Is prenatal massage contraindicated in the first trimester of pregnancy? This is a question that certified pregnancy massage therapists encounter quite a bit.
The first trimester is the first 13 weeks of the 40 week pregnancy cycle. The 40 week (280 day) cycle count actually begins on the first day of the last menstrual cycle. With that definition, a woman is considered two weeks pregnant when she ovulates, which is the time conception actually takes place. Then it is another two weeks before her next menstrual cycle is due to begin, so if she conceived, she is considered four weeks pregnant before she even knows that she is a day late on her next period.
That means that the first third of the first trimester has elapsed before most women even knows that they are pregnant. Not all women are perfectly regular on their cycles, or if they are not trying to conceive might not even be tracking the exact dates of their periods to suspect they are pregnant for another one or two weeks or more. Often women are about halfway into their first trimester before they know that they are pregnant. As hard to imagine as this may be, there have been cases of women at full term not knowing they were pregnant until they went into labor. If the client doesn’t know they are pregnant, then the pregnancy massage therapist obviously won’t know their client is pregnant either, but technically that massage would be considered a prenatal massage since the client is pregnant.
The biggest concern about prenatal massage is the possibility of inducing a spontaneous abortion. Common sense should dictate that if something as pleasurable as massage was abortion inducing, there would be no such thing as a surgical abortion industry. Why go have surgery when you could have a massage instead? Nothing done in the course of a standard massage has ever been shown to trigger a miscarriage in the first trimester. However, if a client does know that she is pregnant and is still in the first trimester (a time for which miscarriage is most likely to occur), it is reasonable for the prenatal massage therapist to err on the side of caution, for the peace of mind of the newly pregnant woman.
In our prenatal massage certification course, we advise our students to lighten any pressure on the low back and to omit all abdominal massage during the first trimester. We also advise our students to avoid any tapotement (percussion) or shiatsu (sustained pressure to various acupressure points), at least not to the points that relate to the reproductive system. Simply performing traditional effleurage and pettrisage massage strokes over these areas would not be enough to trigger any negative response from the acupressure points.
There is no evidence based rationale for considering the first trimester of pregnancy to be a contraindication for massage therapy. The same holds true for the second and third trimester. It is advisable, however, that massage therapists who plan to work on pregnant clients on a regular basis have specialized training. Pregnancy impacts every system of the body, each of which impacts massage. By taking an advanced continuing education course in prenatal massage, massage therapists are prepared to made adjustments for each of the changes taking place in the body of their pregnant massage clients.
If you have ever considered becoming certified as a prenatal massage therapist, we hope that you will consider the courses offered at Institute of Somatic Therapy. For more information on our pregnancy massage certification courses, click here.
(Special thanks to my friend Rachel for letting us use her photo. She used this photo to announce that she is pregnant with her second baby.)