Here are answers to some of the most frequently asked questions about providing massage while pregnant and what to expect.

There are many changes pregnant women go through in every trimester—physical and emotional.

As a female massage therapist, you may have wondered: Is it possible to nurture your clients as well as yourself when your own body is going through so much? How do sudden nausea and shifting gravity affect your ability to provide the same level of quality massage your clients are used to?

When I started massage school, I had two young children, but I had always wanted a big family. As most of us discover, when you’re a self-employed massage therapist, if you don’t work, you don’t get paid.

Would it be possible to do massage while pregnant, and how would that work out? How long could I work? How had other women done that?

Because I have had five pregnancies during my massage career—one of them with twins—fellow massage therapists would reach out to me upon occasion to find out how I managed and how it’s possible to work safely while taking care of oneself and one’s baby.

I reached out to massage therapists who are moms to see what their experiences of massaging while pregnant were like. Modalities practiced ranged from hot stone, Swedish, therapeutic, deep tissue, myofascial, sports, chair massage, Reiki, barefoot massage and even Pillossage, a technique that makes use of heated pillows.

Here are their answers to some of the most frequently asked questions about providing massage while pregnant.

How Far Along in My Pregnancy Can I Work?

First, of key importance is to make sure you have no contraindications that would prevent you from working safely. Communication with your health care provider, whether you’re seeing an obstetrician or midwife, is vital.

In some cases, a high-risk pregnancy will prevent you from working at all. In others, such as with multiple births or advanced maternal age (35 and older), it may simply mean you see your care provider more often, so he or she can keep an eye out for complications that may arise.

Carolyn Boarman of Irvington, Virginia, who, at the time I wrote this article, was due to give birth in two days, recently cut back her hours from five and a half per day to three or four. Deep tissue has been a little harder for her to do, as well as draping. That had gotten a little more complicated because people kept kneeing her in the stomach as they turned over.

During the last month of pregnancy for Ashley Maturin, of Lafayette, Louisiana, she went down to three massages a day. “My feet started swelling at the end, so standing wasn’t ideal. I’d have to go home and put them up to get rid of the excess fluid.”

Foot swelling is a common issue for most women at the end of the pregnancy. Both Boarman and Maturin were quick to point out that their employers were very accommodating, making sure they were comfortable with the amount of work they could handle.

One of the benefits Lauren Gardner of Staunton, Virginia, mentioned was that staying active by practicing barefoot massage and being able to move throughout the day helped in her pregnancy. She was able to work through 38 weeks.

Doing barefoot massage “definitely helped my pregnancy go well, and I believe it kept me from having aches and pains that a lot of women normally experience.”

Another benefit was that her clients loved the extra weight she carried during her pregnancy, as it allowed her to work deeper while doing Ashiatsu. (Yes, you read that right!) Gardner had a little trouble doing seated barefoot work as her belly got bigger, but she adjusted that as needed.

“Looking back, I wish I would’ve kept going, because those last weeks were rougher than the rest of the pregnancy combined. I think if I had kept working, those last weeks would have been more bearable.”

Abby Meyers of Champaign, Illinois, agrees. Despite having tired legs from standing, she feels like being able to see her clients toward the end of the pregnancy “helped to pass the eternity of the last month of pregnancy.”

I couldn’t do hands-on massage during my pregnancy with twins because I would get out of breath when I bent over. Like Gardner’s clients, mine were thrilled with the extra weight during barefoot massage. While I stopped working at 32 weeks, I could have easily worked several weeks longer. (It’s important to note that I did have my midwives’ approval for this, and I was to stop if I ever felt unsafe or got dizzy.)

Like Gardner, Cayln Wright of Reno, Nevada, also worked until 38 weeks. She is currently pregnant and is expecting to work as long this time as well. Specializing in a variety of modalities, Wright notes that her biggest issues are swollen feet from standing long hours and discomfort from bending over.

Angela Engelen in Cape Giradeau, Missouri, managed to avoid some of that while doing chair massage events as well as hands-on. Pregnant with twins, she worked until the evening prior to her C-section at 37 weeks.

In Amherst, New Hampshire, Jenny Methot really kept going—not only did she work on her due date, but she did two one-hour massages and one two-hour massage, finishing by 6:00 p.m. Four hours later, she went into labor, and had the baby the following morning.

What About Body Mechanics?

As your belly grows and hormones cause shifts in ligament length to prepare for delivery, you will need t accommodate your body mechanics.

Methot did have to excuse herself to use the restroom while doing 90-minute or two-hour sessions. In trying to avoid interrupting sessions, other therapists sometimes found themselves dizzy, which happens due to dehydration or the growing uterus putting pressure on blood vessels, or having Braxton-Hicks contractions, which are “practice” contractions, due to a full bladder.

Having to do hands-on massage while growing a baby in your body is no easy feat, mentions Caitlyn Pitre of Baton Rouge, Louisiana. While she expected to work until delivery, she was only able to make it through eight months.

“Modified body mechanics, the extra weight, the hormones—these things greatly affect our work and can become an issue if we’re not very careful. But I love being a therapist and am grateful I was able to continue as long as I did throughout three pregnancies.”

“I attribute the benefit of no swelling of my hands … to the daily workout that improves circulation overall, meaning better supply for my baby and better health for my body,” reports Hollie Vanderheide of Afton, New York.

Vanderheide was able to accommodate the shifting of gravity and the size of her belly by squatting versus bending over. Having snacks at the office and being able to lie down to rest periodically during the day also kept her healthy.

In Flushing, Michigan, Emily Kato is approaching her third trimester of her second pregnancy. With her first, her son was breech—meaning the baby’s position is not head down, but buttocks down or another similar position—which made her very uncomfortable.

“With this pregnancy, at 27 weeks, I am trucking along. The hip pain is slowing me down, but it’s making me listen to my body!” Kato said. Adjusting her table and stools also helps make more room for her belly.

Hip pain is a common theme while pregnant, but getting regular adjustments from the chiropractor for whom Engelen worked kept her sciatic issues at bay.

When doing seated massage, many barefoot therapists find themselves moving their table a little further from the stool as their belly gets bigger. There are some seated moves that aren’t so comfortable, so you will learn to modify and delete as needed.

In the Dayton, Ohio, area, Tzuling Kuo expected to have a hard time bending over or dealing with the dizziness that accompanies some pregnancies.

“I never actually felt discomfort during my work days,” Kuo said. “I did have to snack a lot in between sessions.”

Benefits to Massaging While Pregnant

When comparing her work days to her off days, Kuo mentioned that having to move around and focus on someone else helped her feel less tired. On her days off, she just wanted to lie around and complain about her aching joints due to the hormonal changes.

Another benefit was that climbing up and down off the table to do barefoot massage kept her legs strong and her hip joints flexible.

“This was very valuable during my last trimester when my belly was huge. It was also great for labor!” she said.

Justine Robinson of Summerville, South Carolina, agrees. The physical aspect of doing barefoot massage helped her stay fit during two pregnancies—one of which was with twins.

“It enabled me to work as long as I did as well as be able to push through labor and delivery. And the knowledge base of being an LMT has helped me to understand the physiological changes while pregnant.”

Maturin mentions that she was able to stay more active than most other pregnant women she knows and her body bounced back more quickly.

While Kimberly Radomski of Glen Ellyn, Illinois, had troubles with her workload during both her pregnancies, she was able to keep more active by floating in a pool, something my midwives recommended as well.

“I’m pretty sure being a massage therapist while pregnant helped me to stay in pretty decent shape,” Radomski said. “Without my work, I probably wouldn’t be as active.”

What Will My Clients Think?

The overwhelming majority of therapists mentioned that their clients were very accommodating, despite the baby periodically kicking the client on the head or torso.

Ashley Bowman of Deland, Florida, found an unexpected result. “I had a few gruff old men clients who softened up a lot the more I progressed in my pregnancy. Having little old gruff men suddenly talking sweet to your belly is super unexpected.”

About the Author:

Mary-Claire Fredette

Mary-Claire Fredette, LMT, has eight children, six of whom were born during her massage career. She did hands-on massage for babies three and four; barefoot massage for babies five through eight. She’s the co-founder of Center for Barefoot Massage and owns Affinity Massage Studio in Cincinnati, where she’s been a licensed massage therapist since 1999.