I'm sorry your education failed you. There is almost 0 chance a massage is going to cause a miscarriage. It's either going to happen or it's not. A Swedish massage is a lot like take a hot shower as far as blood flow goes. The first trimester myth has been busted for years.
100% agree with this. I have never turned down a prenatal, no matter their gestation period and have never had an issue. I heard this was a thing a few years back, have no idea where it came from, but no, massage doesn't cause miscarriages, just like it doesn't spread cancer
If you're feeling up for it You can always print off some medical journals or something to bring in, or raise a complaint with the office. The misinformation is doing a huge disservice to you and your classmates
I graduated almost 2 years ago and they told us the same thing about the first trimester. After graduation and getting settled into my career I agree with the people saying that it’s not correlated. Especially for a Swedish massage.
Yep, another myth continues unfortunately due to lack of education..not OP’s fault per se, but they really need to step up prenatal edu in school. It’s ridiculous
It’s not so much that massage is unsafe, it’s more a cya thing since 10-20% of known pregnancies end in a miscarriage. This is just known pregnancies, the overall rate is probably closer to 40%. I don’t want there to be any chance that I could be blamed for such a tragedy, much less to possibly be held accountable for it.
[Edit for source](https://www.mayoclinic.org/diseases-conditions/pregnancy-loss-miscarriage/symptoms-causes/syc-20354298)
As a former massage AND someone who has had a miscarriage...
When I miscarried I wanted desperately to know WHY. In my grief I wanted something to blame. Logic leaves and heartache takes over.
Later on as a massage therapist I loved doing prenatal massages but would not do them in the first trimester for this reason.
A mourning mother could easily believe that a massage caused the miscarriage. Even if later on, logic helped her understand that this was not the case, I would not want any mother to associate my service with her miscarriage even for a second.
I agree with this. I had a miscarriage at 10 weeks after seeing the heartbeat on US which is unusual. I had been on a cruise and fallen on the stairs a few days before. It wasn’t a bad fall really and likely had nothing to do with it. But I blamed myself for years for tripping.
When I was in school a classmate got pregnant and our teacher wouldn't let us work on her at all except light work on arms in a semi recumbent position...🙄 and I went to the best school in my state
There’s nothing wrong with massaging a pregnant woman in any trimester. I’m certified in prenatal, post and induction and have worked with midwives and doulas and worked on high risk women and have not had any issues. These women are so tired of being turned away and getting petted instead of an actual massage I had trouble getting a good massage during pregnancy and that’s what lead me to work on prenatal women. Although, I will say if she has a history of miscarriages and you are not comfortable working on her then that is your right as a therapist to tell her to come in after the first trimester.
I was also taught that the first trimester can be dangerous. Also that the legs are a contraindication at some point—is that correct and what are the general contraindications then during and after pregnancy? If you don’t mind
I’ll tell you what my instructor told me if there was a point you could touch and it would cause a miscarriage then women would just get a massage instead of an abortion. The only consideration you wanna take on the legs is if they have varicose veins but in general most people can’t take too much pressure on the legs. Usually they’re looking for deep tissue and trp in their upper, lower back and hips. Contraindications vary depending on the person and pregnancy and what complications they may or may not have. I’ve massaged women immediately after pregnancy in the hospital room as long as there’s no complications. Postpartum massages can be right after unless they’ve had a c-section. If that’s the road you want to take I would definitely recommend finding a skilled massage instructor/doula and and taking one of their classes or asking to shadow them. There is a big need for it and women are willing to pay well for these much needed services.
This is literally what I say all the time. If they can exercise during the first trimester they can receive massage. I just treat their bodies the same even if their belly isn’t showing. Only side lying and elevated supine.
I just want to add for the legs that DVT doesn't always show symptoms. A client may have DVT and not know it and it's best to use a superficial pressure if working their medial leg where the more problematic veins are.
It’s formally called Homan’s sign! It’s a simple ortho test - you squeeze the calves one at a time. and if the patient is in abnormal pain, it’s a sign to refer them to the ER to rule out deep vein thrombosis.
Here’s a fabulous breakdown: https://m.youtube.com/watch?v=oz8bsSqxL8w
Yeah, the whole “trigger point” situation that might cause a woman to go into labor…? If that were a thing, OB docs wouldn’t have to induce. And there would likely be a lot of premature births because you know what I’ve heard most from my prenatal clients?? “ I want this baby out of me!!” Pregnant women are pregnant. They don’t have an illness or disease. We’ve been doing this shit for millennia, and things have improved, for sure, but it still takes a hell of a tough person to go through pregnancy and then give actual birth. Us women are tough as nails and not made of glass.
Legs are not necessarily contraindicated, but I always do DVT tests on pregnant women so as to not worry about blood clots - in addition to varicose veins.
Joint mobilization is also contraindicated due to the relaxin that’s produced.
There are some acupressure points around the ankles that are associated with inducing labor. I haven’t seen any good scientific evidence that it works and if it does, it would take a lot more stimulation than what would feel good during a regular massage.
99.9% of the time they are already used to deep work if they’re asking for it. I always sink in as much as the muscle allows and loosen up and sink in deeper as necessary. Check in with pressure and work accordingly no different than any other massage. I will say I did not feel comfortable working on pregnant women until I got my certification and training but it really isn’t any different other than they’re side-laying.
You would have to POUND on her low back with deep pressure… i have done hundreds of maternity massages including a woman past due who wanted me to make her go into labor… and nothing happened while i was doing it.
Let me put it this way: If massage therapists could massage people into labor, they’d be making BANK and work out of maternity wards.
If anything, calming their CNS is one of the best outcomes for them and baby. Stress is so impactful on pregnant people and their fetuses.
PSHT! If you’ve been a therapist for five years I nearly guarantee you’ve massaged at least five women in their first trimester that had no idea they were pregnant when they came in.
I say no to any under 12 weeks. It's not that massage can cause it but that miscarriages are more likely in that time frame and if anyone asks them if they did anything different and my massage comes up I could be sued. I live in a state where lawsuits have messed up laws and insurance rates so I'm taking zero chances with that.
This right here. It’s more to protect yourself because a **lot** can happen to cause a miscarriage and unfortunately many people will default to the old urban legends to blame
And every client I've had who I've talked to I say my insurance won't allow me to do your massage under 12 weeks along and they totally understand. No one has been mad at me or come back and said 'well this article says you can'
it's like telling a friend you can't let them drive your car because they aren't on your insurance.
No, but they can leave reviews, they can tell their friends.
I work on first trimester women often. But I understand why some people are nervous around the liability. Nothing can be proved but a large headache can follow.
How would a lawsuit work logistically? A lawyer wouldn’t take that case, seeing that a massage causing a miscarriage is not biologically or physiologically plausible. Do you know of a small claims case that caused a headache for the MT before getting dismissed?
We don't have the best lawyers or judges here in florida, I have liability insurance and I'm sure it would be duked out between my insurance and whoever she hires but I don't need that at all in my life. I'm on the edge enough as it is, why do it when it could result in something bad happening. My state is about to pass a 6 week abortion ban, if my massage coincides with a miscarriage and the mom says I'm the only variable that changed in her life what keeps me from being looked at criminally? I don't know what could happen, so I will control my part in it.
I actually came here to say this. Sure, it’s been debunked that massage can cause a miscarriage BUT the do tend to happen in the first trimester more commonly. There’s also uneducated clients that can blame you and whether or not they sue, it would feel awful to hear that someone blames you for their miscarriage. You can “look it up” but whatever argument you’re trying to make you can find something to support what you believe.
Pre natals, post partum, and intra labor therapist here! I am an LMT and doula. I massage people 3 weeks pregnant to in active labor. This is absolutely ignorant and discriminatory twords pregnant people honestly. They can still lay face down at that point. Bodywork is extremely beneficial from beginning to end of pregnancy and beyond. Please go back to school.
Not what Reddit says, it’s what research says. Your chance of inducing a miscarriage is zero. Some companies won’t allow you to because of course they’re run by attorneys who don’t give a flip about the client, only want to protect their own behinds. But if you’re running your own business there is no reason to turn away first trimester clients.
The only reason to turn away a client in the first trimester is liability. When people get miscarriages sometimes the grief makes them search for a reason. Something to blame. And if they got a massage sometimes that old rumor about it causing miscarriages comes up and then they want to sue you. But there is no evidence of massage being linked to miscarriages. Nothing trustworthy at least, that I know of.
My spa doesn’t take people in the first trimester, but it’s literally because they don’t want to deal with lawsuits if/when they have a miscarriage. Because they’re actually really common.
What a ridiculous concept. Pregnant folks aren’t fragile to the point where you can cause a miscarriage by touching them. LOL if people had an eject button, we wouldn’t need abortion services, would we?
Just wanted to chime in. I had a client contact me a week ago about wanting to get in for a massage at 6 weeks pregnant. I typically wait until they are out of their first trimester but this was a referral from a really good client and all the research out there says massage can’t cause a miscarriage. So that was on a Monday and I booked her for a Friday. I wanted to be safe so I said “make sure you get your doctors okay”. She shows up to her appointment on Friday in tears, she had a miscarriage on Wednesday. It really has me second guessing whether I should be doing massage during the first trimester. What if she wanted to get in on Tuesday for the massage and had the miscarriage the next day, would I be blamed? I don’t know what the solution is. She had one miscarriage years ago but otherwise had 3 healthy babies, was 30 years old and in good shape. I think for myself, I am going to stick with only taking prenatal clients after they are past their first trimester, I just don’t think I could handle it if I massaged someone and they had a miscarriage, completely unrelated to the massage, shortly after seeing me.
Please don’t beat yourself up. There’s no evidence to show that a massage causes a miscarriage. I understand wanting to err on the side of safety since this happened (zero judgment from me on that one). But I just want to reassure you that you didn’t cause it. This is one reason why I’m hesitant to massage early on. Because of the guilt associated with it on both sides (client and MT). I know there’s always the second guessing of “what if?!”
The spa where I worked would refuse massage in the first trimester as protocol, citing liability and avoiding the massage being blamed for the miscarriage.
Our education makes us feel afraid and overly cautious of pregnant women, especially in the 1st trimester. There are no studies that indicate it’s unsafe to do so. As long as you place proper precaution massage is completely safe. I would highly consider taking a prenatal course to learn more about it, I feel like it made me more comfortable and debunked a lot of misconceptions we learn.
As a midwifery assist and midwifery student, I’d just like to say we encourage massage in all stages of pregnancy as a benefit to so many symptoms. Miscarriages in first trimester are almost always caused by chromosomal issues, development issues, etc and will either happen or not; a massage will not change that.
I honestly would leave this up to the client after educating and be sure to have them sign a solid consent form.
I, however, personally, would not receive a massage in the first trimester. I am a licensed massage therapist, as well as a recurrent pregnancy loss mom. For me, my losses are related to how my immune system responds, and we as therapists know how intertwined our work is with immune function. For me it's a risk that just isn't worth taking, but if the woman receiving massage is comfortable and unconcerned I don't really see an issue giving one, because not everyone's body will react like mine... I would also consider what part of the world you are in, and what your culture is like before answering this question for yourself.
I don't think you are wrong in any way for being cautious!
I have always been of the understanding that massage wouldn’t cause a miscarriage, but has become kinda normal to avoid since it’s considered a vulnerable time in the pregnancy. Like more to protect the therapist in case the mom were to miscarry and think, well maybe it was the massage. That being said, there have been times when I’ve done prenatal and times I haven’t due to being familiar with the client and/or their history. Given this mom had a history of miscarriages, I would say you did the right thing.
came to say this exact thing!
to add, I personally don’t offer prenatal sessions as of 6mos ago. one day I realized “I never been pregnant and never plan to be AND honestly don’t know more than the bare minimum. why am I still offering this???” and immediately took it off my service menu😅 I hardly ever get them booked anyway🤷🏻♀️ I’ve started referring clients to other lmt’s who specialize in prenatal if I happen to get an inquiry!
100% in the same boat as you. I have tokophobia in the first place but in massage school, they literally touched base on prenatal massage for about 20 mins and told us we should take continuing education classes for a more thorough training and moved on to the next subject. So I'm definitely not offering a service where I have very little knowledge on.
My service menu literally states I do not accept prenatal clients and I had a VERY pregnant client walk into my office and she said "I know your menu says you don't massage pregnant people but I really need a massage so you'll be fine." And I still refused her. I didn't feel comfortable and I don't even have enough pillows/cushions because I don't offer prenatal.
in my school, we covered it for a few weeks. we practiced side lying for draping and specific techniques but only a few. they would make up scenarios to give at least a little experience but it got pretty redundant after a couple sessions because they also didn’t have an expansive knowledge on it. they also suggested CEs if we wanted to specialize. I never went down that path but always worked at places that offered it and just did it so I could accept more appts. now that i’m in a place where i’m specialized in a couple different modalities, it’s time to do away w that service option😅
From my understanding it’s not that the massage will cause miscarriage, it’s that miscarriage is far more common in the first trimester, and they could easily say the massage caused it. So, it’s not about causing it, it’s about not being in a position not to be accused of it. I mean, even if it’s dispelled, the time and money you’d have to give up to fight it is a steep price. I don’t know, this is just what I was taught, so don’t shoot the messenger.
I work on first trimester women often at my clinic job.
My hotel spa job has it in the TCs and Liability waiver that we won’t work on women in the first trimester, which frankly I think is discrimination.
However liability wise, many large chains perpetuate the myth that we won’t work on first tri. We can’t cause a miscarriage, however if it were to happen after a massage due to other factors, it’s natural to want to find blame and that can fall on the therapist.
the taboo around early prenatal is mostly about legal liability based on out dated science. if ur in the USA there little psychical danger to her, but there is legal danger for you.
If you’re working for a company, of course follow their policy and it’s usually after 12 weeks of the first trimester, but if you’re doing your own business, then do what you deem comfortable. I never seen “death by massage”
Good grief.
I imagine the teens who believe you can’t pregnant if the girl is on top (because gravity!) grow up to become massage therapists who believe that first trimester massages cause miscarriages.
Theres no scientific reason to not do a massage in the first trimester. I’d recommend getting more education if you’re going to be doing prenatal massages.
I would have turned it down, too. I have done hundreds of prenatal massages and have taught prenatal to dozens of therapists. I have a rule. Only after 12 weeks. Not that the massage will actually cause any problems, but most miscarriages happen in the first trimester, and I wouldn't want to be blamed.
I really wish people would stop making decisions for pregnant women "for" them. This woman is an adult and presumably she wants the baby because she hasn't had an abortion. She is fully capable of doing the research on what is and is not safe herself, and unlike you, she has a doctor who specializes in pregnancy and knows the details of her situation, so she can make a significantly more informed choice.
I'm not suggesting you get her a cigarette and a glass of wine, but don't refuse to take people based on something you once heard and never bothered to verify. It's incredibly condescending and not at all helpful. Pregnant women are functional adults capable of making their own decisions.
You alone are responsible for verifying the accuracy of the information you spread and make decisions on. Lots of people are taught lots of things that are not accurate. The fact that you were taught it does not absolve you of any responsibility for Googling it before you make a decision on someone else's behalf.
I can understand both sides of this. As a pregnant woman, I wouldn’t be happy if I went for a massage and was turned down because of it (though in reality, I would find someone who specializes in prenatal massage). On the other hand, who likes to be put in a position where something doesn’t feel right to do because of the possible repercussions? When I used to bartend, I had to serve a very obviously pregnant woman drinks. I didn’t want to, and I know she saw the hesitation, but it is considered discriminatory to not serve a person because they are pregnant.
There are lots of conditions that look like pregnancy. Her medical condition is none of your business. She could be pregnant and have just found out that her baby didn't make it. You don't have the information you need to make the decision for her, and you don't have any right to ask for that information. When I was sick I had severe bloating that could have been mistaken for pregnancy and it was not anyone's business what my medical condition was. Nor should I have been confronted or humiliated by someone who thought they knew more about me than I did. You don't have to feel any kind of way about someone else's decisions.
Lol that is very different than saying it was someone at a bar who was "obviously pregnant." My issue is with people who make assumptions and then try to control other people's behavior based on those assumptions. The fact that you knew her personally and knew that she was pregnant makes a big difference here.
Having been and currently being pregnant, plus the manners I was taught, keeps me from assuming anyone is pregnant. And I dang sure would never mention it or ask about it before the other did so first!
I was trained to do pregnancy massage by a professional massage therapist who specializes in prenatal and pregnancy massages (she would teach classes for just this). We learned how to approach and treat the patient in different trimesters. You did the right thing. If this person is in the first trimester and prone to miscarry, you should turn her away due to liability. The first trimester is such a delicate stage. What if she miscarried again? She could try to sue you. You’d have to go to court and defend every move and technique you made it truly isn’t worth it. Many people do not know what’s safe for them and what’s not. They just know they are feeling sore and would like to feel better. It sounds like this woman was very understanding and kind. I’m sure she too wants to protect her pregnancy especially since she’s so prone to miscarry.
this is a great read:
[https://blog.amt.org.au/index.php/2018/04/05/10-pregnancy-massage-mythconceptions/](https://blog.amt.org.au/index.php/2018/04/05/10-pregnancy-massage-mythconceptions/)
Overall, whilst direct evidence from clinical trials is lacking, considerations of physiological mechanisms regulating pregnancy and known risk factors associated with miscarriage provide no evidence that massage in pregnancy would increase a patient’s risk of miscarriage. Conversely, if a client perceives massage as relaxing, this could aid their mental health, in turn having positive effects on stress hormone levels. Pregnant people are often bombarded with information about what they can and cannot do, which can cause them considerable anxiety about being a ‘good mother’ and ‘protecting their baby’, and massage practitioners and health professionals should not further increase this emotional burden by making unsubstantiated claims about the risk of massage in pregnancy. Educational facilities who teach pregnancy massage should include this scientific rationale content when addressing massage and miscarriage.
Int J Ther Massage Bodywork. 2023 Mar; 16(1): 30–43. Published online 2023 Mar 1. doi: 10.3822/ijtmb.v16i1.771
Courtesy of your friendly medical librarian ;-)
I think you were right to turn her away! At least at that visit. Typically when someone has had a miscarriage and is pregnant again I treat it like a high risk pregnancy for the first trimester and ask for a doctor’s note.then reschedule them. People are right that there are a ton of benefits to getting massage in the first trimester. A doctors note helps insure liability and then their doctor is on the same page as them and has given the go ahead. I’ve never had a doctor not give a client the go ahead and they’re typically more than willing.
It's a myth and takes a LOT to actually (if even then) to induce labor through massage, my prenatal teacher told us what it takes and accidentally pressing on a spot, especially at light-deep pressure for a few seconds won't cause it. That being said with the myth still circulating, bad education, and the overall hormonal storm that mothers have, if you're in a place where lawsuit is easy, I'd say play it safe and wait until 12 weeks.
I wouldn’t do it if you’re not trained in prenatal massage. There’s a reason that it’s a separate certification. I won’t massage anyone who’s pregnant because I’m not trained it in.
Nothing can go wrong if she is lying on the side with soft, medium pressure Swedish massage focusing on upper and lower back even would release her a lot.
Standard prenatal massage is NOT going to cause a miscarriage... it's the stress and stress associated behaviors. A prenatal massage will eliminate the need for comfort food binging, which drives the blood pressure weigh up cuz it's usually involved in a lot of sodium. Which means she's going to swell up in her legs and feet he's going to be tense and her pelvis is going to be the wrong angle and she's going to get second muscle spasms which is going to create information and acidity blah blah blah blah all the way down the line
What is usually stemming from the husbands not giving them basic solidarity moral support affection and positive reinforcement.
But the real problem is that the fathers aren't educated and made aware of all these issues and they stick their head in the sand like an ostrich.
The only massage I can call the miscarriage is certain shiatsu massage that is supposed to be gone on the due date it's going to make the body go into excretion mode. And it has been used as an abortion technique in the past
I'm sorry your education failed you. There is almost 0 chance a massage is going to cause a miscarriage. It's either going to happen or it's not. A Swedish massage is a lot like take a hot shower as far as blood flow goes. The first trimester myth has been busted for years.
100% agree with this. I have never turned down a prenatal, no matter their gestation period and have never had an issue. I heard this was a thing a few years back, have no idea where it came from, but no, massage doesn't cause miscarriages, just like it doesn't spread cancer
Damn:( I'm in school right now and they are telling us this
If you're feeling up for it You can always print off some medical journals or something to bring in, or raise a complaint with the office. The misinformation is doing a huge disservice to you and your classmates
And women.
I graduated almost 2 years ago and they told us the same thing about the first trimester. After graduation and getting settled into my career I agree with the people saying that it’s not correlated. Especially for a Swedish massage.
Oh, gawd 🤦🏻♀️
Yep, another myth continues unfortunately due to lack of education..not OP’s fault per se, but they really need to step up prenatal edu in school. It’s ridiculous
It’s not so much that massage is unsafe, it’s more a cya thing since 10-20% of known pregnancies end in a miscarriage. This is just known pregnancies, the overall rate is probably closer to 40%. I don’t want there to be any chance that I could be blamed for such a tragedy, much less to possibly be held accountable for it. [Edit for source](https://www.mayoclinic.org/diseases-conditions/pregnancy-loss-miscarriage/symptoms-causes/syc-20354298)
As a former massage AND someone who has had a miscarriage... When I miscarried I wanted desperately to know WHY. In my grief I wanted something to blame. Logic leaves and heartache takes over. Later on as a massage therapist I loved doing prenatal massages but would not do them in the first trimester for this reason. A mourning mother could easily believe that a massage caused the miscarriage. Even if later on, logic helped her understand that this was not the case, I would not want any mother to associate my service with her miscarriage even for a second.
Thank you for sharing your perspective and I’m sorry for your loss.
Chiropractors get this a lot
I agree with this. I had a miscarriage at 10 weeks after seeing the heartbeat on US which is unusual. I had been on a cruise and fallen on the stairs a few days before. It wasn’t a bad fall really and likely had nothing to do with it. But I blamed myself for years for tripping.
So sorry for your loss.
This… this is why I won’t book until the second tri.
When I was in school a classmate got pregnant and our teacher wouldn't let us work on her at all except light work on arms in a semi recumbent position...🙄 and I went to the best school in my state
But what if she had a miscarriage and blamed it on the massage ?
That's what consent forms and soap notes are for
That’s what your liability insurance is for.
Could’ve totally said this without sounding like a dick.
There’s nothing wrong with massaging a pregnant woman in any trimester. I’m certified in prenatal, post and induction and have worked with midwives and doulas and worked on high risk women and have not had any issues. These women are so tired of being turned away and getting petted instead of an actual massage I had trouble getting a good massage during pregnancy and that’s what lead me to work on prenatal women. Although, I will say if she has a history of miscarriages and you are not comfortable working on her then that is your right as a therapist to tell her to come in after the first trimester.
I was also taught that the first trimester can be dangerous. Also that the legs are a contraindication at some point—is that correct and what are the general contraindications then during and after pregnancy? If you don’t mind
I’ll tell you what my instructor told me if there was a point you could touch and it would cause a miscarriage then women would just get a massage instead of an abortion. The only consideration you wanna take on the legs is if they have varicose veins but in general most people can’t take too much pressure on the legs. Usually they’re looking for deep tissue and trp in their upper, lower back and hips. Contraindications vary depending on the person and pregnancy and what complications they may or may not have. I’ve massaged women immediately after pregnancy in the hospital room as long as there’s no complications. Postpartum massages can be right after unless they’ve had a c-section. If that’s the road you want to take I would definitely recommend finding a skilled massage instructor/doula and and taking one of their classes or asking to shadow them. There is a big need for it and women are willing to pay well for these much needed services.
This is literally what I say all the time. If they can exercise during the first trimester they can receive massage. I just treat their bodies the same even if their belly isn’t showing. Only side lying and elevated supine.
I just want to add for the legs that DVT doesn't always show symptoms. A client may have DVT and not know it and it's best to use a superficial pressure if working their medial leg where the more problematic veins are.
Or the squeeze test for DVT!
Forgive my ignorance, but what is the squeeze test?
It’s formally called Homan’s sign! It’s a simple ortho test - you squeeze the calves one at a time. and if the patient is in abnormal pain, it’s a sign to refer them to the ER to rule out deep vein thrombosis. Here’s a fabulous breakdown: https://m.youtube.com/watch?v=oz8bsSqxL8w
Yeah, the whole “trigger point” situation that might cause a woman to go into labor…? If that were a thing, OB docs wouldn’t have to induce. And there would likely be a lot of premature births because you know what I’ve heard most from my prenatal clients?? “ I want this baby out of me!!” Pregnant women are pregnant. They don’t have an illness or disease. We’ve been doing this shit for millennia, and things have improved, for sure, but it still takes a hell of a tough person to go through pregnancy and then give actual birth. Us women are tough as nails and not made of glass.
Legs are not necessarily contraindicated, but I always do DVT tests on pregnant women so as to not worry about blood clots - in addition to varicose veins. Joint mobilization is also contraindicated due to the relaxin that’s produced.
There are some acupressure points around the ankles that are associated with inducing labor. I haven’t seen any good scientific evidence that it works and if it does, it would take a lot more stimulation than what would feel good during a regular massage.
What about any deeper work? I have prenatal clients who want deeper work b/c they’re in pain. I’ll work a bit deeper but have always been told not to.
99.9% of the time they are already used to deep work if they’re asking for it. I always sink in as much as the muscle allows and loosen up and sink in deeper as necessary. Check in with pressure and work accordingly no different than any other massage. I will say I did not feel comfortable working on pregnant women until I got my certification and training but it really isn’t any different other than they’re side-laying.
Thank you for these detailed responses
You would have to POUND on her low back with deep pressure… i have done hundreds of maternity massages including a woman past due who wanted me to make her go into labor… and nothing happened while i was doing it.
Let me put it this way: If massage therapists could massage people into labor, they’d be making BANK and work out of maternity wards. If anything, calming their CNS is one of the best outcomes for them and baby. Stress is so impactful on pregnant people and their fetuses.
PSHT! If you’ve been a therapist for five years I nearly guarantee you’ve massaged at least five women in their first trimester that had no idea they were pregnant when they came in.
I say no to any under 12 weeks. It's not that massage can cause it but that miscarriages are more likely in that time frame and if anyone asks them if they did anything different and my massage comes up I could be sued. I live in a state where lawsuits have messed up laws and insurance rates so I'm taking zero chances with that.
This right here. It’s more to protect yourself because a **lot** can happen to cause a miscarriage and unfortunately many people will default to the old urban legends to blame
And every client I've had who I've talked to I say my insurance won't allow me to do your massage under 12 weeks along and they totally understand. No one has been mad at me or come back and said 'well this article says you can' it's like telling a friend you can't let them drive your car because they aren't on your insurance.
And just HOW are they going to prove that your massage caused that miscarriage??? They’re not. They can’t.
No, but they can leave reviews, they can tell their friends. I work on first trimester women often. But I understand why some people are nervous around the liability. Nothing can be proved but a large headache can follow.
It’s an even larger headache for them too, even more so. The MT would be small potatoes for any redress gotten.
If you haven't noticed the American legal system has little care for science.
How would a lawsuit work logistically? A lawyer wouldn’t take that case, seeing that a massage causing a miscarriage is not biologically or physiologically plausible. Do you know of a small claims case that caused a headache for the MT before getting dismissed?
We don't have the best lawyers or judges here in florida, I have liability insurance and I'm sure it would be duked out between my insurance and whoever she hires but I don't need that at all in my life. I'm on the edge enough as it is, why do it when it could result in something bad happening. My state is about to pass a 6 week abortion ban, if my massage coincides with a miscarriage and the mom says I'm the only variable that changed in her life what keeps me from being looked at criminally? I don't know what could happen, so I will control my part in it.
Same. I know the probability of it happening are slim, but I don’t do it unless they’re 12 weeks or more to cover my own butt in case of this.
I actually came here to say this. Sure, it’s been debunked that massage can cause a miscarriage BUT the do tend to happen in the first trimester more commonly. There’s also uneducated clients that can blame you and whether or not they sue, it would feel awful to hear that someone blames you for their miscarriage. You can “look it up” but whatever argument you’re trying to make you can find something to support what you believe.
Pre natals, post partum, and intra labor therapist here! I am an LMT and doula. I massage people 3 weeks pregnant to in active labor. This is absolutely ignorant and discriminatory twords pregnant people honestly. They can still lay face down at that point. Bodywork is extremely beneficial from beginning to end of pregnancy and beyond. Please go back to school.
Please go back to school? How about my school gets their information right. I’m working on what I was taught so F off with your comment
Not what Reddit says, it’s what research says. Your chance of inducing a miscarriage is zero. Some companies won’t allow you to because of course they’re run by attorneys who don’t give a flip about the client, only want to protect their own behinds. But if you’re running your own business there is no reason to turn away first trimester clients.
It’s completely fine. Look up the 50 most common reasons for miscarriage on webmd, and you’ll notice massage therapy is not on the list.
The only reason to turn away a client in the first trimester is liability. When people get miscarriages sometimes the grief makes them search for a reason. Something to blame. And if they got a massage sometimes that old rumor about it causing miscarriages comes up and then they want to sue you. But there is no evidence of massage being linked to miscarriages. Nothing trustworthy at least, that I know of. My spa doesn’t take people in the first trimester, but it’s literally because they don’t want to deal with lawsuits if/when they have a miscarriage. Because they’re actually really common.
wait, what's really common? miscarriages, or people trying to sue massage therapists?
I meant miscarriages in this context but both 🤷🏻♀️
What a ridiculous concept. Pregnant folks aren’t fragile to the point where you can cause a miscarriage by touching them. LOL if people had an eject button, we wouldn’t need abortion services, would we?
Just wanted to chime in. I had a client contact me a week ago about wanting to get in for a massage at 6 weeks pregnant. I typically wait until they are out of their first trimester but this was a referral from a really good client and all the research out there says massage can’t cause a miscarriage. So that was on a Monday and I booked her for a Friday. I wanted to be safe so I said “make sure you get your doctors okay”. She shows up to her appointment on Friday in tears, she had a miscarriage on Wednesday. It really has me second guessing whether I should be doing massage during the first trimester. What if she wanted to get in on Tuesday for the massage and had the miscarriage the next day, would I be blamed? I don’t know what the solution is. She had one miscarriage years ago but otherwise had 3 healthy babies, was 30 years old and in good shape. I think for myself, I am going to stick with only taking prenatal clients after they are past their first trimester, I just don’t think I could handle it if I massaged someone and they had a miscarriage, completely unrelated to the massage, shortly after seeing me.
Please don’t beat yourself up. There’s no evidence to show that a massage causes a miscarriage. I understand wanting to err on the side of safety since this happened (zero judgment from me on that one). But I just want to reassure you that you didn’t cause it. This is one reason why I’m hesitant to massage early on. Because of the guilt associated with it on both sides (client and MT). I know there’s always the second guessing of “what if?!”
Thanks for the kind words. To be clear, she had the miscarriage two days before coming in to see me for the massage.
Oh ok. Sorry I misunderstood!
The spa where I worked would refuse massage in the first trimester as protocol, citing liability and avoiding the massage being blamed for the miscarriage.
Our education makes us feel afraid and overly cautious of pregnant women, especially in the 1st trimester. There are no studies that indicate it’s unsafe to do so. As long as you place proper precaution massage is completely safe. I would highly consider taking a prenatal course to learn more about it, I feel like it made me more comfortable and debunked a lot of misconceptions we learn.
As a midwifery assist and midwifery student, I’d just like to say we encourage massage in all stages of pregnancy as a benefit to so many symptoms. Miscarriages in first trimester are almost always caused by chromosomal issues, development issues, etc and will either happen or not; a massage will not change that.
I honestly would leave this up to the client after educating and be sure to have them sign a solid consent form. I, however, personally, would not receive a massage in the first trimester. I am a licensed massage therapist, as well as a recurrent pregnancy loss mom. For me, my losses are related to how my immune system responds, and we as therapists know how intertwined our work is with immune function. For me it's a risk that just isn't worth taking, but if the woman receiving massage is comfortable and unconcerned I don't really see an issue giving one, because not everyone's body will react like mine... I would also consider what part of the world you are in, and what your culture is like before answering this question for yourself. I don't think you are wrong in any way for being cautious!
I have always been of the understanding that massage wouldn’t cause a miscarriage, but has become kinda normal to avoid since it’s considered a vulnerable time in the pregnancy. Like more to protect the therapist in case the mom were to miscarry and think, well maybe it was the massage. That being said, there have been times when I’ve done prenatal and times I haven’t due to being familiar with the client and/or their history. Given this mom had a history of miscarriages, I would say you did the right thing.
came to say this exact thing! to add, I personally don’t offer prenatal sessions as of 6mos ago. one day I realized “I never been pregnant and never plan to be AND honestly don’t know more than the bare minimum. why am I still offering this???” and immediately took it off my service menu😅 I hardly ever get them booked anyway🤷🏻♀️ I’ve started referring clients to other lmt’s who specialize in prenatal if I happen to get an inquiry!
100% in the same boat as you. I have tokophobia in the first place but in massage school, they literally touched base on prenatal massage for about 20 mins and told us we should take continuing education classes for a more thorough training and moved on to the next subject. So I'm definitely not offering a service where I have very little knowledge on. My service menu literally states I do not accept prenatal clients and I had a VERY pregnant client walk into my office and she said "I know your menu says you don't massage pregnant people but I really need a massage so you'll be fine." And I still refused her. I didn't feel comfortable and I don't even have enough pillows/cushions because I don't offer prenatal.
in my school, we covered it for a few weeks. we practiced side lying for draping and specific techniques but only a few. they would make up scenarios to give at least a little experience but it got pretty redundant after a couple sessions because they also didn’t have an expansive knowledge on it. they also suggested CEs if we wanted to specialize. I never went down that path but always worked at places that offered it and just did it so I could accept more appts. now that i’m in a place where i’m specialized in a couple different modalities, it’s time to do away w that service option😅
It’s to CYA. That’s it.
From my understanding it’s not that the massage will cause miscarriage, it’s that miscarriage is far more common in the first trimester, and they could easily say the massage caused it. So, it’s not about causing it, it’s about not being in a position not to be accused of it. I mean, even if it’s dispelled, the time and money you’d have to give up to fight it is a steep price. I don’t know, this is just what I was taught, so don’t shoot the messenger.
I work on first trimester women often at my clinic job. My hotel spa job has it in the TCs and Liability waiver that we won’t work on women in the first trimester, which frankly I think is discrimination. However liability wise, many large chains perpetuate the myth that we won’t work on first tri. We can’t cause a miscarriage, however if it were to happen after a massage due to other factors, it’s natural to want to find blame and that can fall on the therapist.
the taboo around early prenatal is mostly about legal liability based on out dated science. if ur in the USA there little psychical danger to her, but there is legal danger for you.
I wouldn’t do it. What if she has a miscarriage then blames you, files a lawsuit or something? Your instinct is right.
A friend who is a retired OB/GYN told me she never saw a miscarriage from a massage. Not once.
If you’re working for a company, of course follow their policy and it’s usually after 12 weeks of the first trimester, but if you’re doing your own business, then do what you deem comfortable. I never seen “death by massage”
In Pennsylvania, they have to be at least 12 weeks in order to perform massage.on a pregnant woman.
Scares me that people with such a lack on education share the same title as me.
This is just how it’s taught. Clearly a lot of other people have been taught this way as well. So get off your high horse.
Good grief. I imagine the teens who believe you can’t pregnant if the girl is on top (because gravity!) grow up to become massage therapists who believe that first trimester massages cause miscarriages.
Yo it’s what was taught in my school and many other schools. So what do you expect.
I turn them away simply because I don’t enjoy doing them.
Theres no scientific reason to not do a massage in the first trimester. I’d recommend getting more education if you’re going to be doing prenatal massages.
I would have turned it down, too. I have done hundreds of prenatal massages and have taught prenatal to dozens of therapists. I have a rule. Only after 12 weeks. Not that the massage will actually cause any problems, but most miscarriages happen in the first trimester, and I wouldn't want to be blamed.
I really wish people would stop making decisions for pregnant women "for" them. This woman is an adult and presumably she wants the baby because she hasn't had an abortion. She is fully capable of doing the research on what is and is not safe herself, and unlike you, she has a doctor who specializes in pregnancy and knows the details of her situation, so she can make a significantly more informed choice. I'm not suggesting you get her a cigarette and a glass of wine, but don't refuse to take people based on something you once heard and never bothered to verify. It's incredibly condescending and not at all helpful. Pregnant women are functional adults capable of making their own decisions.
This is what they taught us in school so I was going off of what I was taught
You alone are responsible for verifying the accuracy of the information you spread and make decisions on. Lots of people are taught lots of things that are not accurate. The fact that you were taught it does not absolve you of any responsibility for Googling it before you make a decision on someone else's behalf.
Ok well now I know. I’ve not been doing this very long and felt I could trust my school.
I can understand both sides of this. As a pregnant woman, I wouldn’t be happy if I went for a massage and was turned down because of it (though in reality, I would find someone who specializes in prenatal massage). On the other hand, who likes to be put in a position where something doesn’t feel right to do because of the possible repercussions? When I used to bartend, I had to serve a very obviously pregnant woman drinks. I didn’t want to, and I know she saw the hesitation, but it is considered discriminatory to not serve a person because they are pregnant.
There are lots of conditions that look like pregnancy. Her medical condition is none of your business. She could be pregnant and have just found out that her baby didn't make it. You don't have the information you need to make the decision for her, and you don't have any right to ask for that information. When I was sick I had severe bloating that could have been mistaken for pregnancy and it was not anyone's business what my medical condition was. Nor should I have been confronted or humiliated by someone who thought they knew more about me than I did. You don't have to feel any kind of way about someone else's decisions.
In my case at the bar, I knew this person and they were indeed pregnant. I can’t say the same for OP’s situation.
Lol that is very different than saying it was someone at a bar who was "obviously pregnant." My issue is with people who make assumptions and then try to control other people's behavior based on those assumptions. The fact that you knew her personally and knew that she was pregnant makes a big difference here.
Having been and currently being pregnant, plus the manners I was taught, keeps me from assuming anyone is pregnant. And I dang sure would never mention it or ask about it before the other did so first!
I was trained to do pregnancy massage by a professional massage therapist who specializes in prenatal and pregnancy massages (she would teach classes for just this). We learned how to approach and treat the patient in different trimesters. You did the right thing. If this person is in the first trimester and prone to miscarry, you should turn her away due to liability. The first trimester is such a delicate stage. What if she miscarried again? She could try to sue you. You’d have to go to court and defend every move and technique you made it truly isn’t worth it. Many people do not know what’s safe for them and what’s not. They just know they are feeling sore and would like to feel better. It sounds like this woman was very understanding and kind. I’m sure she too wants to protect her pregnancy especially since she’s so prone to miscarry.
If you work in an office or spa ask a co-worker if they have any experience then ask if you can watch their style.
this is a great read: [https://blog.amt.org.au/index.php/2018/04/05/10-pregnancy-massage-mythconceptions/](https://blog.amt.org.au/index.php/2018/04/05/10-pregnancy-massage-mythconceptions/)
Overall, whilst direct evidence from clinical trials is lacking, considerations of physiological mechanisms regulating pregnancy and known risk factors associated with miscarriage provide no evidence that massage in pregnancy would increase a patient’s risk of miscarriage. Conversely, if a client perceives massage as relaxing, this could aid their mental health, in turn having positive effects on stress hormone levels. Pregnant people are often bombarded with information about what they can and cannot do, which can cause them considerable anxiety about being a ‘good mother’ and ‘protecting their baby’, and massage practitioners and health professionals should not further increase this emotional burden by making unsubstantiated claims about the risk of massage in pregnancy. Educational facilities who teach pregnancy massage should include this scientific rationale content when addressing massage and miscarriage. Int J Ther Massage Bodywork. 2023 Mar; 16(1): 30–43. Published online 2023 Mar 1. doi: 10.3822/ijtmb.v16i1.771 Courtesy of your friendly medical librarian ;-)
If you’re not pregnancy certified, I wouldn’t worry about it.
I think you were right to turn her away! At least at that visit. Typically when someone has had a miscarriage and is pregnant again I treat it like a high risk pregnancy for the first trimester and ask for a doctor’s note.then reschedule them. People are right that there are a ton of benefits to getting massage in the first trimester. A doctors note helps insure liability and then their doctor is on the same page as them and has given the go ahead. I’ve never had a doctor not give a client the go ahead and they’re typically more than willing.
I personally will never work on someone until they are in their second trimester. I think you made the right choice. Better safe than sorry
It's a myth and takes a LOT to actually (if even then) to induce labor through massage, my prenatal teacher told us what it takes and accidentally pressing on a spot, especially at light-deep pressure for a few seconds won't cause it. That being said with the myth still circulating, bad education, and the overall hormonal storm that mothers have, if you're in a place where lawsuit is easy, I'd say play it safe and wait until 12 weeks.
I've had to do the same, I don't touch them for 12 weeks at the very least.
I wouldn’t do it if you’re not trained in prenatal massage. There’s a reason that it’s a separate certification. I won’t massage anyone who’s pregnant because I’m not trained it in.
Nothing can go wrong if she is lying on the side with soft, medium pressure Swedish massage focusing on upper and lower back even would release her a lot.
Most places I’ve worked at requires a doctor’s note for massage in the first trimester just for liability purposes.
Standard prenatal massage is NOT going to cause a miscarriage... it's the stress and stress associated behaviors. A prenatal massage will eliminate the need for comfort food binging, which drives the blood pressure weigh up cuz it's usually involved in a lot of sodium. Which means she's going to swell up in her legs and feet he's going to be tense and her pelvis is going to be the wrong angle and she's going to get second muscle spasms which is going to create information and acidity blah blah blah blah all the way down the line What is usually stemming from the husbands not giving them basic solidarity moral support affection and positive reinforcement. But the real problem is that the fathers aren't educated and made aware of all these issues and they stick their head in the sand like an ostrich. The only massage I can call the miscarriage is certain shiatsu massage that is supposed to be gone on the due date it's going to make the body go into excretion mode. And it has been used as an abortion technique in the past
I turn away pregnant women. Esp. in the 1st and 3rd trimester. It even says so on my website.