Prenatal massage is a specialised form of massage therapy designed specifically for pregnant individuals. Prenatal massage uses gentle pressure, pregnancy-safe positioning, and modified techniques to relieve the aches, tension, and stress that come with carrying a baby. Unlike a regular massage, every element of a prenatal session is adapted to protect both the parent and the developing child. This article covers what prenatal massage involves, how it differs from standard massage, what the research says about its benefits, when to start, how to stay safe, and what to expect at your appointment.

What Is the Difference between a Prenatal Massage and a Normal Massage?

The difference between a prenatal massage and a normal massage is the pressure, positioning, and technique modifications used to keep the pregnant person and baby safe. A standard therapeutic massage may use deep tissue pressure, prone (face-down) positioning, and firm manipulation of muscle groups. Prenatal massage replaces all of that with light-to-medium pressure, side-lying positioning supported by pillows and bolsters, and careful avoidance of specific body areas that could trigger contractions or affect circulation during pregnancy.

Prenatal massage relies primarily on Swedish massage techniques, which use long, flowing strokes to relax muscles and improve blood and lymph circulation without deep penetration into the tissue layers. Some trained prenatal therapists also incorporate myofascial release therapy and craniosacral therapy, both of which use very gentle sustained pressure to release tension in the connective tissue and the central nervous system. These techniques produce relief without the intensity that makes deep tissue work inappropriate during pregnancy.

The therapist performing a prenatal massage should hold specific training in prenatal care beyond the standard registered massage therapy credential. A therapist trained in prenatal massage understands the anatomical and hormonal changes pregnancy produces, knows which areas to avoid, and can recognise symptoms like blood clots or varicose veins that require medical referral. Clinics that offer pregnancy chiropractic alongside prenatal massage often coordinate care between practitioners so that each session builds on the other.

What Happens during a Prenatal Massage?

During a prenatal massage, the therapist begins with a brief health history and assessment to understand where you carry the most tension, which trimester you are in, and whether you have any pregnancy-related conditions that require modification. The therapist then helps you get comfortable on the treatment table in a side-lying position, supported by firm cushions (bolsters) under your head, between your knees, and along your back.

The massage itself typically lasts 30 to 60 minutes. The therapist works through the major muscle groups that pregnancy places under the most strain: the lower back, hips, glutes, legs, shoulders, and neck. Every stroke uses light-to-medium pressure, and the therapist checks in with you throughout the session to make sure the pressure feels comfortable and not painful. A prenatal massage should never cause discomfort. The goal is to release muscle tension and promote relaxation, not to dig into deep tissue the way a sports or deep tissue massage would.

Throughout the session, you remain covered by sheets and a blanket. The therapist undrapes only the area being worked on at any given moment, then re-covers it before moving to the next area. A systematic review published in Midwifery (Hall et al., 2020) found that registered massage therapy during pregnancy was effective at reducing both anxiety and depression, with the calming effect of the session itself contributing as much as the physical manipulation of the muscles.

What Gets Massaged during Prenatal Massage?

The areas massaged during prenatal massage are the lower back, hips, glutes, upper back, shoulders, neck, arms, hands, legs, and feet. These are the muscle groups that absorb the most strain as the body’s centre of gravity shifts forward during pregnancy, the pelvis widens, and the ligaments loosen under the influence of the hormone relaxin.

Certain areas require caution or avoidance. The abdomen is generally not massaged during prenatal sessions, or is touched only with very light, superficial strokes if the client requests it. The inner ankle area near the Achilles tendon and certain points on the hands and feet are avoided by most trained prenatal therapists because of a theoretical association with reflexology pressure points that some practitioners believe could stimulate uterine contractions. Deep pressure on the calves is also avoided due to the increased risk of blood clots during pregnancy.

The therapist may also address headaches and sinus pressure through gentle cranial and facial massage. Many pregnant individuals experience tension headaches from hormonal changes and postural shifts, and this part of the session can provide immediate relief. Some patients also benefit from complementary treatments like acupuncture, which can address nausea, fatigue, and pain through a different mechanism.

How Do They Position You for a Prenatal Massage?

During a prenatal massage, the therapist positions you on your side, typically the left side, supported by pillows and bolsters. Side-lying is the standard and safest position for prenatal massage because it avoids pressure on the abdomen and prevents compression of the inferior vena cava, the major blood vessel that returns blood from the lower body to the heart. Lying flat on the back during the second and third trimesters can compress this vessel, potentially reducing blood flow to the uterus and causing dizziness or low blood pressure.

Some massage facilities advertise tables with a cut-out hole designed to let a pregnant person lie face-down. Most prenatal massage experts advise against these tables because the hole allows the abdomen to dangle, which can stretch the uterine ligaments uncomfortably and still place pressure on the abdominal area. Side-lying with proper bolster support remains the safest and most comfortable option for both the parent and the baby.

The therapist will reposition you to the opposite side partway through the session so that both sides of the body receive equal treatment. Firm pillows between the knees keep the hips aligned, and a pillow under the head prevents neck strain. This positioning allows the therapist to access the back, hips, legs, shoulders, and arms effectively while keeping you fully supported.

What to Wear during Prenatal Massage?

What you wear during prenatal massage is entirely your choice. Some patients undress completely and rely on the sheet and blanket draping for coverage. Others prefer to keep their undergarments on. Some choose to wear loose, comfortable clothing that the therapist can work around. All of these options are acceptable, and your therapist should make it clear that your comfort level determines how much you undress.

Throughout the session, you are covered by sheets and a blanket at all times. The therapist only exposes the specific area being worked on, then re-covers it before moving to the next section. If you have any preferences about which areas are massaged or which areas you prefer to keep covered, communicate that to your therapist before the session begins.

What Are the Benefits of Prenatal Massage?

The benefits of prenatal massage include reduced stress hormones, relief from pregnancy-related back and leg pain, decreased swelling, improved mood, better sleep, and potential improvements in labour outcomes. Research from the last two decades has built a strong evidence base for these benefits, and prenatal massage is now recognized as a legitimate complementary therapy by multiple medical institutions.

A landmark review by Field, Hernandez-Reif, Diego, Schanberg, and Kuhn published in the International Journal of Neuroscience (2005) found that massage therapy reduces cortisol levels by an average of 31% while increasing serotonin by 28% and dopamine by 31%. Cortisol is the body’s primary stress hormone. Serotonin and dopamine are neurotransmitters that regulate mood, sleep, and emotional well-being. The reduction in cortisol combined with the increase in mood-regulating neurotransmitters explains why prenatal massage produces both physical relaxation and emotional relief.

A separate study by Field et al. published in the Journal of Psychosomatic Obstetrics and Gynaecology (2004) focused specifically on depressed pregnant women who received bi-weekly massage from their partners for 16 weeks starting in the second trimester. By the end of the study, the massage group had lower cortisol and norepinephrine levels and higher dopamine and serotonin levels compared to the control group. The massage group also reported significantly less leg and back pain, lower anxiety, and improved mood. Physiotherapy and massage work through different mechanisms but target many of the same pregnancy-related complaints, which is why multidisciplinary clinics often recommend both.

The global prevalence of low back pain during pregnancy is approximately 40.5%, according to a systematic review and meta-analysis published in BMC Pregnancy and Childbirth (2023). Other studies report that up to 76-80% of pregnant women experience back pain at some point during their pregnancy. A 2024 cross-sectional study published in the Journal of Contemporary Clinical Practice found that back pain prevalence increases from 33% in the first trimester to 81% in the third trimester. Prenatal massage directly addresses this pain through muscle tension release, improved circulation, and reduction of the nerve compression that causes sciatic pain in late pregnancy.

Additional benefits of prenatal massage supported by research include:

• Reduced edema (swelling) in the hands, feet, and ankles through improved lymphatic drainage and circulation
• Relief from sciatic nerve pain caused by uterine pressure on the muscles of the pelvic floor and lower back
• Improved sleep quality through nervous system regulation and physical relaxation
• Reduced frequency and intensity of tension headaches caused by hormonal changes and postural shifts
• Better labour outcomes, including higher birth weight and lower risk of preterm delivery, as reported by the Touch Research Institute at the University of Miami
• Increased oxytocin production, which supports labour contractions and maternal-infant bonding after birth

When Should I Start Prenatal Massages?

You should start prenatal massages at the beginning of the second trimester, which is 12 weeks of pregnancy. Most healthcare providers and trained prenatal massage therapists recommend waiting until after the first trimester because miscarriage rates are highest during the first 12 weeks, and avoiding massage during this period is considered the safest approach. The restriction is precautionary rather than evidence-based, meaning there is no proven link between massage and miscarriage, but most practitioners err on the side of caution.

Once you reach the second trimester, prenatal massage can become a regular part of your care routine. A licensed massage therapist at the Cleveland Clinic recommends getting a prenatal massage once every two weeks for maximum benefit during the second trimester. As you move into the third trimester and the physical discomforts increase, frequency can increase to once per week. Combining prenatal massage with chiropractic care during pregnancy can address both the soft tissue tension that massage treats and the spinal and pelvic alignment changes that chiropractic adjustments correct.

Approximately 20% of pregnant women experience clinically significant anxiety and/or depression, according to the American Massage Therapy Association (AMTA). Data from the Survey on Maternal Health conducted in Canada between 2018 and 2019 found that 17.9% of Canadian women had symptoms consistent with postpartum depression and 13.8% had symptoms consistent with postpartum anxiety. Starting prenatal massage early in the second trimester and maintaining it through delivery gives the hormonal regulation effects time to accumulate and may help reduce the risk of perinatal mood disorders.

Is 37 Weeks Too Late for a Prenatal Massage?

No, 37 weeks is not too late for a prenatal massage. Therapeutic massage is safe through the entire third trimester for healthy pregnancies, and many patients increase their massage frequency to once per week during this stage because the physical discomforts of late pregnancy are at their peak. At 37 weeks, the baby is considered full term, and the benefits of massage, including pain relief, stress reduction, and improved sleep, are especially valuable as the body prepares for labour.

Some patients continue receiving prenatal massage right up until their due date. The key is to maintain communication with both your massage therapist and your healthcare provider so that any changes in your pregnancy status are accounted for. A trained prenatal therapist will adjust the session based on how far along you are, what symptoms you are experiencing, and any new developments your midwife or obstetrician has flagged.

How to Stay Safe during Prenatal Massage

Staying safe during prenatal massage starts with choosing a registered massage therapist who holds specific training in prenatal care. In Ontario, registered massage therapists (RMTs) are regulated by the College of Massage Therapists of Ontario (CMTO), which sets professional standards and requires ongoing education. A therapist trained in prenatal massage understands the physiological changes of each trimester and knows how to modify techniques accordingly.

Speak with your midwife, obstetrician, or family doctor before booking your first prenatal massage session, especially if you have a high-risk pregnancy. Your healthcare provider may advise against massage if you have any of the following conditions: preeclampsia, pregnancy-induced hypertension, recent bleeding, pre-term contractions, severe edema, deep vein thrombosis risk, or a history of pre-term labour. Patients recovering from pregnancy-related pelvic floor issues should also consult their provider before starting massage.

During the session itself, the therapist should use only light-to-medium pressure. Deep tissue work is not appropriate during pregnancy because strong pressure can affect blood pressure, potentially dislodge blood clots in high-risk patients, and cause unnecessary discomfort. The session should feel relaxing and relieving at all times. If any technique causes pain or discomfort, tell your therapist immediately so they can adjust.

Are Prenatal Massages Covered by Insurance?

In Canada, prenatal massage performed by a registered massage therapist (RMT) is commonly covered by extended health insurance plans. Most major Canadian insurance providers, including Sun Life, Manulife, Canada Life, Green Shield, Desjardins, and Blue Cross, include RMT coverage in their extended health benefit packages. The coverage typically applies to all massage therapy services delivered by a registered therapist, including prenatal massage.

We direct bill to most major insurance providers here in Markham, which means you pay little or nothing out of pocket at your visit. Check your specific plan to confirm how many massage therapy sessions your coverage includes per year and whether a physician’s referral is required for reimbursement. Some plans also cover exercise rehabilitation and other complementary services that can support your pregnancy alongside massage.

Attribute	Prenatal Massage	Regular Massage
Pressure level	Light to medium only	Light to deep tissue
Positioning	Side-lying with bolster support	Face-down (prone) or face-up (supine)
Primary technique	Swedish massage, myofascial release, craniosacral	Swedish, deep tissue, sports, trigger point
Areas avoided	Abdomen (or very light touch only), inner ankles, deep calf pressure	No standard restrictions
Therapist training	RMT with additional prenatal certification	RMT (standard credential)
Session length	30-60 minutes (most common)	30-90 minutes
When to start	Second trimester (12+ weeks) recommended	Any time
Healthcare clearance	Recommended, especially for high-risk pregnancies	Generally not required
Insurance coverage (Canada)	Covered under most extended health plans as RMT service	Covered under most extended health plans as RMT service

Sources: Cleveland Clinic; American Pregnancy Association; College of Massage Therapists of Ontario (CMTO); Field et al., International Journal of Neuroscience, 2005; KC Rehab clinic information.

What to Do before a Prenatal Massage

Preparing for your first prenatal massage is simple. A few steps before your appointment help your therapist deliver the best session possible and help you get the most out of the experience.

1. Get clearance from your midwife, obstetrician, or family doctor, especially if you have a high-risk pregnancy or any pregnancy-related complications
2. Drink water before your appointment to stay hydrated, which helps your muscles respond better to massage and supports circulation
3. Eat a light meal or snack one to two hours before the session so you are comfortable but not overly full
4. Wear loose, comfortable clothing to your appointment for easy changing
5. Communicate your concerns, preferences, and any areas of pain to your therapist before the session begins so the treatment plan can be customized to your needs
6. Let your therapist know your current trimester, any recent changes in your pregnancy, and whether your healthcare provider has flagged any conditions

Arriving a few minutes early gives you time to fill out any intake forms, ask questions, and settle in before your session begins. The Massage Therapy Foundation awarded a $300,000 research grant in 2026 for a University of Denver study specifically examining how prenatal massage affects maternal mental health when incorporated into evidence-based wellness programmes. This ongoing investment in prenatal massage research reflects the growing recognition that massage is more than a luxury during pregnancy; it is a clinically supported complementary therapy.

Frequently Asked Questions

Do Prenatal Massages Feel Good?

Yes, prenatal massages feel good. The light-to-medium pressure combined with side-lying support and warm draping creates a deeply relaxing experience that most pregnant individuals describe as both physically relieving and emotionally calming. The session is designed to ease tension and promote comfort, not to cause any pain or discomfort. If a technique does not feel comfortable, your therapist adjusts immediately.

Can a Baby Feel Massage in the Womb?

A baby may respond to the relaxation the parent experiences during prenatal massage, but the baby does not feel the massage strokes directly. Research from the Touch Research Institute at the University of Miami suggests that prenatal massage reduces maternal cortisol levels, which can lower fetal cortisol exposure and contribute to a calmer uterine environment. Some parents report that their baby becomes more still during massage sessions, which may reflect the calming effect of reduced stress hormones in the bloodstream.

Can Prenatal Massage Help with Swelling during Pregnancy?

Yes, prenatal massage can help with swelling during pregnancy. Edema in the joints, particularly the ankles, feet, and hands, is common during pregnancy because the heavy uterus increases pressure on major blood vessels and reduces circulation. Massage stimulates the soft tissues and lymphatic system to improve fluid movement and reduce the collection of fluid in swollen joints. The American Pregnancy Association identifies edema reduction as one of the primary therapeutic benefits of prenatal massage.

Is Prenatal Massage Safe in the Third Trimester?

Yes, prenatal massage is safe in the third trimester for healthy pregnancies. Many therapists recommend increasing session frequency during this stage because the physical demands of late pregnancy are at their highest. Complementary treatments like laser therapy can also support tissue healing during the third trimester. Always confirm with your healthcare provider that your pregnancy remains low-risk, and choose a registered massage therapist with prenatal training for every session.

Which Part of the Body Cannot Be Massaged during Pregnancy?

The parts of the body that are generally avoided during prenatal massage include the abdomen (or only very light touch), the inner ankles near the Achilles tendon, and certain reflexology points on the hands and feet. Deep pressure on the calves is also avoided because pregnancy increases the risk of blood clots in the lower legs. A trained prenatal massage therapist knows these precautions and adjusts the session accordingly to keep both the parent and the baby safe.

How Often Should You Get a Prenatal Massage during Each Trimester?

Most prenatal massage therapists recommend the following frequency for healthy pregnancies: during the first trimester, most providers advise waiting until 12 weeks before starting massage. During the second trimester, once every two weeks is ideal for building the cumulative benefits of stress reduction and pain relief. During the third trimester, once per week provides the most benefit as physical discomforts increase. These recommendations may vary based on your individual needs and your healthcare provider’s guidance.

Putting It All Together

Prenatal massage is one of the most effective non-pharmacological ways to manage the physical and emotional demands of pregnancy. The research supports its ability to lower stress hormones, raise mood-regulating neurotransmitters, relieve back and leg pain, reduce swelling, improve sleep, and contribute to better labour outcomes. Starting in the second trimester and continuing through delivery gives these benefits time to compound, and choosing a registered massage therapist with prenatal training keeps every session safe.

At KC Rehab, our registered massage therapists work alongside chiropractors and physiotherapists under one roof so that your prenatal care stays coordinated from the first trimester through postpartum recovery. If you are pregnant and interested in adding massage to your care plan, call us at 905-205-1668 to book your appointment.