Pre/Post Natal Massage Therapy

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“Your health is an investment and not an expense.”

– Unknown

Pre/Post natal massage can make a significant difference to the wellness of a mother.  After all, pregnancy is not an illness. [1]  The focus is addressing the special needs of women as their bodies undergo the many dramatic changes that occur during and post pregnancy.  Did you know massage can create the same positive physiological states and increased alpha brain wave activity as meditation?  According to Carole Osborne, “the massage movements provide variations in pressure, rhythm and positioning that flood the sensory nerve pathways with the input that increases body awareness and overrides signals of pain and stress.” [1}

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  • stress reduction activating the parasympathetic nervous system (PNS) leading to steadier blood pressure, pulse, respiratory rates 
  • relaxation leading to regular blood flow to the uterus, placenta, fetus 
  • healthier immune system 
  • less fearful and anxious 
  • reduction in pain levels
  • improved circulation and physiological functioning
  • improve sleep 
  • soothe muscle fatigue 
  • reduction of musculoskeletal strain and pain
  • labor preparation
  • encouraging nurturing maternal touch  
  • postpartum recovery 

Stress Reduction 

  • nurturing, skilled touch 
  • individualized attention to needs
  • emotional support, especially in the absence of supportive family and friends 
  • attentive, non judgemental listening and emotional processing 
  • education and encouragement in stress-reducing activities 
  • appropriate referrals to other specialists 


Scheduling weekly massages to help relieve any added stress and strain placed on the body pre and post pregnancy can be beneficial to the mother. 


Even after a single session the mother can start to feel the health benefits of the session.  Scheduling multiple sessions is potentially more powerful in pain reduction and diminishing anxiety and depression.  [1]  According to Carole Osborne, “keep in mind it takes 9 months to make a baby and at least equal time to recover from the gestation.  Pelvic ligaments can be particularly slow to recover.” [1] Carrying and caring for a baby requires upper body strength.  Extended periods of static postures and carrying can strain muscles and joints potentially leading to trigger point development.  [1]  

Duration of treatment

We recommend at least 1 to 2 hours to give a thorough full body massage, to address any specific issues or concerns.  

Trimester Recommendations 

Comfort, safety, communication and therapeutic effectiveness considerations are key for treating pregnant clients.  Note special consideration is given on body positioning for treatment sessions based upon your stage of pregnancy.  As a friendly reminder let your therapist now how far along you are at each visit and give them any updates since your last appointment session to help guide them to customize the treatment. [1]  

First Trimester (Weeks 1 to 13) 

Common Maternal Developments 

  • enlarge tender breast 
  • emotional and hormonal adjustments 
  • fatigue 
  • frequent urination 
  • morning sickness or all day nausea and/or vomiting 

Safe Positioning 

  • supine, sidelying, semi reclining, prone or in a chair depending on the clients comfort level 
  • adapt for breast tenderness and other comfort and safety concerns, especially if in prone position 

Second Trimester (weeks 14 to 26) 

Common Maternal Developments 

  • pregnancy seems more real
  • increased weight 
  • back, pelvic, hip and leg pain may develop 
  • round and broad ligament pain 
  • stretch marks and other skin and hair changes 
  • varicose veins and/or spider veins 
  • constipation and/or heartburn 

Safe Positioning 

  • prone position is NOT recommended even with specialized equipment 
  • supine position – use pillow under right lower torso, up to week 22.  
  • after 22 weeks, only use semi reclining, and side lying positions to prevent supine hypotensive syndrome
  • chair massage safe 

Third Trimester (weeks 27 to 40+)

Common Maternal Developments 

  • eagerness and anxiety 
  • further weight gain 
  • increases back, pelvic, hip pain 
  • diastasis recti 
  • symphysis pubis syndrome 
  • hyperventilation 
  • heartburn, constipation or hemorrhoids 
  • edema in feet and legs
  • wrist or hand pain 
  • leg cramps and “restless leg” syndrome 
  • varicose veins
  • urinary frequency 
  • braxton-hicks contractions 

Safe Positioning 

  • semi reclining, and side lying positions ONLY
  • chair massage safe 

Precautions & Contraindications 

Talk with your massage therapist if you’re currently experiencing any of these symptoms to see if scheduling a massage therapy appointment is appropriate for you at this point in time.  When in doubt, always talk with your doctor/midwife to double check everything is safe and healthy. [1]

  • vaginal bleeding or gush or vaginal fluids 
  • pelvic or abdominal pain or cramping
  • lower back or medial thigh pressure or pain unaffected by position in space
  • regular uterine contractions before 37 weeks
  • high blood pressure 
  • swelling, pain or redness in your hands, feet, or legs
  • swelling of legs in the 1st or 2nd trimester 
  • abnormal lab tests indicating protein or sugar in urine 
  • persistent and severe mid back pain on the right side and shoulder, unaffected by your position in space 
  • severe nausea or vomiting 
  • severe headaches, blurred vision or chest pain
  • convulsions
  • excessive hunger and thirst 
  • severely bulging veins, discolored and painful leg pain 
  • cessation or reduction of fetal movement 
  • abnormal fetal heartbeat 
  • any concern about the fetus size or weight 
  • thrombophlebitis 
  • deep vein thrombosis (DVT)
  • varicose veins 
  • spider veins 
  • pitting edema, systemic edema, rapid weight gain  
  • hypersensitivity to oils, lotions, essential oils 
  • high risk pregnancy 

Questions & Answers 

Question: While I am pregnant should I avoid having my ankles and feet massaged? 

Answer: Their is understandable concern to protect the pregnancy but the level of warning is excessive.  We recommend working with someone trained in acupuncture/acupressure or reflexive zone therapy.  Only bone-to-bone, energy-focused pressure to these exact reflex areas will possibly create these negative prenatal effects. [1]

Question: When would it be appropriate to stimulate these points on the ankles and feet? 

Answer: Under the guidance of a therapist trained in Asian Bodywork Therapies rooted in Chinese medicine they would work with the woman who is in labor or on the verge of it with repeated stimulation and energetic pathways.  

Question: In order to prepare for the breathing demands of labor what breathing technique should I practice at home? 

Answer: All expecting moms-to-be should practice diaphragmatic breathing re-education.  Benefits – promotes relaxation, increased kinesthetic awareness, reduce overuse of upper chest and neck muscles that can contribute to headaches, neck and back pain or thoracic outlet syndrome (TOS). Promoting maternal and fetal oxygenation.  

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Here’s the basic procedure for diaphragmatic breathing:

  1. Sit in a comfortable position or lie flat on the floor, your bed, or another comfortable, flat surface.
  2. Relax your shoulders.
  3. Put a hand on your chest and a hand on your stomach.
  4. Breathe in through your nose for about two seconds. You should experience the air moving through your nostrils into your abdomen, making your stomach expand. During this type of breathing, make sure your stomach is moving outward while your chest remains relatively still.
  5. Purse your lips (as if you’re about to drink through a straw), press gently on your stomach, and exhale slowly for about two seconds.
  6. Repeat these steps several times for best results.

Question: Can massage therapy be a helpful tool as preparation for labor? 

Answer: Yes, massage therapy can be beneficial in labor delivery preparation.   Learning how to relax and use your breath to reduce pain levels is critical for a healthy delivery.  Massage therapy can help with improving your flexibility to allow your legs to widely abduct.  Working with a pelvic floor physical therapist specialist can help strengthen your perineal muscles teaching you pelvic floor exercises and perineal self-massage techniques. 

Finding Trained Therapist 

Before booking a massage appointment we recommend researching well trained therapist in your area who have been trained by Carole Osborne.  We recommend calling and speaking with the therapist to see if you feel it is a good fit.  

We believe in treating the whole person with a holistic approach and blend our knowledge and training to offer you a unique approach specific to you and your needs.  We have additional blog post for you to check out on movement, nutrition and traditional chinese medicine.    

We love teaching mindful movement and are here to support you in your journey. We offer customized online remote training from anywhere in the world. Contact us today to get started and learn to move with less pain and greater ease. We look forward to partnering with you and answering your movement questions and/or concerns.   

Assumption of the Risk: By attempting any of the exercises, you do so at your own risk.  We make no representations, guarantees or warranties that the information or exercises on this blog are appropriate for you or will result in improvements of your medical condition or function.  

Not medical advice or physical therapy.  This content is intended to provide information and instructions on general exercises that may help increase strength, mobility, and function for specific areas of the body.  It is not intended to be a substitute for obtaining a medical diagnosis or medical or physical therapy advice from a qualified licensed provider.  You should seek medical advice from a qualified physician or physical therapist before trying any of the exercises or self-treatment suggestions on this blog, particularly if your pain is from a traumatic injury or event. 


  1. OSBORNE, C., 2011. Pre- and Perinatal Massage Therapy: A Comprehensive Guide to Prenatal, Labor, and Postpartum Practice, 2nd Edition (LWW Massage Therapy and Bodywork Educational Series). 2nd edn. LWW.