Are maternity massages safe for the baby?

Maternity massage isn't just a regular massage performed during pregnancy. In this specialty massage, which is most often based on the Swedish method, techniques are adapted to the specific needs and counter-indications of pregnancy. The goal is to relieve pregnancy-related symptoms while avoiding any potentially unsafe practices.

A lot of massage centers avoid it, though, and many more won't perform it in the first-trimester. Typically, the policy is attributed to a perceived connection between maternity massage and miscarriage, and sometimes a fear that abdominal work could result in placental detachment from the uterine wall during early pregnancy.

While a shortage of scientific evidence makes absolutes difficult, the commonly held belief among professional massage therapists and medical experts is that these concerns are unfounded in the case of a woman experiencing a normal, healthy pregnancy.

Neither placental detachment nor miscarriage has ever been linked to prenatal massage in any scientific research. Most experts believe the reason why some massage therapists stay away, especially during the first trimester, and some doctors don't recommend it has to do with liability fears. Miscarriages are so common in the first 12 weeks that people who could possibly be considered legally liable -- like someone who had her hands on the pregnant woman's belly before the miscarriage or someone who recommended that contact -- simply (and perhaps wisely) decide to avoid any possible perception of causal effect that could lead to a lawsuit.

Again, we're talking about normal, healthy pregnancies here. Complicated pregnancies can be a different story, but not because massage has been linked to increased risks in those cases. Complicated or high-risk pregnancies are simply that: complicated and high-risk. In cases of preeclampsia, history of miscarriage or pre-term labor, or pregnancy-induced hypertension, for instance, any under-studied therapy would probably be of concern. This includes acupuncture, herbal remedies and most other complementary and alternative medical therapies (CAM). Undertaking any one of them would be unwise without explicit clearance from a woman's obstetrician or midwife.

Pregnancy specifics are only part of the equation, though. In considering clearing any patient for prenatal massage, in high-risk and perfectly normal pregnancies alike, there's probably at least one question that every prenatal-care provider will ask ...

Complementary and alternative medical (CAM) therapies are a varied lot, but they suffer from a common ailment: a general lack of uniform certification standards. The result is that while some practitioners are highly trained and highly knowledgeable, others are, to varying degrees, less so.

Massage is included in this group. There is no single umbrella organization guiding the training of massage therapists; a licensed massage therapist (LMT) is licensed by a specific school or training program. Maternity massage is a particular problem area because it's a specialty: Just because someone is fully trained in, say, Swedish massage therapy doesn't mean he or she is fully trained in prenatal Swedish massage therapy.

And it matters. Prenatal massage involves different techniques than regular massage. There are simple ones, such as position. A woman receiving a prenatal massage will lie either face-down on a maternity-specific massage table (which has a hole cut out for the belly) or else, more commonly, on her side, with her belly propped up and protected by pillows in later trimesters. This latter position is often the preferred one, since the abdomen is better supported.

Other changes are more technique-oriented. For instance, many therapists trained in prenatal massage avoid the abdomen altogether, and the rest use very light pressure and only an open, soft palm -- there is no kneading or pressing there. They avoid specific pressure points believed to stimulate the uterus, and keep leg massage superficial in case of pregnancy-related blood clots. They use extra oil over varicose veins, which respond poorly to friction.

The safest prenatal massage is performed by a therapist with advanced training in the specialty, rather than one who took a class or two as part of an overall massage program. Massage schools and certifying organizations can provide names of qualified therapists, as can many obstetricians, midwives and pregnant (or once-pregnant) friends. It's also fine to simply ask a potential therapist whether he or she completed a training program in prenatal massage on top of general massage training.

So, aching back? Trouble sleeping? Sounds like someone could use a prenatal massage with a highly-trained specialist -- after clearing it with her care provider, high-risk pregnancy or not. The extra peace of mind can only help an aching body loosen up, breathe deep and enjoy.

For more information on pregnancy, massage and related topics, check out the links on the next page.