How to Safely Enjoy a Prenatal Massage
When your body is tired and sore or your mind is racing with anxiety, there’s nothing quite like a massage to destress—and pregnancy can certainly prove taxing, both physically and mentally. But when you’re expecting, keeping yourself and baby safe is of course top priority. So can pregnant women get massages? The answer is a resounding yes. (Phew!) When performed properly, prenatal massage is not only safe, but it also comes with a myriad of benefits. It can provide relief from physical discomfort, boost your mood, alleviate prenatal depression and anxiety and, if your loved one is massaging you, it can even bring you and your partner closer together. Here is everything you “knead” to know about safely enjoying a prenatal massage. (Sorry, we couldn’t resist the pun.)
Prenatal massage is more than just a pampering spa service to splurge on for special occasions—it’s actually a type of therapy in integrative medicine. Trained professionals use their hands to apply pressure and movement to different parts of the body to stimulate muscles, ligaments, tendons and skin. A prenatal massage is tailored to address the tight spots that may be exacerbated by pregnancy, all while keeping your and baby’s safety in mind. To that end, the masseuse will position and support your body appropriately and be mindful of the types of oils used during the massage.
“The massage can be transformative, releasing long-held tension with the right pressure and positioning,” says Sara Lyon, a licensed massage therapist and founder of Glow Birth & Body, a prenatal and postpartum massage therapy practice in Oakland, California, and Chicago, Illinois. “It takes into account the anatomical and endocrine changes impacting the pregnant body. Prenatal hormones like oxytocin and relaxin are optimal for deep relaxation and tissue healing. It’s an opportunity to take advantage of those hormones and elevate the massage experience.”
Most spas offer pregnancy massages (often called “mommy-to-be” massages), but you can also get one at certain clinics and medical centers, or from doulas certified in massage therapy.
As with any massage, the physical stimulation of massage during pregnancy can ease tightness and discomfort and release tension and stress. But in fact, research shows ample and far-ranging benefits of prenatal massage in addition to working out any kinks.
• Reduces muscle pain. As baby grows, your body has to account for the changes—and that can cause some discomfort. “The most common request from pregnant guests involves massages that are focused on the lower back, hips, neck and feet,” says Tiffany Delalay, spa director at The Spa at MacArthur in Sonoma, California. “It makes complete sense—those areas can be most impacted by increased weight and swelling that occurs during pregnancy.” Prenatal massage can also help ease neck and shoulder pain (and the tension headaches those pains can sometimes prompt), as well as sciatica, a common complaint among moms-to-be since the pelvis flares open to accommodate the growing baby.
• Bolsters immune function. Staying healthy is all the more important when you’re expecting, but pregnancy naturally lowers your immune defenses. It’s of note, then, that in animal studies, mice that were hand-stroked, as opposed to brush-stroked, had a better immune system response. Research also shows a boost in immunity for chemotherapy and immunodeficiency disorder patients undergoing massage therapies. “Physiologically, massage increases circulation and helps the body flush out toxins via the lymphatic system,” adds Lyon.
• Lowers risk of prenatal depression. Moderate pressure and touch stimulate the skin, which in turn activates nerve receptors to calm the mind. The vagus nerve, in particular, serves to regulate internal organ function, including heart rate and respiratory rate. “The increase in vagal activity slows down the nervous system, reduces stress hormones like cortisol, increases the love hormone, oxytocin, and increases serotonin, the body’s natural antidepressant and anti-pain neurotransmitter,” says Tiffany M. Field, PhD, director of the Touch Research Institute at the University of Miami School of Medicine. In one study, published in the Journal of Bodyworks and Movement Therapies, getting a 20-minute pregnancy massage twice a week for three months showed a decrease in depression and anxiety.
• May help prevent preterm labor. Prenatal depression is also linked to preterm birth between 32 and 36 weeks of pregnancy, as well as low birth weight for baby, according to research. Elevated stress hormones, like cortisol, can cause complications with the placenta, says Field. A prenatal massage can bring these biochemical changes into balance, maintaining a healthy in-utero environment for baby.
Good news: You can get a prenatal massage at any point in pregnancy, even early on, Field says. In fact, it may be particularly helpful in the first trimester if you have morning sickness. While there is no direct research that links massage to pregnancy-related nausea relief, a study found that a 20-minute massage significantly reduced nausea in breast cancer patients undergoing chemotherapy.
That said, some facilities may choose not to offer prenatal massage for moms-to-be who are still in their first trimester—not because massage is riskier during this time, as the American Pregnancy Association (APA) explains, but simply because they’d like to avoid any liability issues should their client go on to experience a miscarriage, which is statistically more likely to happen during the first 12 weeks of any pregnancy.
The third trimester is especially great for prenatal massage. By then, your body has undergone a huge transformation, and you’re likely to be both physically and mentally exhausted by the pregnancy. It even works as a preparation exercise for labor. “Massage allows the pregnant client to practice breathing through physical intensity to release muscles, softening instead of holding against the pain,” says Lyon. “This is also the ideal reaction to contractions. There are very few things you can do to practice that kind of physical and mental surrender.”
A massage may even relax you at the onset of labor—just don’t count on it as an alternative epidural. While some studies have found that massage at regular intervals throughout the labor can help lower anxiety and pain levels, other research has revealed inconclusive data on the true effectiveness of massage in easing labor pain.
Prenatal massage is meant to nurture you, both physically and mentally, so to fully enjoy it, you’ll want to put your mind at ease knowing that you and baby are safe. A massage during pregnancy doesn’t differ all that much from a regular massage, but there are a few safety tips to keep in mind when you’re expecting.
Starting in the second trimester (and beyond), lying on your side, possibly propped up by pillows, is the optimal position during a massage. Lying on your stomach is of course no longer a comfortable or safe option, and according to the APA, massage tables that feature a belly cutout can still apply pressure to your abdomen; plus, having your belly dangle can also cause the uterine ligaments to stretch uncomfortably. Lying on your back once you’re in your second trimester can also be unsafe, as the weight of your growing belly can compress an important blood vessel in your back and interfere with blood flow.
Many massage therapists don’t offer hot stone massage for their pregnant clients, as raising your core temperature isn’t recommended in pregnancy. Many also decline to perform deep tissue massage, since too much pressure—especially near veins in the legs—can potentially dislodge a blood clot, which expectant moms are at higher risk of developing. According to Field, moderate pressure that moves the skin is optimal.
Lastly, always seek out a certified massage therapist who is trained specifically in prenatal massage, and get the green light from your doctor before booking an appointment.
Where not to massage a pregnant woman
There are plenty of areas on a mom-to-be’s body that could benefit from extra attention, given the typical aches and pains of pregnancy, but there are also a few spots that massage therapists will generally avoid when performing prenatal massage.
• Leg veins. One study highlighted that pregnant women are more likely to have unidentified deep vein thrombosis. It’s possible that a vigorous leg massage could dislodge a blood clot, potentially leading to an embolism. “Steer clear of veins,” Field says.
• Belly. Lightly stroking your baby bump is perfectly normal (especially when you feel those baby kicks!), but you don’t want to actually massage the belly. Moreover, animal studies have shown that massaging the bellies of chickens led to hearing problems in fetuses, Field notes.
• Ankles. While there is no scientific data showing that a foot massage during pregnancy can prompt labor, anecdotal evidence suggests massaging the Achilles tendon can stimulate contractions, though the link is unclear. Delalay says, to be safe, avoiding the ankle during the first trimester is a good idea. “That area has pressure points that correlate with the reproductive organs,” she says. When in doubt, an Epsom salt foot soak is a good alternative.
Still, try not to stress over these more sensitive areas. It’s true there are certain pressure points that may stimulate contractions, but an average prenatal massage from a well-trained therapist isn’t going to catapult you into labor. “The body usually has to be on the verge of labor already for those points to be effective,” Lyon explains. “Clinical studies show that successful acupressure for labor induction has to bruise the skin and the pressure has to be on very specific points that are quite painful for most women…. It would make you jump off the table if you weren’t prepared for it.” The most important thing is to listen to your body and what feels good, and speak up when something doesn’t.
You may be tempted to hire a live-in masseuse for the duration of your pregnancy, but turning to your partner, or a vibrating massager, may be the next best thing. Not only does daily massage during pregnancy help reduce your risk of prenatal depression and premature labor, but your partner who’s doing the massaging can reap some benefits too. “Their stress hormones are reduced by stimulating pressure receptors in their hands and arms as they massage,” Field says.
To get set up, make sure you’re comfortable. Tucking supportive cushions under you helps keep the body in alignment when you’re lying on your side. Place a pillow between your knees for added support. Next, consider if you’d like to use a lotion or massage oil. While essential oils are by no means necessary for a successful at-home prenatal massage, aromatherapy can enhance the experience. “I love using lavender for our pregnancy massages for its relaxing and baby-safe properties,” Delalay says. Just give the oils a sniff before using to make sure your heightened senses aren’t offended, and steer clear of certain essential oils that aren’t recommended for pregnancy.
Ready to try a prenatal massage at home? Here are some key pointers from the pros.
Foot massage during pregnancy
Your partner can still massage your feet, as long as they’re careful to avoid the ankle area. Note that in acupressure, the flat side of the heel is linked to the lower back and glutes, while applying pressure to the space under your big toe can help relieve neck pain.
Leg massage during pregnancy
Instead of kneading your leg muscles (especially if you have varicose veins), have your partner rotate your thigh muscles (quads and hamstrings) around your femur—first clockwise, then counter clockwise—as you stand leaning over a chair or countertop. “These leg muscles attach at your lower back and pelvis, so you’ll feel everything releasing with the motion,” Lyon added.
Hip massage during pregnancy
Lyon recommends a standing “double hip squeeze,” which can be a great massage during pregnancy and even labor. Lean forward onto a table or countertop with your forearms supporting the upper body. Ask your partner to stand behind you and squeeze your hips (the fleshy sides of glutes) inward. They should hold, but not massage, your hips for 10 seconds and then release. Repeat several times. “The counter pressure of your partner’s palms pressing into your hips will relax your lower back, hips and upper legs,” Lyon says.
Back massage during pregnancy
You can do this lying on your side or while straddling a chair. Have your partner start with your lower back by applying pressure with their fists to the upper buttock area, and then work their way up your spine.
Shoulder massage during pregnancy
Since your neck and shoulders carry a lot of tension, ask your partner to ease any knots with long, moderate-pressure movement down your trapezius muscles—the back muscles that extend down your neck, out to your shoulders and into your upper back, forming a trapezoid shape. “During pregnancy, expecting mothers’ posture shifts to accommodate the increased amount of weight on the front of your body,” Delalay says. “Because of this, it is so important to focus on massaging not only the lower back, but also the neck and upper back.”
You don’t need to rely on a partner to enjoy an at-home pregnancy massage! For on-demand muscle release, try using an electric vibrating massager. “Vibration is not dangerous and will feel great on the larger muscles,” Lyon says. “But always be sensible: don’t use a Theragun on your belly.”
With pregnancy comes significant changes—to your body as well as to your lifestyle and overall emotional balance. The good news is that prenatal massage can offer some welcomed respite from those physical and mental challenges. As Lyon says, “There truly is no bad time for a massage.”
About the experts:
Sara Lyon is a licensed massage therapist and founder of Glow Birth & Body, a prenatal and postpartum massage therapy practice in Oakland, California, and Chicago, Illinois. She holds diplomas in prenatal massage, orthopedic massage and Shiatsu, and is also a doula and birth educator, and author of the book You’ve Got This: Your Guide to Getting Comfortable with Labor.
Tiffany Delalay is the spa director at The Spa at MacArthur in Sonoma, California. She has more than 30 years of experience working in the spa industry and has gained specific expertise and insight into prenatal treatments, tracking the latest trends and developments in the field and engaging directly with pregnant clients.
Tiffany M. Field, PhD, is the director of the Touch Research Institute at the University of Miami School of Medicine, which conducts research on the effects of massage therapy on various medical and psychological conditions, including preventing prematurity and reducing depression. Field received her doctorate degree from UMass in 1976.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.