1) Massage during the first trimester

Some masseurs refuse to give massages during the first trimester, as this is when most miscarriages occur. This is simply because they do not want to be associated with this event should it occur. However, there is no evidence that massage can cause miscarriage and massage is not contraindicated during the first trimester. In fact, massage at this time is completely necessary, as it helps the woman negotiate the physical, emotional and spiritual changes of her pregnancy. Your potential is maturing into a powerful new role and identity.

2) Leg massage during pregnancy.

Deep vein thrombosis in the legs only occurs in 15 out of 10,000 pregnant women (Olmsted County live birth data between 1966 and 1995). Of these, 12 will have clear signs of a possible blood clot, leaving 3 in 10,000 pregnant women with an undiagnosed blood clot. Despite these low numbers, some massage therapists indicate that massage on the inside of the leg is not advisable, as it could dislodge an undiagnosed clot. Considering that massage improves blood flow and therefore reduces the risk of a blood clot, refusing to give a competent massage to the legs potentially exposes 9,997 out of 10,000 pregnant women to unnecessary risks.

A more realistic approach is to give a competent massage while checking for signs and symptoms of a possible blood clot. The simplistic solution of banning deep massage or inner leg massage appears to be more prevalent in countries where litigation is high and appears to be based on misunderstandings and fear rather than on existing evidence-based practice by the following reasons:

  • Despite this overemphasis on blood clots, a reliable method of evaluating for a blood clot is not provided, so there is no good reason to continue or stop massage. The Homan test is still routinely taught in massage schools to detect deep vein thrombosis even though it is not reliable and is no longer used, other clinical tests are being used instead.

  • Massage helps prevent clots by preventing stagnant blood pooling in the legs. It is very necessary during pregnancy as there is a greater tendency for the blood to clot during pregnancy.

  • Pregnant women who have been on bed rest are at higher risk of developing blood clots, as their inactivity causes blood to pool in the legs. They are advised to exercise their legs by pointing the foot up and down. This creates a strong pumping action in the calves that helps blood flow through the legs. This has a more powerful effect than massage or pressure point work. If massage is considered risky, standard hospital care is even riskier.

  • The Spleen, Liver and Kidney meridians of Traditional Chinese Medicine play an important role in health, especially during pregnancy. As they go through the inside of the legs, working on the pressure points in the legs can be extremely beneficial. In particular, it substantially reduces the risk in diabetic mothers when their diabetes is Spleen and Kidney Yang deficiency type diabetes (here there may not be excessive thirst, hunger, urination or heat normally associated with diabetes, but there is an increased risk of incompetent cervix, placenta previa, and detached placenta). In this case, giving only a light superficial massage to the legs can expose the mother to a much greater risk than a normal and firmer pressure massage.

3) Using an abdominal hole on the massage table.

This is done to allow the mother to lie on her stomach without compressing her stomach during a massage therapy session. However, because your stomach is now not properly supported, your lower back and pelvis are under stress and your uterine ligaments are stretched. Both are common causes of pain during pregnancy. Pressure from the edges of the hole in the abdomen also reduces the blood supply to the abdomen.

4) Avoid lying on your back during pregnancy

This ignores that a pregnant woman is often placed on her back for prolonged periods during labor, a common hospital procedure. Only lying on your back for a massage or in general if there is 1) known threat of blood clot formation in the legs, 2) supine hypotension, or 3) low back pain or pain due to sacroiliac or iliosacral dysfunction.

5) Lying only on the left side during pregnancy

Lying on the right side is supposed to put slight pressure on the inferior vena cava, a large vein that carries blood from the legs and pelvis to the heart. However, although the inferior vena cava is located on the right edge of the spine, it is questionable whether lying on the right side can slow blood flow through this vein. Also, lying on the left side puts pressure on the heart and stomach, so they may not function at optimal efficiency.

6) The use of pressure points contraindicated.

Massage schools teach that some pressure points should not be used during pregnancy as they can induce labor. However, they can be used if there is a good reason to use them. If massage could induce labor, abortion clinics would use massages at these points instead of expensive medical interventions. Pressure on these points can only induce labor at the end of the term and then it is still difficult to do this.

All pregnant women can benefit from massage during pregnancy. If at any time during the massage you feel discomfort, please inform your therapist immediately.