Complementary Therapies as Adjuncts in the Treatment of Postpartum Depression

Kira M. Weier, CNM, MSN; Margaret W. Beal, CNM, PhD


J Midwifery Womens Health. 2004;49(2) 

In This Article


The therapeutic value of massage has been recorded in several studies. It has been shown to reduce stress and anxiety; relax muscles; aid in circulation, digestion, and excretion; and reduce pain perception.[42,43,44] There are many different types of massage -- effleurage, deep tissue, and relaxation massage. Even the most simple massage may convey to the recipient a feeling of being cared for.[45] Both maternal and infant massage have been evaluated in the treatment of postpartum depression.

Maternal Massage

In 1996, Field et al.[46] conducted a study that compared massage and relaxation and their effects in 32 depressed teen mothers. The participants, who had recently given birth, were randomly assigned to one of two intervention groups. One group received 10 sessions of massage therapy, and the other received 10 sessions of relaxation therapy. Outcome measurements included pre- and postsession depression and anxiety scores, specific behavior measures, and cortisol levels. Although both groups had lower anxiety scores after their first and last sessions, only the massage group had statistically significant changes in behavior and saliva cortisol levels after their sessions. The massage group was also the only group to show significant decreases in depression scores, state anxiety scores, and stress throughout the course of the study. This study suggests that massage therapy may offer short-term improvements in mood and stress in the postpartum period.

Infant Massage

Studies have also demonstrated benefits of infant massage, including beneficial effects on parameters that could affect postpartum depression. Field et al.[47] have shown that compared to rocking, infant massage can lead to more organized infant sleep patterns and more positive interaction behaviors, parameters that would likely have a positive effect on the stress and anxiety levels of a depressed mother. The study by Field et al. compared the effects of rocking and massage on 40 full-term infants between the ages of 1 and 3 months who were born to depressed mothers. The infants either received 15 minutes of rocking or 15 minutes of massage twice a week for 6 weeks. In addition to the effects mentioned above, the infants who received massage spent significantly more time in inactive alert and active awake states, cried less, and had lower levels of cortisol in their saliva. Massage was also shown to be significantly more effective than rocking for inducing sleep. The infants in the massage group also gained significantly more weight and showed a significantly greater improvement on emotionality, sociability, and soothability temperament scores over the 6-week study.

More recently, researchers have investigated instructing and supervising mothers in infant massage as a way to improve the maternal-infant interaction. This may in turn play a role in improving the other deleterious psychological and physiologic effects of maternal depression on infants. Onozawa and colleagues[48] evaluated whether attending infant massage classes could reduce postpartum depression and improve the mother-infant interaction in 34 depressed primiparous mothers at a median of 9 weeks postpartum. Depression was identified by using the Edinburgh Postnatal Depression Scale at 4 weeks after birth, and the mothers were randomly assigned to either a massage (treatment) group or a support (control) group. Both groups attended five weekly sessions, and researchers assessed depression and quality of interaction at the beginning and end of the study. Outcome measures were depression scores and global ratings of mother-infant interactions at 2 months. Depression decreased in both groups, but only the massage group showed statistically significant improvement in mother-infant interaction. These two studies suggest that involvement in infant massage classes may be helpful in reducing some stressors for depressed mothers and improving their interactions with their infants.


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