Clearing Up Misconceptions About Pregnancy and Massage

Ever since I got a website, I see a lot more pregnant women for prenatal massage. I don't know if there's a baby boom happening or if it's just easier for them to find me. I have learned that a lot of massage therapists don't do prenatal massage and many of the franchises will not accept pregnant clients, either. If a therapist has not been trained to do prenatal massage, they should certainly refer out to a therapist who has been trained. However, some of the reasons for turning down pregnant clients are based on unwarranted fear and misinformation.

Many massage therapists report that they have been told not to give massage to a woman during her first trimester. Some have been told that there is a risk that massage may cause a miscarriage. This is an absurd idea and is probably based more on fear of litigation (unfortunately, the U.S. is a very litigious society) than on any actual risk. Most women don't know they are pregnant until they are well into their first trimester. The only way we could completely avoid giving massage to women in their first trimester would be to refuse to massage all women of childbearing age. Certainly no one is advocating that.

According to the American Pregnancy Organization, 10% - 25% of all clinically recognized pregnancies end in miscarriage and most of them occur during the first 13 weeks. For most miscarriages, the cause is unknown, but some known causes are chromosomal defects, failure of the fertilized egg to implant properly, maternal age, or excessive use of drugs or alcohol. Moderate exercise, sex, and working outside of the home do not cause miscarriage. If normal activity is not sufficient to cause miscarriage, there is no reason to believe that a relaxing massage would in any way cause it, either.

Another potentially harmful piece of misinformation is the belief that massaging the feet or ankles of a pregnant woman can either cause miscarriage or induce labor. There is absolutely no evidence to support this claim. This idea probably comes from two sources: foot reflexology and acupuncture. Foot reflexology was invented in the early 1900s and has no scientific basis. Foot reflexologists claim that specific points on the feet correspond to various internal organs in the body and that by pressing on them, one can stimulate these organs. The supposed "reflex points" for the uterus and ovaries are on the ankles and foot reflexologists believe that stimulating them by direct pressure or massage can cause miscarriage or induce labor. There is no evidence at all for the existence of these reflex points. Not only is there no evidence to support this claim, there's no reason to think it even might have some validity, since there is no plausible mechanism to explain how this might occur. In addition, in acupuncture, it is believed that there are acupuncture points at the ankles that will stimulate the uterus and ovaries. However, when researchers have tried to use acupuncture on these points to induce labor in women past their due date, they have failed. Even sticking acupuncture needles into the point every other day for a week failed. If one cannot induce labor by sticking needles into these points every other day for a week, it seems irrational to think that merely rubbing the ankles with massage oil is going to induce labor or miscarriage, either. If we could induce miscarriage or labor this easily, the demand for abortion would stop overnight and there would no longer be any need to induce labor with hormones. However, this is not the case.

Unfortunately, this piece of misinformation has become firmly rooted not just in the massage community but has spread outside of it. Some pregnant women have told me that they have been turned down for pedicures because of this irrational fear, much to their dismay. Humans would not have become the dominant species that they are if something as innocuous as some mild pressure on the ankles would cause miscarriage.

Sometimes massage therapists, when confronted with the lack of evidence to support this idea, will respond, "Well, I'll avoid it just to be careful." One should always err on the side of caution when in doubt, but that does not mean we have to be governed by false fears. By erroneously thinking they need to avoid the feet and ankles "just in case," massage therapists perpetuate this misconception. What's the harm? Well, consider this scenario: a pregnant woman has a prenatal massage and asks the massage therapist to pay particular attention to her lower legs, ankles, and feet, because they have become a bit swollen and achy, a common occurence during pregnancy. Suppose the massage therapist tells her that she can't massage her ankles and feet because it might cause a miscarriage. The woman is denied the comfort of massage, for no good reason, on the very place where she would enjoy it the most. Even worse, what happens if this woman does happen to have a miscarriage? That is a sad enough event on its own, but what if the woman then remembers a day when her feet were aching and she massaged them? Or she had an itch on her ankle and rubbed it? She may then begin to think that she caused the loss of her baby and suffer terrible distress that could haunt her for the rest of her life. Misinformation can cause harm. 

Even when false ideas are harmless, they should be corrected for the sake of accuracy. Massage therapists should be at the forefront of correcting mistaken ideas about pregnancy and massage. By putting forth accurate information, we can help bring the comfort of prenatal massage to more women during this special time of their life.

If you've been taught these errors, please help correct them. Pass this on to your colleagues. Let massage therapists and pregnant women know that, barring complications that might be contraindications, it's safe to receive massage at any time during pregnancy. Your pregnant clients will thank you.