The best time to start prenatal massage is during the second trimester, after 12 to 14 weeks of pregnancy, when morning sickness typically fades and new lower back and hip discomfort begins. The third trimester offers the most physical relief because aches, swelling, pelvic pressure, and poor sleep intensify as the baby grows and shifts position in preparation for birth. A randomised controlled trial published in the Journal of Maternal-Fetal and Neonatal Medicine found that women who received biweekly 60-minute prenatal massage sessions experienced a 30% reduction in cortisol levels and improved heart rate variability, a key indicator of autonomic nervous system balance. Babies born to mothers in the massage group had higher birth weights and better Apgar scores compared to the control group.

This article explains when to start prenatal massage by trimester, how often to schedule sessions, what positions are used, which areas to avoid, when prenatal massage is not recommended, and what the research says about the benefits for both mother and baby.

When Is the Best Time to Get a Prenatal Massage?

The best time to get a prenatal massage is during the second trimester (weeks 14 to 27), which is widely considered the ideal and safest time to begin regular sessions, though the third trimester (weeks 28 to 40) is when most women experience the greatest physical relief. The second trimester is the recommended starting point because the risk of first-trimester miscarriage has passed, morning sickness has typically subsided, and the body is beginning to experience the postural and circulatory changes that prenatal massage addresses most effectively. Lower back pain, hip tightness, and leg discomfort often begin during the second trimester as the growing uterus shifts the body’s centre of gravity forward, increasing the curve in the lumbar spine and placing new strain on the muscles of the back, hips, and pelvis.

The third trimester is when prenatal massage delivers its most significant physical relief. The baby’s weight increases rapidly during weeks 28 to 40, producing swelling in the ankles and feet, pelvic pressure from the baby’s descending position, leg cramps from compressed blood vessels, and difficulty sleeping from the combination of physical discomfort and hormonal changes. Approximately 80% of pregnant women experience lower back pain at some point during pregnancy, according to multiple clinical sources, and the third trimester is when that pain typically peaks. Scheduling massage therapy during this period addresses these symptoms directly through improved circulation, muscle tension release, and nervous system regulation.

Is Prenatal Massage Safe in the First Trimester?

Yes, prenatal massage is generally safe in the first trimester when performed by a trained registered massage therapist (RMT), though many therapists and clinics prefer to wait until after 12 weeks before beginning treatment. The caution around first-trimester massage is not based on evidence that massage causes miscarriage. The first 12 weeks of pregnancy carry a higher baseline risk of miscarriage regardless of any external factors, and most clinics avoid treatment during this window as a liability precaution rather than a clinical one. The American Pregnancy Association confirms that women can begin massage therapy at any point in their pregnancy, including the first trimester, provided they have clearance from their prenatal care provider.

If you choose to receive massage during the first trimester, lighter pressure and shorter sessions are typically recommended. Swedish massage, which uses gentle gliding strokes and mild pressure to improve circulation and relax muscle tension, is the safest and most commonly recommended technique throughout all stages of pregnancy. Deep tissue work and strong pressure on specific acupressure points are avoided during the first trimester as an additional precaution. Speaking with your midwife or obstetrician before scheduling your first session is always the right first step, particularly if you have a history of complicated pregnancies or are experiencing symptoms such as spotting or cramping.

At What Week Should You Start Prenatal Massage?

You should start prenatal massage at week 12 to 14 of pregnancy, which marks the beginning of the second trimester and the point at which the risk of first-trimester miscarriage drops significantly. By week 14, the placenta is fully formed and has taken over hormone production from the ovaries, the pregnancy is firmly established, and the body is beginning to experience the musculoskeletal changes that prenatal massage is designed to address. Starting at this point allows you to build a consistent massage schedule through the second and third trimesters, which produces cumulative benefits for both pain management and stress hormone regulation.

Research from the Touch Research Institute at the University of Miami found that women who received biweekly prenatal massages for just five weeks showed decreased norepinephrine and cortisol (stress hormones) and increased dopamine and serotonin (mood-regulating hormones), according to findings published in the Journal of Psychosomatic Obstetrics and Gynaecology. These hormonal changes also led to fewer complications during birth and fewer instances of newborn complications such as low birth weight. Starting massage at week 12 to 14 gives you the maximum window to accumulate these benefits before delivery.

How Often Should You Get Prenatal Massage?

You should get prenatal massage once per month during the first trimester (if receiving), once every two to three weeks during the second trimester, and once per week during the third trimester as physical demands on the body intensify. This progressive frequency matches the trajectory of pregnancy discomfort: mild in the early months, moderate in the middle months, and at its peak in the final weeks before delivery.

Trimester	Weeks	Recommended Frequency	Primary Focus
First Trimester	1-13	Once per month (if approved by care provider)	Relaxation, stress reduction, mild tension relief
Second Trimester	14-27	Once every 2-3 weeks	Lower back pain, hip tightness, postural changes, improved circulation
Third Trimester	28-40	Once per week	Swelling (edema), pelvic pressure, sciatic pain, sleep improvement, labour preparation

Sources: American Pregnancy Association, Garrow Wellness Center, Cleveland Clinic, clinical consensus

Weekly sessions in the third trimester provide the most benefit because the body changes rapidly during the final 12 weeks. The baby gains the majority of its birth weight during this period, which increases the mechanical load on the mother’s spine, pelvis, and legs. Weekly massage keeps muscle tension from accumulating, maintains improved circulation, and supports better sleep quality. Acupuncture can complement prenatal massage during the third trimester by targeting specific points associated with nausea, pelvic discomfort, and labour preparation.

Is 37 Weeks Too Late for a Prenatal Massage?

No, 37 weeks is not too late for a prenatal massage. The third trimester, including weeks 37 through 40, is actually when prenatal massage provides the most targeted physical relief. At 37 weeks the baby is considered full-term, the body is preparing for labour, and the physical symptoms of late pregnancy, including severe lower back pain, hip and pelvic pressure, swollen ankles and feet, leg cramps, and disrupted sleep, are at their most intense. Prenatal massage at this stage focuses on releasing tension in the lower back, hips, and glutes, reducing edema through lymphatic drainage techniques, and promoting relaxation that supports better sleep.

How Far Along Can a Pregnant Woman Get a Massage?

A pregnant woman can get a massage up to and including week 40 of pregnancy, right up until labour begins, as long as she has clearance from her prenatal care provider and the massage is performed by a trained prenatal massage therapist. There is no gestational age at which massage must stop for a healthy, low-risk pregnancy. Some RMTs incorporate labour preparation techniques into sessions at 39 to 40 weeks, focusing on the muscles and connective tissue of the pelvis, lower back, and inner thighs to help the body prepare for the physical demands of delivery.

Do Massages Help Start Labour?

Massages do not reliably start labour, but specific acupressure techniques applied at full term (39 to 40 weeks) may help prepare the body for labour by softening the pelvic muscles and stimulating certain pressure points associated with uterine activity. The distinction matters: prenatal massage relaxes muscles and reduces tension, which creates a more favourable physical state for labour, but it does not induce contractions the way medical induction does. Acupressure points such as Spleen 6 (above the inner ankle) and Large Intestine 4 (between the thumb and index finger) are associated in traditional Chinese medicine with labour stimulation, which is why trained therapists avoid these points during earlier trimesters and may use them carefully at full term. The evidence for acupressure-induced labour initiation is limited but growing. Pregnancy chiropractic care during the final weeks can complement massage by optimising pelvic alignment for the baby’s descent and positioning.

What Are the Benefits of Prenatal Massage?

The benefits of prenatal massage include reduced stress hormones, decreased muscle pain and joint stiffness, improved blood and lymphatic circulation, better sleep quality, sciatic nerve pain relief, mood regulation, and improved birth outcomes for both mother and baby. Research confirms these benefits across multiple studies spanning more than two decades.

1. Reduced stress hormones and improved mood. Research from the Touch Research Institute found that biweekly prenatal massage reduced cortisol and norepinephrine while increasing dopamine and serotonin. A 2025 randomised controlled trial confirmed a 30% reduction in cortisol levels with regular prenatal massage sessions.
2. Decreased lower back and hip pain. Prenatal massage releases tension in the lumbar paraspinal muscles, hip flexors, and gluteal muscles that bear the increased load of the growing uterus. Approximately 80% of pregnant women experience lower back pain during pregnancy, making this one of the most sought-after benefits.
3. Reduced swelling (edema). Massage stimulates soft tissues and improves lymphatic drainage, reducing the collection of fluids in swollen ankles, feet, and hands caused by the 40 to 50% increase in blood volume that occurs during pregnancy.
4. Sciatic nerve pain relief. The expanding uterus places pressure on the pelvic floor muscles and lower back, which in turn compresses the sciatic nerve. Massage releases the surrounding muscle tension to reduce pressure on the nerve.
5. Improved sleep quality. Relaxation of the nervous system through massage promotes deeper and more restful sleep, which many women struggle with during the second and third trimesters.
6. Better birth outcomes. Depressed pregnant women who received massage had fewer prenatal complications, and their newborns were less likely to be premature or have low birth weight, according to research published by the Touch Research Institute. Chronic prenatal stress can programme the baby’s nervous system for an overactive stress response later in life, making stress reduction during pregnancy a priority for long-term infant health.

Massage therapy is the most commonly recommended complementary therapy during pregnancy, according to a review published in PMC. The hormonal, circulatory, and musculoskeletal benefits compound over multiple sessions, which is why consistent scheduling throughout the second and third trimesters produces the best results. Physiotherapy exercises prescribed alongside prenatal massage can strengthen the core and pelvic floor muscles that support the growing uterus, creating a combined approach to pain prevention and physical preparation for labour.

What Position Are You In for Prenatal Massage?

During prenatal massage, you are positioned on your side (side-lying) with supportive pillows placed between your knees, under your belly, and behind your back to keep your body comfortable and properly aligned. Side-lying is the recommended position for pregnant women during massage after the first trimester, according to the American Pregnancy Association and clinical consensus among prenatal massage practitioners. This position prevents compression of the major blood vessels, particularly the inferior vena cava, which can restrict blood flow to the uterus when you lie flat on your back for extended periods.

Your RMT treats one side of the body, then helps you turn to the other side to treat the opposite muscles. The pillow arrangement is adjusted each time you reposition. Some treatment time may also be spent in a semi-reclined seated position for work on the neck, shoulders, and upper back. The entire process is designed to keep you and the baby safe while giving the therapist access to the muscle groups that carry the most tension during pregnancy.

Can You Lay on Your Stomach for a Massage at 12 Weeks Pregnant?

You may be able to lay on your stomach for a massage at 12 weeks pregnant if your belly is still small enough for the position to feel comfortable, but side-lying is preferred from the second trimester onward. Some massage tables feature a cutout or pregnancy cushion that allows the belly to hang through the opening, but the American Pregnancy Association advises caution with these setups because they can apply pressure to the abdomen or allow the uterine ligaments to stretch uncomfortably. At 12 weeks the uterus is just beginning to rise above the pelvic bone, so some women can still lie face-down without discomfort. By 14 to 16 weeks, most women find that side-lying is significantly more comfortable and safer for the growing baby. Your massage therapist assesses your comfort and adjusts the positioning at each appointment as your body changes.

What Areas Should Not Be Massaged While Pregnant?

The areas that should not be massaged while pregnant include the abdomen with deep pressure, certain acupressure points on the ankles and wrists, the inner thigh near the groin, and any area with varicose veins, open wounds, or active skin irritation. Light, gentle touch on the abdomen is generally safe, but deep abdominal massage is avoided because it can place direct pressure on the uterus and the developing baby. Your RMT uses only soft, superficial strokes on the belly, if any, and never applies deep or sustained pressure to this area.

Certain acupressure points are avoided because they are associated in traditional Chinese medicine with stimulating uterine contractions. Acupuncture practitioners and trained prenatal massage therapists are both aware of these points and avoid them during treatment, particularly before 39 weeks. Deep tissue work on the legs is also modified during pregnancy because of the increased risk of blood clots (deep vein thrombosis) that pregnancy hormones create. Your therapist uses lighter, flowing strokes on the legs rather than deep, concentrated pressure to support circulation without disturbing deep vein structures.

Why Can’t You Massage a Pregnant Woman’s Ankles?

The caution around massaging a pregnant woman’s ankles relates to the acupressure point Spleen 6 (SP6), located approximately four finger widths above the inner ankle bone, which is associated in traditional Chinese medicine with stimulating uterine contractions. The clinical evidence for SP6 stimulation inducing labour is limited, but the point has been used for centuries in acupressure practice as a labour preparation technique, and trained prenatal massage therapists avoid sustained deep pressure on this area as a standard safety precaution before 39 weeks. Light, general massage on the ankles and lower legs is typically fine and helps reduce swelling. The restriction applies specifically to focused, sustained pressure directly on the SP6 point, not to gentle work on the ankle area as a whole.

Can a Prenatal Massage Cause Contractions?

A prenatal massage performed by a trained therapist is very unlikely to cause contractions, because certified prenatal massage practitioners are specifically trained to avoid the techniques and pressure points that could stimulate uterine activity. The concern about massage-induced contractions comes from the acupressure points discussed above. When these points are avoided, and when the massage uses Swedish techniques with moderate pressure rather than deep tissue manipulation, the risk of triggering contractions is negligible. If you experience any tightening, cramping, or contractions during a massage session, tell your therapist immediately so they can adjust or stop the treatment.

When Should You Not Do Prenatal Massage?

You should not do prenatal massage if you have a high-risk pregnancy, preeclampsia, deep vein thrombosis (DVT) or a history of blood clots, placenta previa, recent vaginal bleeding, cervical insufficiency, or any condition your OB-GYN or midwife has specifically flagged as a contraindication for massage therapy. Prenatal massage is safe for the majority of healthy, low-risk pregnancies, but certain medical conditions require additional caution or outright avoidance.

• High-risk pregnancy as identified by your prenatal care provider
• Preeclampsia (pregnancy-induced high blood pressure with organ involvement)
• Deep vein thrombosis (DVT) or a personal history of blood clots
• Placenta previa (placenta covering the cervix)
• Recent vaginal bleeding or spotting without a diagnosed cause
• Cervical insufficiency or a history of preterm labour
• Severe, sudden-onset headaches or visual disturbances (possible preeclampsia symptoms)
• Fever or active infection

Always check with your OB-GYN or midwife before booking your first prenatal massage session, especially if you have any of the conditions listed above. Your care provider can specify whether massage is safe for your particular pregnancy and communicate any precautions to your RMT. Bringing a note from your care provider to your first appointment helps the therapist plan your treatment with full knowledge of your medical history. Pelvic floor therapy may be recommended alongside or instead of prenatal massage for women with specific pelvic conditions that require a more targeted therapeutic approach.

Is It Good to Massage While Pregnant?

Yes, it is good to massage while pregnant because research consistently shows that prenatal massage reduces stress hormones, relieves pain, improves circulation, supports better sleep, and contributes to healthier birth outcomes for both mother and baby. The evidence base spans more than two decades and includes randomised controlled trials, systematic reviews, and longitudinal studies. The hormonal benefits are particularly compelling: reduced cortisol and norepinephrine combined with increased dopamine and serotonin create a measurable shift in the body’s stress and mood chemistry that benefits both the mother’s mental health and the developing baby’s neurological environment.

Prenatal massage at our Markham clinic is performed by registered massage therapists trained in prenatal techniques, including safe side-lying positioning, appropriate pressure levels for each trimester, and awareness of areas and pressure points to avoid. We coordinate prenatal massage with chiropractic care, physiotherapy, and exercise rehabilitation to provide a comprehensive approach to pregnancy wellness that addresses musculoskeletal pain, pelvic alignment, core stability, and stress management as a unified programme rather than isolated treatments.

Frequently Asked Questions

Does Prenatal Massage Help with Back Pain during Pregnancy?

Yes, prenatal massage helps with back pain during pregnancy by releasing tension in the lumbar paraspinal muscles, hip flexors, and gluteal muscles that bear the extra mechanical load of the growing uterus. Approximately 80% of pregnant women experience lower back pain at some point during pregnancy. Regular massage addresses this pain through direct muscle tension release, improved blood circulation to the affected area, and reduction of the stress hormones that amplify pain perception.

Do I Need a Doctor’s Note for Prenatal Massage?

A doctor’s note is not legally required for prenatal massage in Ontario, but most registered massage therapists recommend that you consult your OB-GYN or midwife before starting treatment, especially during the first trimester or if you have any pregnancy complications. Some clinics request a note from your care provider as part of their intake process. Bringing documentation of your prenatal health status helps your therapist plan safe, effective treatment.

Can I Get Prenatal Massage Covered by Insurance in Canada?

Yes, prenatal massage performed by a registered massage therapist (RMT) is covered under most Canadian extended health insurance plans as part of your massage therapy benefit. Coverage is subject to your plan’s annual maximum and coinsurance rate. Direct billing is available at many clinics, meaning you pay only the uncovered portion at the time of your visit. Check your benefits booklet or call your insurer to confirm your massage therapy coverage before booking.

What Is the Difference between Prenatal Massage and Regular Massage?

The difference between prenatal massage and regular massage is that prenatal massage uses modified positioning (side-lying rather than face-down), avoids specific pressure points and deep abdominal work, adjusts pressure levels for each trimester, and focuses on the musculoskeletal areas most affected by pregnancy such as the lower back, hips, pelvis, and legs. Regular massage typically places the client face-down and applies techniques across the full body without trimester-specific restrictions. Only RMTs with prenatal training should perform massage on pregnant clients.

Is Prenatal Massage Safe for Twins or Multiples?

Prenatal massage can be safe for women carrying twins or multiples, but it requires explicit clearance from your OB-GYN because multiple pregnancies carry a higher risk of complications including preterm labour, preeclampsia, and gestational diabetes. Your RMT will use lighter pressure, shorter sessions, and more frequent repositioning to keep you comfortable. Custom orthotics may also be recommended for women carrying multiples to support the additional mechanical load on the feet, ankles, and knees during the third trimester.

Putting It All Together

The best time to start prenatal massage is during the second trimester, after week 12 to 14, and the third trimester is when the most significant physical relief occurs. Scheduling massage consistently from the second trimester through delivery produces cumulative benefits for stress reduction, pain management, circulation, sleep quality, and birth outcomes. The research is clear: prenatal massage reduces cortisol, increases mood-regulating hormones, relieves the musculoskeletal pain that affects the vast majority of pregnant women, and contributes to healthier outcomes for both mother and baby.

If you are pregnant and experiencing back pain, hip tightness, swelling, or difficulty sleeping, our registered massage therapists at KC Rehab are trained in prenatal massage techniques and can build a session plan that matches your trimester, your symptoms, and your comfort level. Call us at 905-205-1668 or book an appointment online.