Elaine Stillerman’s Top 7 Tips for Working with Pregnant Massage Clients

You love the idea of working with pregnant women and you want to expand your practice to include them. I totally understand—I have been doing this for over 40 years and it still remains exciting and fulfilling work. Here are my top tips for working with pregnant massage clients.

1. Start with respect and appreciation.

It is a unique honor and privilege to touch and soothe women who are carrying new lives. You should approach this deserving population with sensitivity, deep respect and awe. Ask permission before massaging a pregnant massage client’s abdomen. Accept her choices without comment and move on.

2. Temper your enthusiasm.

You may think being pregnant is an exciting time in a woman’s life—and it can be. But it also can be fraught with anxiety, stress and emotional upheavals. Let your client express her feelings about this pregnancy.

3. Be confident that first-trimester bodywork is safe.

With proper training, first-trimester bodywork is safe; miscarriages are not caused by massage.
A large percentage of pregnant women have nausea, especially during the first trimester. Massage is contraindicated when a client has nausea, so wait until the sickness subsides; if she feels better, book her for a late afternoon session and include techniques that help minimize nausea.

4. Get specialized, live, hands-on training.

Pregnant massage clients deserve to be treated by professionals who have taken the time and have committed themselves to learning in a live, hands-on class with a qualified teacher.

This training provides knowledge of appropriate massage techniques to support the client through the three trimesters of pregnancy, during labor and in postpartum recovery. It also addresses the precautions and contraindications.

Distance learning is fine for some subjects, but there is no way you can feel a baby’s movements in the womb, the lymphatic rhythm, or tissue release without being present in a class with live, pregnant models.

5. Maintain a wide network.

Do you know an obstetrician, midwife or doula you would recommend? Give clients their names—and let these professionals refer their clients to you. The more related services you suggest, the more people there are who can refer clients out to you.

6. Always have her comfort in mind.

With appropriate positioning and cushioning, most women can safely enjoy a massage facedown during each trimester. Correct use of ergonomic cushions in a side-lying position gently caresses and supports her body without compressing her abdomen.

Try these techniques:

• Pull the pillow under her head through her jaw line for complete cervical support.
• Place a wedge or small pillow under her belly to support the uterine ligaments and relieve back pain.
• Let her hold a rolled towel in her arms, if she wants one.
• Place a wedge in the small of her back—the “door stop”—so she feels secure on the treatment table.
• Place an adequate number of pillows between her knees so her hip, knee and ankle of the top leg are all on one plane; this prevents the sacroiliac joint from stretching.
• Make sure her knee doesn’t drop lower during the massage. If her baby is occiput posterior, bring her top leg forward. This tilts her pelvis enough to get the back of the baby’s head off her sacrum and relieve back pain.
• In a supine position, use pillows to elevate her upper torso (to an angle of 45°-70°) and support her neck, and under her legs so they are slightly higher than her heart; this is a very comfortable position.

7. Make stress reduction your primary goal.

During pregnancy, maternal blood volume increases 30 to 50%, with the uterus and placenta the main repositories. When stress is elevated, the catecholamines that are secreted reroute the essential blood supply from the uterus to the extremities, due to the flight, fight, freeze response.

For the mother, heightened stress levels can cause fatigue, sleeplessness, anxiety, eating disorders, headaches and backaches; long-term exposure can lead to suppressed immune function, high blood pressure and heart disease.

About the Author:

Clients, Elaine, massage, Pregnant, Stillermans, Tips, Top, Working ⋆ Elaine Stillerman’s Top 7 Tips for Working with Pregnant Massage Clients

Elaine Stillerman, LMT, is the developer and instructor of the professional certification course MotherMassage: Massage during Pregnancy. She has published several books, including “Prenatal Massage: A Textbook of Pregnancy, Labor, and Postpartum Bodywork” (Mosby’s Massage Career Development).


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