Massage in Pregnancy: Risks, Positioning and "Pressure Point" Myths

Urgent signs first

Get urgent help in pregnancy, whether or not you have had a massage. Call 911 (or your local emergency number) for sudden difficulty breathing, chest pain, or someone passing out, which can be signs of a clot in the lung. [1] A painful, swollen leg with red or darkened skin may be a clot in a leg vein (DVT), and the NHS lists pregnancy and the 6 weeks after birth as times of higher risk. [2]

Call your midwife, obstetric provider or maternity unit urgently if your waters break, you have vaginal bleeding, your baby moves less than usual, or you may be in labor before 37 weeks. [3] (These are NHS instructions; follow your own provider's advice.)

What the evidence shows

A 2021 systematic review of 12 randomized trials looked at relaxation massage in women at least 12 weeks pregnant, compared with standard care or another intervention. Only 2 trials reported side effects, and they were minor and transient. [4] In the one single-session study the review described, 40% reported soreness, headache, worse musculoskeletal symptoms, tiredness or dizziness. That study had no control group. [5] The review's authors concluded that healthy women with uncomplicated pregnancies may receive massage throughout pregnancy. [5] They reported no external funding. [5]

Limits. Seven trials excluded women with difficult pregnancies or existing complications, and five did not report these conditions. [4] The review also says there is little evidence on whether massage would improve or worsen high-risk conditions. [5] Massage cannot be blinded, and many trials compare it with usual care, so reported relief may partly reflect attention and expectation. Proper evidence not found in what we read for an obstetric society guideline on massage in pregnancy; we read the review and the NHS pages cited here, which do not give one.

Why blood clots matter in pregnancy

The review authors write that women are 5 times more likely to develop DVT when pregnant, and that DVT symptoms can resemble ordinary pregnancy discomforts such as leg swelling and back pain. [5] A case report describes a 25-year-old woman at 25 weeks who collapsed with a massive pulmonary embolism shortly after leg and foot massage; the fetus died in utero. [6] Its authors argue that massage in pregnancy should be contraindicated unless a clot risk is ruled out. [6]

This is one case report, so it shows possibility, not frequency. The review authors recommend no deep muscle massage of the legs and arms in pregnancy, while allowing gentle stroking for swelling. [5] That is one team's recommendation, not a regulator's rule. If you have leg pain or swelling, get it checked rather than massaged. See massage and blood clots.

Positioning and areas, as reviewers describe them

The same review authors say that if a pregnant woman lies down, massage should be in a side-lying position; sitting is also possible. They say lying on the stomach is uncomfortable for many, and that staying on the back for long should be avoided to prevent vena cava syndrome (a problem linked to lying on the back). [5] They also advise against massage of the abdomen and advise a pregnant woman with a complicated or high-risk pregnancy to consult her obstetrician. [5]

Practices vary, and this page does not teach any technique. A therapist trained in prenatal work will explain what they do. See prenatal massage: what it is and cautions and massage during pregnancy: trimesters and warning signs.

The "pressure point" myth

The review authors say some practitioners believe stimulating certain acupressure or reflexology points during pregnancy may induce labor, which can lead therapists to avoid pregnant clients, and that there are no scientific indications to support the claim. [5] They cite one randomized study that found no effect of acupressure on the onset of labor within 97 hours. [5]

A Cochrane review of acupuncture and acupressure for induction of labor (22 trials, 3,456 women) found no evidence of benefit from acupressure in reducing cesarean sections compared with sham control (2 trials, 239 women). [7]

What this does and does not mean:

• Strength of evidence: limited. The trials are small, the Cochrane trials tested acupressure as a method of inducing labor in the third trimester, and they do not cover every kind of touch.


• It is not an endorsement of using acupressure to start labor. Do not try to bring on labor yourself. Ask your midwife or obstetrician.


• For acupressure itself, see acupressure in labor and pregnancy.

Before you book

Tell the therapist how far along you are and about any bleeding, high blood pressure, placenta problems, clot history or complications. Ask your midwife or obstetrician first if the pregnancy is high risk. See therapies in pregnancy and pregnancy and breastfeeding safety.