Massage During Pregnancy

Massage has long been practiced for the purpose of improving health and wellness, reduce stress, and relieve tension in the muscles. There have been limited responses on the use of massage during pregnancy from the health community regarding the safety and purpose. New research is showing that massage therapy can be a helpful part of a woman’s prenatal care and should be given careful consideration.

The benefits of prenatal massage:
Research shows that massage therapy performed during pregnancy can reduce anxiety, decrease symptoms of depression, relieve muscle aches and joint pains, and improve labor outcomes and newborn health.

Massage works to support a variety of needs using different techniques. The most common is a technique called Swedish Massage, which aims to relax muscle tension and improve lymphatic and blood circulation through mild pressure applied to the muscle groups of the body. Swedish Massage is the most appropriate massage technique during pregnancy because it addresses many common discomforts associated with the skeletal and circulatory changes brought on by hormone shifts during pregnancy.

Hormone regulation

Studies done in the past 10 years have shown that hormone levels associated with relaxation and stress are significantly altered, leading to mood regulation and improved cardiovascular health, when massage therapy was introduced to women’s prenatal care. Hormones such as norepinephrine and cortisol (“stress hormones”) were reduced and dopamine and serotonin levels (low levels of these hormones are associated with depression) were increased in women who received bi-weekly massages for only five weeks. These changes in hormone levels also led to fewer complications during birth and fewer instances of newborn complications, such as low birth weight. The evidence points strongly to maternal and newborn health benefits when relaxing, therapeutic massage is incorporated into regular prenatal care.

Reduction of swelling

Edema, or swelling of the joints during pregnancy, is often caused by reduced circulation and increased pressure on the major blood vessels by the heavy uterus. Massage helps to stimulate soft tissues to reduce collection of fluids in swollen joints, which also improves the removal of tissue waste, carried by the body’s lymph system.

Improvement of nerve pain

Sciatic nerve pain is experienced by many women in late pregnancy as the uterus rests on muscles of the pelvic floor and lower back. The pressure of the uterus spreads tension to the muscles of the upper and lower leg, causing them to swell and put pressure on nearby nerves. Massage therapy addresses the inflamed nerves by helping to release the tension on nearby muscles. Many women have experienced significant reduction in sciatic nerve pain during pregnancy through regular massage.

Other potential benefits of prenatal massage:
* Reduced back pain
* Reduced joint pain
* Improved circulation
* Reduced edema
* Reduced muscle tension and headaches
* Reduced stress and anxiety
* Improved oxygenation of soft tissues and muscles
* Better sleep

What precautions should be taken when seeking prenatal massage?

As with any therapeutic approach to pregnancy wellness, women should discuss massage with their prenatal care provider. The best way to address the risks of prenatal massage is to be informed and to work together with knowledgeable professionals.

Body position during prenatal massage

Many professionals consider the best position for a pregnant woman during massage is side-lying. Tables that provide a hole in which the uterus can fit may not be reliable and can still apply pressure to the abdomen, or allow the abdomen to dangle, causing uncomfortable stretching of the uterine ligaments. Consult your massage therapist before your first appointment to verify what position they place their clients in during the massage.

Seek an appropriate massage therapist

It is important to seek care from a certified prenatal massage therapist. Certified therapists have received training beyond the national standards for massage therapists and know how to address specific pregnancy needs and sensitive areas of the body.

Be aware of sensitive pressure points

Trained prenatal or pregnancy massage therapists are aware of pressure points on the ankles and wrists that can gently stimulate pelvic muscles, including the uterus. Certified prenatal massage therapists are trained to avoid very specific and intentional pressure to these areas during pregnancy. Any woman who has experienced pre-term contractions or consistent Braxton-Hicks contractions should alert her therapist to that fact so that pressure points can be avoided completely.

Women with the following conditions should speak with a health care provider prior to receiving a massage:
* High risk pregnancy
* Pregnancy induced hypertension (PIH)
* Preeclampsia
* Previous pre-term labor
* Experiencing severe swelling, high blood pressure, or sudden, severe headaches
* Recent birth

Is prenatal massage safe throughout the entire pregnancy?

Women can begin massage therapy at any point in their pregnancy – during the first, second, or third trimester. Many facilities will refuse to offer massage to a woman who is still in her first trimester because of the increased statistics for miscarriage associated with the first 12 weeks of pregnancy.

Incorporating Massage Into Your Prenatal Care

The benefits of massage can improve overall prenatal health for many pregnant women. Along with the guidance and advice of a prenatal care provider, massage therapy can be incorporated into routine prenatal care as an emotional and physical health supplement proven to improve pregnancy outcome, and maternal health. Consult your midwife or obstetrician before beginning any new therapeutic practice.
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Last Updated: 10/2007

Compiled using information from the following sources:

Field, T. (1999). Pregnant Women Benefit From Massage Therapy. Journal of Psychosomatic Obstetrics and Gynaecology, Mar;20(1):31-8.

Field, T. (2004). Massage Therapy Effects on Depressed Pregnant Women. Journal of Psychosomatic Obstetrics and Gynaecology, Jun;25(2):115-22.

Heimlich, Patti, RMT, CD, ICCE, The Benefits of Massage During Pregnancy, Labor & Postpartum. www.expectantmothersguide.com/library/houston/massage/htm. Article accessed online 10/18/2007.

Howell ,Julie, NMT, PMT, Prenatal Health Through Massage Therapy: For Women and Their Babies. www.newlifejournal.com/decjan03/howell/01/03/full.shtml. Article accessed online 10/18/2007.

Last updated: 05/2008