10 Pregnancy Massage Mythconceptions
By Sharon Livingstone
“Sometimes massage therapists, when confronted with the lack of evidence to support this idea, will respond, “Well, I’ll avoid it just to be careful.” One should always err on the side of caution when in doubt, but that does not mean we have to be governed by false fears. By erroneously thinking they need to avoid the feet and ankles “just in case”, massage therapists perpetuate this misconception.”
Alice Sanvito, Massage Therapist, Massage St Louis
Did you know that 64% of people who received massage and other CAM treatments prior to pregnancy continued to have treatment during pregnancy?(1)
When a pregnant person books in to have a massage, they actually want a massage. No pregnant person wants to be refused treatment based on misinformation, false information and unsubstantiated myths.
So Where Do The Myths Come From?
Pregnancy massage myths aren’t only spread by massage therapists. They’re prevalent in massage schools, beauty schools, online forums for pregnant people, and even trip up many GPs.
Leslie Stager, author of Nurturing Massage for Pregnancy, wrote an article for ABMP about pregnancy massage misinformation which discusses where the myths originated. Stager discovered that during the 1900s, when midwives and home birthing were being replaced by a medical model of care, “Pregnancy was identified as a dangerous and fragile condition with many forms of activity viewed as potential adversaries to a healthy outcome”.
Although there was a shift back to the home-style and less intimidating birthing methods during the 1970s and 80s, for some unknown reason massage therapists remained in the “pregnancy is a dangerous and fragile condition” camp. We were still being taught that the slightest touch would damage a pregnant person and/or their baby.
During the 1990s, evidence of the benefits of prenatal massage was growing. According to Stager:
“Research indicated that massage could help decrease stress and the production of catecholamines (stress-related hormones), improve hormonal functions, speed labor, reduce pain from contractions, and increase the frequency and ease with which a mother touched her new infant, benefits known to traditional birth attendants long ago.”
The Myths of Pregnancy Massage
1. Massage causes miscarriage
This myth underlies most of the other pregnancy massage myths and ignores commonsense. Miscarriage has many causes but massage is not one of them.
Medline Plus lists causes and prevention of miscarriage on their website. Massage is not listed.
In her article on Clearing Up Misconceptions About Pregnancy and Massage, Alice Sanvito from Massage St Louis wrote:
For most miscarriages, the cause is unknown, but some known causes are chromosomal defects, failure of the fertilized egg to implant properly, maternal age, or excessive use of drugs or alcohol. Moderate exercise, sex, and working outside of the home do not cause miscarriage. If normal activity is not sufficient to cause miscarriage, there is no reason to believe that a relaxing massage would in any way cause it, either.
There is no evidence to suggest that massage causes miscarriage.
Miscarriage has its own set of myths. The “Further Reading” section at the bottom of this article includes some useful information on miscarriage.
One of the most common reasons I’ve heard from Massage Therapists for not treating pregnant people is a fear of litigation. If miscarriage occurs after a pregnant person receives massage, there appears to be a belief that the Massage Therapist will be sued. Stager failed to find any evidence of a successful lawsuit. Equally, I found no information on a massage therapist being sued (successfully or unsuccessfully) for causing a miscarriage.
2. Massage is contraindicated in the first trimester
This myth seems to arise out of the first myth and may be connected to the fact that miscarriage most commonly (in 80% of miscarriages) occurs within the first trimester.(2)
Most massage therapists have probably massaged a pregnant person in their first trimester without realising it because the client may not have known they were pregnant.
There is no research-based or clinical reason for not touching a pregnant person during the first trimester.
3. Don’t massage during entire pregnancy
This myth is generally grown from fear and may derive from the outdated belief that pregnancy turns a pregnant person into something fragile, where even the slightest touch will cause unknown but horrific outcomes.
Unless a known contraindication is present, such as those listed under “Contraindications for massage during pregnancy” below, there is no evidence to support avoiding treatment.
4. Don’t massage over the abdomen
If it’s OK for the pregnant person (or their partner) to rub a pregnant abdomen, then why not a massage therapist? Bub may kick back if it doesn’t like it (or if it does).
The history of pregnancy is happily littered with supportive partners providing a nice abdomen rub, without the impediment of knowing about all those massage myths.
Commonsense test: Ask a pregnant person with kids how often their kids kick, hit, sit on or cuddle that pregnant belly.
5. Don’t massage over the lumbar region
This myth is sometimes restricted to the first trimester, most likely due to the unproven link to miscarriage. Please refer to “massage does not cause miscarriage” above.
Commonsense test: A pregnant person with low back pain will rub their own back with no fear of harming their baby, so why would a qualified Massage Therapist cause harm?
6. You must have specific pregnancy massage qualifications to treat pregnant people
Massage Therapists are trained to treat clients with a variety of presentations. They don’t undertake specialist training before treating a client who has fibromyalgia or Crohn’s Disease or Multiple Sclerosis or who is recovering from surgery. Massage Therapists can obviously undertake further study on treating pregnant people, particularly if they would like to specialise in this area, but it is not mandatory or a prerequisite for performing massage on a pregnant person.
7. You must have clearance from the treating medical practitioner before treating pregnant people
The GP, OB/GYN or other treating specialist may have reasons to advise their patient not to have massage and, in that scenario, Massage Therapists should defer to the treating doctor. However, unless there is a contraindication such as those listed below, there’s no requirement to get clearance from the treating medical practitioner. Any potential issues should come to light through a thorough pre-treatment intake.
8. Massage of the feet and ankles causes miscarriage and/or pre-term labour
There is no evidence that massage of the feet and/or ankles causes any detrimental impact on the pregnant person.
Alice Sanvito’s article discusses the reasons behind this myth, and suggests that the information comes from foot reflexologists and acupuncture practitioners.
“… when researchers have tried to use acupuncture on these points to induce labor in women past their due date, they have failed.”
If an acupuncture needle can’t find an alleged specific point to induce labour, then how can a Massage Therapist? If acupuncture can’t induce labour post-date, then why would massage result in pre-term labour or miscarriage?
Commonsense test: Are partners (and kids) of pregnant people who rub the pregnant person’s tired feet causing harm? What about shoes and walking – do they induce labour?
9. You need to pay extra professional indemnity insurance to treat pregnant women
Any insurer that tries to extract extra money from a Massage Therapist for performing massage on a pregnant person needs to be dumped and/or given a stern talking to.
Massage is a low risk activity, that’s why our insurance premiums are so low.
10. Don’t treat with the pregnant person in the prone position
While pregnant people are told not to lie supine because it may compress the inferior vena cava and potentially harm the mother and starve the baby of oxygen, there is no evidence to support the myth that women can’t be massaged while prone and supported by the use of bolsters, pillows, pregnancy cushions or a special treatment table, as long as the client is comfortable and remains comfortable.
Contraindications for Massage During Pregnancy
There are some instances where massage is contraindicated, including:
-Specific advice from treating medical professional.
-Placenta Previa (but not in all cases)
-Some high risk pregnancies (OB/GYN will advise):
- High blood pressure/PIH (Pregnancy Induced Hypertension)
- Previous pre-term labour
- Recent bleeding
- Pre-term contractions
- Sudden severe headache.
Still Not Convinced?
Try this quick exercise. Go to PubMed and enter this search string:
massage + miscarriage
Please write a quick overview of the search results in the comments section at the end of this post.
If you thought that was fun, try the search string:
massage + first trimester + adverse effects
Pelvic Physical Therapist Sarah Haag’s Pregnancy and Pain talk at the San Diego Pain Summit in February 2018 ($US19.99)
Kristen Fischer “Dispelling Miscarriage Myths So Women Get the Help They Need”
About the Author
Sharon Livingstone is a massage therapist in Sydney, NSW. A love of sport drew her to the industry but discovering job satisfaction came from helping people live with less pain keeps her in it. Sharon is a writer, keen bushwalker and frustrated traveller, who no longer daydreams of walking across France again because she’s booked her trip.