Pregnancy Massage- Do’s and Dont’s Of Prenatal Massage

Pregnancy is beautiful, exciting….and a bit exhausting! Your legs ache, your back hurts, and in the third trimester, you can feel like you will never sleep again.

However, take heart. There is relief found in a massage modality called Prenatal Massage. I, myself, along with countless other women, have discovered the benefits of this type of massage.

By the end of this article, you should have a pretty good idea (as a massage professional, whether seasoned or just beginning),what to do before, during, and after a pregnancy massage, and what to avoid to preserve the safety and comfort of your client.

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Listen, Listen, LISTEN

When a pregnant client books an appointment with you, chances are she is uncomfortable, if only a little, and likely having some trouble sleeping or relaxing.

These are common concerns. First, be sure to confirm that your mommy-to-be has OK’d the massage with her doctor. Once this is confirmed, your job is to let her talk.

Pregnancy can be very physically tolling, and she might have several things going on that you will not be aware of. So, begin the conversation by asking her to tell you anything she might be physically feeling, and let her explain all issues. You might not be able to help with all of them, but you’ll want to cover as many as possible.

I have found that, through my years of working with prenatal clients, previous practitioners would unfortunately not always really hear them out…and that can be super annoying to someone who is looking to walk out feeling better.

Make sure to find out if she is sleeping well, able to lie down comfortably, able to walk, sit, stand without acute pain.

All of these are aspects that may be considered as you are moving through the massage.

Positioning For Effectiveness: Side-Lying VS. Pregnancy Pillow

The Side-Lying Prenatal Massage Position

So, there are two ways that I believe can both be very effective in performing a prenatal massage.

This is where many therapists are deterred in offering prenatal, because they aren’t sure how to position the client on the table…and it admittedly can be a little awkward at first if the client has not gotten a massage before while pregnant.

But you can cut through the unknown pretty quickly by understanding that you can approach the massage with either something called a Massage Pregnancy Pillow, or by doing what I have always done and take the side-lying approach, which usually is comfortable for the client and a bit easier to work with, in my opinion.

A Pregnancy Pillow in massage is a cushioned apparatus that can be placed on top of the massage table. It allows for the client to lie face down, even in the later stages of pregnancy, and there is a nice little cut out for the belly 🙂

As cute as it sounds, the downside is that it is pretty bulky, and the client’s modesty might be a little compromised when they have to flip over onto their back.

However, I have used them a number of times and they do work.

In my practice, I always first asked the client if she would be comfortable lying on her side, and then explained to her how to position herself on the table.

It’s really simple. I always have two to three overstuffed pillows available, and I ask the client to lie on one side or the other (totally up to her), and to position the pillows in a way that is comfortable to her. Usually, the client opts to have one in between the knees for padding, and under the head.

If you are choosing to use the Massage Pregnancy Pillow, you will want to drape a sheet OVER it, and ask your client to lie in a face down position.

IMPORTANT: Always, always make sure that you are checking in regularly during the massage to confirm that the client is comfortable. If she begins to feel dizzy, nauseated, or light-headed, it’s time to elevate her head, move into a different position, or terminate the massage altogether. Risking the health and Mama and baby is not worth it.

Comfort and Modesty – How To Achieve Both

As with any other massage, you will want to be sure that your client is properly draped at all times. This is a bit more challenging in side-lying position because you will need to thread the sheet in between the legs (kind of like a diaper), but it can be done.

The draping for a Pregnancy Pillow massage is very similar to a regular massage.

If you are working with a veteran Mama who has several children and lots of prenatal massage experience, she may not be as modest (all modesty is pretty much lost in the delivery room, haha). But it’s still important to keep her covered and comfortable.

Depending on the time of year and weather, you may want to only have a sheet draping the client, both because in pregnancy it gets hot, and because its easier to work around while performing the massage.

I do not usually use a heavy blanket with prenatal clients, because I end up fighting with it to keep the client covered.

Saving YOUR Back

If you are new to the modality of prenatal massage, you need to know that before you ever bring a client into your massage room, you need to do a little adjusting.

Ideally, you have an adjustable height table, that can be raised and lowered fairy easily.

If you are doing the massage with a Pregnancy Pillow, you will definitely want to lower the table. The height of the pillow is going to drastically increase how high the client is lying on the table. Your arms are going to hate you if you don’t allow for this.

If you are opting for side-lying, I would highly recommend raising the table. You’re going to have to get into a bit of a lunge position to work the back while the client is on her side, and you don’t want to be in a low lunge for the better part of a massage. I may have made that mistake a time or two 🙂

Try to have a rolling stool available as well, because if you get fatigued from squatting down while your client is side-lying, you may be able to sit on the stool and still effectively perform the massage.

During The Massage

If you are choosing to use the Pregnancy Pillow, the massage will flow pretty much as any other massage does.

The only things you will really need to make allowance for are the table height and the fact that you will need to remove the pillow when your client turns over onto her back. I recommend exiting the room to allow the client to get up after you have finished the back part of the body, and have her sit on the edge of the table with the sheet covering her.

When you re-enter the room, you can remove the Pregnancy Pillow from the table, and then help your client into a supine position on the table.

If your client is side-lying, my normal practice is to have her start out on one side, then ask her to carefully turn over to her other side while I turn around so that she is not uncomfortable.

When I have about 20 minutes left in the massage, I will make sure that the client is covered, and help her into a supine position on the table.

When the massage is wrapping up, always check with the client to see how she is feeling, and ask her if she would like you to help her off of the table. It’s often a little dizzying getting up from the table while pregnant.

Perfecting The Practice

This form of massage will definitely take a bit of practice and experience before you have it down.

Don’t get discouraged. Prenatal Massage can be one of the most profitable massage modalities. There are a lack of therapists who perform prenatal, and the demand it high. Especially for women to prefer holistic methods of healing.

Remember, a doctor’s approval is always recommended, and women with high risk pregnancies, dangerous conditions, risk of preterm labor, and women in their first trimester should refrain from receiving a massage.

You will find that if you have kept the client’s comfort as a priority and executed the massage with skill, she will probably leave feeling wonderfully relaxed, ready for a much-needed nap, and desiring to book another appointment with you!

If you have any questions or comments about Prenatal Massage, please leave them below! Or feel free to send me an email at

Have a blessed and beautiful day!



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