had signed up for the 2014 Mind Belly Connection Fertility and Wellness Summit. It was an online conference with several downloads, and that was how I found Clare Blake. She did some of their lectures. I started looking into her work, and I downloaded some of the resources off of her website. Then I realized that she was teaching courses in fertility massage, so that was when I decided to go for it and went to Ireland to take her course.
Jeda: And what specifically drew you to her, versus other people in the United States that are doing similar work?
Dawn: My instincts told me that Clare and I would be a good fit. It is the combination of the science involved as well as the spiritual part of it, and a perfect balance between those two things. She is very knowledgeable. She understands all of the physiology involved, and then there is also a part of helping the patients to connect with their reproductive system, their womb specifically, Clare prefers to call it the womb rather than the uterus. I thought that was unique and I think that often with fertility patients, it’s good to track your cycle and have all the tests, and have everything in your brain. But then we lose the connection with our wombs throughout that process. It all becomes very analytical and you are just looking at numbers and that kind of thing, so I’m hoping to help the person to take a break from that.
Jeda: You’re the first in North America to have this credential. Is it a relatively new type of study, or is there a reason that other massage therapists do not have this type of credential? Maybe because it is so far away to go and study?
Dawn: I would say so. I’m not sure how long Clare has been teaching the course, but I think she has been doing so for a few years now, starting in the UK. Maybe other people do not have an interest or don’t realize that this exists, I am not sure.
Jeda: Becoming a massage therapist was a big change in direction from what you were doing originally. How did you realize that you had a calling to be a massage therapist?
Dawn: Well I use to work in film and advertising, I used to mainly produce TV commercials. I realized that I needed a change. I felt that I wanted to do something that would help people, more than what I was doing. So I left my job, took some time off and did some travelling and soul searching. I have always enjoyed receiving massages and I have always respected the massage therapists that I know. I decided that this would be the ultimate job for me, so I decided to go to massage therapy school.
Jeda: Had you always been one of those people in your family who was massaging everyone?
Dawn: No, actually, and it was a big shock to everybody. All of my family and friends were pretty surprised, that I went from advertising to this, but it was the right decision. It has been a wonderful career, and I feel a lot more passionate about it than I did about my previous job.
Jeda: I can tell! What is it exactly that you love about it? I can tell how much you care about the patients that you treat, and how much you care about their well-being and getting better…
Dawn: I guess I do have a lot of enthusiasm, even ten years in. I like helping to make a difference for people, and I feel that I have an ability, with each patient, to tune into what they need on any given day, any given treatment.
Jeda: Going from being a massage therapist to being very specifically focused on fertility massage, would you say that some of your journey with your own family was influencing that decision?
Dawn: Yes, definitely. I had a fertility journey of my own. It took quite a while to conceive my first daughter. The second pregnancy was not as much of an issue--it happened pretty quickly--which is why they’re so close in age. I have two young daughters now. I have a lot of empathy for what these patients are going through, based on my own experiences, so that was definitely a part of why I started becoming interested in this area.
Jeda: Can you explain what the difference is between the regular massage and fertility massage?
Dawn: I like to refer to it as either fertility massage or “general” massage because I realized that I was calling it “regular” and that makes it sound like fertility massage is “irregular”, which it isn’t. There is overlap, definitely, and it also depends on what else is going on in the person’s body at the time, besides having trouble conceiving. I am directing my treatment specifically to the reproductive system, and I am doing a lot of abdominal work. In general, massage therapists don’t tend to work on the abdominal area very much, I know I hadn’t in the past. It can be a very sensitive area for people, sometimes they might be ticklish, sometimes there are emotional triggers.
Jeda: I know when you gave me the fertility massage so that I could experience it, I loved the abdominal massage. I find normally when I get massaged, nobody touches your abdomen. When you are lying face up, maybe your neck, your arms, your legs, but it is nice to have work done on areas that aren’t usually touched.
Dawn: It is taboo in a way, and I am not sure why. But now that I have been treating a lot of abdomens, it is second nature, it just feels like such a natural part of the treatment. What I learned from Clare was to focus on three areas, the first is the low back/sacral/upper gluteal area. The second area is the upper abdomen, which is related to emotions and the digestive system. The third area is the lower abdomen, including the womb. Those are the three main areas to focus on, but depending on what else is going on with the person, if I have time I will also try to do some neck, shoulder, head, and jaw work. There is often a lot of tension in those areas for anybody, but specifically for fertility patients.
Jeda: When you’re working with a patient for the first time, can you explain what kind of process they would go through? Is it an hour? How do you figure out exactly what they need? Where do you focus your attention?
Dawn: I have all patients fill out our general massage therapy intake form, and then for fertility patients there is also a one page form that is specific to fertility. I always like to read that before they come in so I can gather some questions and learn more information about their situation. The treatment itself is an hour. Usually the first treatment we spend quite a bit more time discussing what’s going on before starting the treatment. So the first treatment there is a little less hands-on time on the table, but in subsequent treatments, there is less talking and more massaging. It depends on where the woman is in her cycle. So I can treat fertility patients any time in the cycle, but I can do the most techniques between the end of the period and ovulation. That is when I would apply a castor oil pack to the abdomen and also do the womb massage. If a woman has her period, or if she is post-ovulation in a cycle that she is trying to conceive then I don’t do those two parts.
Jeda: Would the castor oil pack and the womb massage be between your period and your ovulation?
Dawn: Or it could be post-ovulation in a cycle when a woman is not actively trying to conceive. But if she is trying to conceive in that cycle, if there is any chance of pregnancy, then those are the two parts that I omit.
Jeda: If you are changing your technique through the different phases of the cycle what kind of techniques would you use for someone who could potentially be pregnant, post-ovulation?
Dawn: I still work on the sacral/ lower back area and the upper abdomen. I also have some Mexican shawls--they are called Rebozo--and I do stretching, wrapping and things like that, with these shawls. They are often used by doulas and midwives during childbirth. They can be used as an elaborate wrap for baby, once baby is born. Rebozos can also be used for postpartum mothers, for something called “closing the bones”. We wrap up the head (turban style), the womb, and the feet and just let the woman lie still. It’s a way I think of having her reconnect with her body.
Jeda: After delivery how long should she lie like that?
Dawn: As much time as she has to do it!
Jeda: Do you do that technique?
Dawn: I do, I usually only wrap the womb. I have not done the head and the feet as much, but I have tried it a few times and you can pick up legs and move them around and do traction of the head and feet.
Jeda: When the womb is wrapped, would you massage other areas?
Dawn: Yes I usually wrap up the womb and put their hands on top of that area, as a way of connecting her to her womb. I especially like using that technique if someone has had a miscarriage, because that is a painful experience. It is a good way of “forgiving” your womb, of reconnecting, and knowing that it’s OK to feel the way that you do.
Jeda: When you’re treating patients are you mainly treating patients that are trying to conceive naturally or are you working mostly with patients who are doing IVF or assisted reproductive technology, that type of thing, or does it matter?
Dawn: It doesn’t matter, I have treated quite a wide variety of patients, some trying to conceive naturally, some that are just starting to try to conceive, others that have been trying for quite a while. Everybody has a unique story, a unique situation, but I would say the majority of the patients who come in to see me are using some type of assisted reproductive technology. But the principles are the same regardless.
Jeda: Can you treat them through an IVF cycle when they are doing their injections, or before and after they have their egg retrievals?
Dawn: Yes, what I usually say when someone is going through their IVF cycle, I will have them come in at least once between when they are finished bleeding and when the egg retrieval is happening, and then again between the egg retrieval and the transfer--at least one time, as many times as they can, but hopefully at least once. More and more these days we are seeing people who are not necessarily having the retrieval and the transfer in the same cycle, we are seeing a lot of frozen embryos transfers as well, but again the same principles apply-- between when the bleed or the period is done and either ovulation, for those who are trying to conceive naturally, or transfer for those doing IVF.
Jeda: So you can still do the fertility massage during the period then?
Dawn: I can. I would still give somebody a massage during their period. The castor oil pack is contra-indicated because it could increase bleeding. We have had discussions about this between the practitioners at our clinic--is this necessarily a bad thing, if somebody has a lighter periods? But in general, the rule says no castor oil pack during the period. If someone is just at the very end of their period and spotting, I would still use the castor oil pack. Massaging directly over the area of the womb is not recommended while someone has their period.
Jeda: And when you are doing the massaging over the womb, are you specifically feeling for anything? What kind of techniques are you using?
Dawn: The womb is actually quite deep, and so we can’t really palpate it directly, this is a tough one to put into words…
Jeda: One of the things that I think about is how osteopaths and visceral massage therapists do a lot of light touching and kind of feeling the rhythm of the organs. I don’t use that technique so I do not have 100% idea of how that all works. But would you say that there is a contrast between what you are doing and they are doing, or is it similar?
Dawn: It is similar. It is visceral manipulation. I am feeling for temperature, I am comparing the two sides of the lower abdomen; do they feel the same, does it feel like there is come kind of congestion or fascial restrictions, things like that. I am using my palpation skills and my intuition of what might be going on. And if I know a woman’s story (if she has had a blocked tube or a cyst removed, or something that) I will also keep that in mind. and I will treat that issue.
Jeda: Can you unblock tubes?
Dawn: No. I don’t think there have not been any studies, so that would be the sort of claim that I would not want to make.
Jeda: We see a lot of women who have been trying for a long time and they have been through a few IVF cycles, and they may have had surgery or fibroids removed or different laparoscopic procedures. Not often, but sometimes they might have a lot of scars from those procedures. Can you still work on an abdomen that has scars or someone that has had a past c-section or gallbladder or appendix removed, do you still work on those?
Dawn: Definitely. The patient needs to tell me if it is a sensitive area, either physically or emotionally, I would need to know that. But working directly on that area and trying to break up that scar tissue and soften it a little bit is a really good idea because everything is connected fascially in that area. We want things to be more mobile and have everything in working order, so it is a really good idea to work on the scar tissue as long as it is not too sensitive or the scar is not too new.
Jeda: Would you ever do something like that for post c-section patients, to help heal or prepare for the next pregnancy, or just in general post-surgery?
Dawn: Yes. I think c-section scars heal at different rates so it can be very sensitive in the beginning, so the patient would need to decide her comfort level with having that area worked on, but I definitely like working with postpartum moms. That’s my other favourite area, in terms of supporting these women in taking some time for themselves, away from baby for just an hour, and helping them with whatever physical things are going on after having a baby.
Jeda: Do you get a lot of feedback from your patients, since you’ve been transitioning during the last 8 months, to these very specific fertility techniques? What kind of feedback do you get? I know a lot of the patients I send to you end up coming back and telling me they are pregnant!
Dawn: Yes, that’s always the best--that’s the feedback we are looking for! Sometimes I will actually set up my room for a fertility massage for a certain patient, and she’ll walk in and tell me “I am four weeks pregnant”, “I am six weeks pregnant”, and so on. This is so exciting, an exhilarating feeling throughout the clinic. That’s the best feedback. I have even seen a few people who are ovulating that day or maybe the next day, or are having intrauterine insemination or an IVF transfer very soon after I have given them the treatment, and then to find out that they are pregnant is really exciting. In general people tend to feel very relaxed, sometimes they fall asleep during the treatment--which is probably something they need more of-- and that type of thing. The feedback has been very good, especially since having taken Clare’s course in Ireland.
Jeda: When you treated me, it was so relaxing and it was so nice, and afterwards it was like I was in a Zen state. Do you have any specific patients you can tell us about--obviously you are not going to reveal any names-- but any fun stories, or a particular patient you have that you were really excited about?
Dawn: Yes, so there was this one patient in particular. She is in a same-sex relationship and was trying home inseminations. She came in on a Saturday and got a massage from me and acupuncture from Heather Howe at our clinic. She went home and did the insemination that night, and it worked! It was exciting to hear that because she has had a few failed inseminations previously. That was pretty cool!
Jeda: Once she was pregnant did you continue treating her, and can you continue treating patients once they are pregnant?
Jeda: I know you have done a lot of pregnancy massage. Have your pregnancy massage techniques changed since you have been studying fertility massage?
Dawn: Maybe a little bit. I obviously don’t work over the womb early in pregnancy. Taking Clare’s course has definitely influenced me, in general, in terms of trusting my instincts and my intuition, more than I did before.
Jeda: Do you treat specific conditions? Would you say this is really great for endometriosus, or PCOS or unexplained infertility? Or in Chinese medicine, we may say “cold uterus”.
Dawn: All of the above can benefit from fertility massage. and the castor oil packs in particular can really be effective for a lot of those conditions--especially if there is any scar tissue. It will help loosen any adhesions, and then I follow it with the massage itself we do both within the treatment.
Jeda: So the idea with the castor oil pack is to soften adhesions?
Dawn: It gets things moving in general, so it gets the circulation going to that area, it’s helping to detoxify, it’s helping to draw whatever is there out, including scar tissue, adhesions, and so on.
Jeda: And in terms of scar tissues can it be anywhere in the pelvis?
Dawn: Yes. The digestive system and the reproductive system obviously are very connected, and it is pretty interesting to see how many fertility patients also have digestive issues. I am sure you probably see this as well.
Jeda: And everything starts with digestion, because whatever they eat is going to be what fuels the rest of their body. Speaking of digestion, do you give other types advice, or homework, or send them home with castor oil packs?
Dawn: I usually talk to them about the timing of when to come back to see me, when the most beneficial times are. If they are interested in doing castor oil packs at home, which can be very helpful, I will give them the information about how to do so. I don’t go into nutritional advice since that’s not in our scope of practice as massage therapists, but I do often refer them either to you, Jeda Boughton (Doctor of Chinese Medicine) or Dr Alana Shaw, our naturopathic doctor, for doing food diaries, and that kind of thing. Or if they have other issues, such as thyroid, that is definitely beyond my scope, but then I know they will be in good hands with the other practitioners at BodaHealth.
Jeda: Would you ever send them home and ask them to massage a certain area of their own body?
Dawn: Yes, they can definitely do self- massage, it can be beneficial. I often talk to patients about deep diaphragmatic breathing, since a lot of us are very shallow breathers. Clenching the jaw is a big one as well, becoming more aware of what we are doing in terms of clenching the jaw, holding the breath, posture, hunching forward, that type of thing.
Jeda,: So you are giving them postural advice?
Jeda: Some people who don’t live in Vancouver might not be able to find a fertility massage therapist, someone who does that type of work. Do you have any advice, some things people can do at home, or something they can ask their massage therapist to do for them?
Dawn: I would say definitely the castor oil pack is a pretty easy thing that a woman can do for herself at home, and then in terms of massage, having more massage therapists start working on the abdomens. Don’t be afraid!
Jeda: So there is nothing that you can do to hurt somebody if you are working on their abdomen?
Dawn: It depends on somebody’s condition. Obviously we are very cautious. Sometimes if a woman is doing assisted reproductive technology they could be getting injections in the abdomen, so they could be quite sensitive and there could be some bruising--so obviously that practitioner should be very cautious and check in with the patient to see if she is feeling sensitive in that area. But I find that even when somebody is having injections, they like to have that area worked on. It can be comforting and give some relief as well.
Jeda: Especially with the castor oil pack I would presume. Do you use heat on that as well?
Dawn: Yes, the castor oil is a piece of cotton flannel saturated with castor oil. We place that directly below the belly button. I usually use a thin piece of plastic because castor oil is very messy and sticky, and then put a heating pad on top of that. That can sit for 15 or 20 minutes nightly, in between the end of the period and ovulation
Jeda: And are you using a special kind of castor oil?
Dawn: I order large containers of the Heritage Store Palma Christi brand online.
Jeda: It is not the local drug store brand?
Dawn: No, I think it is good to find something organic, and something food grade would be ideal.
Jeda: Can you do fertility massage on men?
Dawn: I can. To be honest, in theory, a lot of the same principles would apply but I haven’t done it yet, just because women tend to be the ones to seek out treatment. Men tend to be a little more resistant or shy, or for whatever reason men haven’t been booking fertility massages, but that is an area I would like to explore.
Jeda: When you were studying fertility massages did you study treating men?
Dawn: Not really. She touched on the fact that the same principles apply, but her practice is exclusively treating women.
Jeda: We sort of touched on this with the nutrition aspect, but how are you finding working in an integrated clinic, and the way that your work and your treatments connect with the other fertility practitioners at Boda?
Dawn: Well that’s the best part of the whole thing. I enjoy doing what I do on my own, but I also really enjoy interacting and the comradery that I have with the other practitioners at Boda. We are all focused on fertility, and we are all passionate and enthusiastic about what we do. I love being able to bounce ideas off each other and to learn things from the other practitioners, and to refer to each other when it’s indicated. I think that we are very unique in that we can offer all of these services under one roof.
Jeda: I know it is nice for me too. I just love it. It’s great when patients see all of us, and being able to say to each other “hey what do you think?” and “what do you think is going to be the best route for this patient?”, and everybody has their own perspective.
Dawn: We all have the same goal, but we might be coming at it from a little bit different place, so it is just so great to put that all together and to help people.
Jeda: Is there anything that we have not talked about that you want to mention? Anything for people that might be listening, anything that you are working on, articles, website, books, study, etc?
Dawn: There are lot of things in the works, but I am also a busy working mother, so it may not be happening as quickly as we would all like, but there are more exciting things to come!
Jeda: How can people find out more about you, and about fertility massage?
Dawn: The best thing is to go to our website: www.BodaHealth.ca Each of us has our biography, so you can read more about me there. There is also a fertility massage “frequently asked question” link from the fertility section of the website. You could also check out Clare Blake’s website: www.fertilitymassage.co.uk I am listed there, as well as other practitioners throughout the world, and she has a lot of good resources on her website.
Jeda: Thank you so much for being here for this conversation Dawn. It’s been awesome! I have learned a lot, and I am so glad that we had it because there have been a lot of things that I have been wanting to ask you. We get so busy at the clinic that we can’t sit down and have a conversation like this, so thank you.
Dawn: It’s true, thank you!
Dr. Jeda Boughton is a Doctor of Traditional Chinese Medicine and Registered Acupuncturist in Vancouver. She is also a Registered Herbologist and the founder of BodaHealth.