Prenatal Massage Misconceptions - What Every LMT Needs to Unlearn
As a Continuing Education provider for Massage Therapists, I often witness the fear and uncertainty that surrounds prenatal massage - especially when it comes to contraindications, positioning, and safety. This hesitation is understandable given how little emphasis many massage schools place on prenatal training. Some receive a few short hours of instruction, and some receive none at all. Instructors often teach different approaches to prenatal massage, and the guidance doesn’t always align with what others are teaching. This lack of consistency can add to the confusion therapists feel. Many therapists genuinely want to serve pregnant clients but feel underprepared and uneasy, so they turn them away. Unfortunately, this means that a population who can benefit immensely from massage often goes without the support they need.
In addition to the lack of proper training, many therapists rely on information passed along by colleagues, which often leads to miscommunication and added confusion. When therapists attend my courses, they frequently share what they’ve picked up from the massage community, and it usually turns out to be misinformation. This kind of misinformation catches on fast, and before long, some therapists accept it as truth.
To clear things up, I want to walk through a few of the biggest misconceptions I hear most often about prenatal massage and share the truth behind each one, so you can feel more confident working with your clients.
Misconception #1: Therapists must be certified in prenatal massage
Some therapists shy away from pregnant clients, assuming a prenatal certification is required before they can safely offer massage. It’s important to know that a prenatal massage board does not exist. Some continuing education instructors offer prenatal certifications, which can provide therapists with advanced training. These programs give valuable knowledge and help build confidence when working with pregnant clients, but they are optional, and no state requires them. Since many massage schools provide little to no prenatal training, I encourage therapists to attend courses taught by experienced prenatal instructors. Whether or not a certification is offered, these trainings can provide valuable knowledge and help build confidence when working with pregnant clients.
Misconception #2: Prenatal massage is not safe in the first trimester
Many therapists avoid offering massage during the first trimester, fearing it might cause a miscarriage. However, there is no evidence that massage causes pregnancy loss. Sadly, miscarriage occurs in approximately 10–25% of known pregnancies, and about 80% occur in the first trimester (Cleveland Clinic, 2025). This is primarily due to chromosomal and hormonal abnormalities and not anything a therapist does.
It’s not uncommon for spas and massage therapy offices to postpone prenatal massage until the second trimester, primarily out of concern for liability. Business owners worry about the potential risks, even though massage in the first trimester is safe when performed properly. These concerns often shape company policies despite a lack of medical evidence, and this can contribute to the hesitation therapists feel around first trimester clients.
Many first trimester clients are actually not seeking prenatal massage for the first time, especially if they are new to massage. The main symptoms during early pregnancy are morning sickness, fatigue, and changes in breast size. Significant structural or postural changes are not present in the first trimester. Please note morning sickness (severe nausea and vomiting) are contraindications for massage. Pregnant clients who have received massage from you before becoming pregnant may want to continue that professional relationship during their first trimester. You can decide to continue working with them if you feel confident, at ease, and if you’ve received training. If you’re uncertain, the client will likely sense it and you may not properly and safely administer the massage. I advise therapists to avoid massaging in the first trimester if they feel uneasy or haven’t had adequate training.
Misconception #3: Light pressure only for pregnant clients
In my trainings, therapists often share that they’ve heard pregnant clients must be massaged using only light pressure, out of concern for harming the client. Caution must be used on the abdomen and on the legs, and deep pressure is avoided on those areas. However, clients may request and safely receive firmer pressure on other parts of the body if they are comfortable with it. We want to avoid deep pressure that elicits pain. Massage should remain comfortable, as activating the client’s sympathetic nervous system can negatively affect both the client and the baby. My ultimate goal in a prenatal session is to calm my client’s nervous system while also addressing postural and structural changes, supporting muscles and providing my client with therapeutic benefits overall. Supporting parasympathetic nervous system function is vital for a healthy pregnancy.
Why must we use light pressure on the legs? Pregnant clients are five times more likely to develop blood clots than non-pregnant clients. This is due to the production of blood factors that promote normal clotting so the client doesn’t hemorrhage during labor (UT Southwestern Medical, 2025). The anteriorly tilted pelvic and the weight of the uterus impeded the return of blood in veins in the lower part of the body. The medial veins typically harbor clots: the deep iliac, femoral and deep saphenous veins (Osborne, 2012). Light pressure towards the heart should be used on the legs to ensure client safety. If a therapist is trained in Manual Lymph Drainage, it can be used on the legs to aid with swelling.
Light pressure should also be used on the abdomen, provided the client grants permission for you to massage that area. It’s advisable to use the weight of your hand and perform clockwise strokes. During pregnancy, we avoid massaging the psoas or any inguinal areas/ligaments to keep our clients safe.
Misconception #4: Acupressure points must not be touched
This category brings up much confusion and debate among massage professionals. Certain acupressure points on the client’s body been identified as potentially influencing the onset of labor. These points include LI4, SP6, BL60, BL67, GB21, BL31, BL32 and the uterus and ovary reflexes (Healthline, 2025). These are found on the web of the hand, the upper trapezius, the ankles, lower leg and feet. These areas can absolutely be touched and massaged during your sessions. However, therapists should avoid applying direct, pointed and sustained pressure to these acupressure points. Acupuncturists confirm these points have the ability to affect the uterus, ovaries and the fetus, potentially drawing the baby downward, and beginning active labor.
Some massage therapists question the accuracy of this information, or they dismiss Chinese medicine practices altogether. Regardless, it’s wise to use caution and avoid applying direct acupressure to these points. Toward the end of pregnancy, many clients have asked me to stimulate these areas in hopes of encouraging labor. Personally, I do not feel comfortable fulfilling those requests, as I do not want the responsibility of potentially contributing to a baby’s arrival earlier than intended.
Prenatal massage is a supportive and powerful modality, and pregnant clients greatly benefit from our services. We can influence postural and structural changes, alleviate paint, calm the nervous system, and provide support for both the client and their baby throughout pregnancy. My hope is this helped you better navigate the many misconceptions that exist within our massage community.
References
Cleveland Clinic. (n.d.). Miscarriage: Causes, Symptoms, and Risk Factors.
Retrieved September 8, 2025, from https://my.clevelandclinic.org...
Healthline. (n.d.). Acupressure Points for Inducing Labor: Where to Target.
Retrieved September 8, 2025, from https://www.healthline.com/hea...
Osborne, C. (2012). Pre- and Perinatal Massage Therapy: A Comprehensive Guide to
Prenatal, Labor, and Postpartum Practice (2nd ed.). Boston: Lippincott Williams &
Wilkins.
UT Southwestern Medical Center. (n.d.). Pregnancy and Blood Clots: Understanding
Risks and Prevention.
Retrieved September 8, 2025, from https://www.utsouthwestern.edu...