Wanting a massage while pregnant? While you may desire to be on your tummy for a massage, here are a few reasons why this may not be the best position in terms of anatomy and comfort, even if the therapist has a "special" cut-out table. In the first three months, breasts may be very tender so lying on your stomach is not particularly comfortable. Pregnant women also tend to experience increased sinus issues, so being face down in a face cradle can create pressure in the sinus cavities. And most importantly, lying on your stomach, particularly once you are past 13 weeks, can increase the intra-uterine pressure and strain the ligaments that attach the uterus to the sacrum or tailbone. Being on our tummy also re-creates the sway back that is so common in pregnancy. This is the very position that is the cause of low back pain in the first place.
Our training, which includes over 45 years of collective experience, has convinced us that especially after 13 weeks, pregnant women should only be treated in a side-lying position. This offers "maximum safety and comfort throughout all pregnancies" (Osborne 2012), even higher risk ones. The strain on uterine ligaments and muscles is minimized while on your side and it also helps to reduce pressure on the sinuses, breasts, and uterus. Not only is this side-lying position very comfortable for the woman, it allows the therapist excellent access to the neck and shoulders, rib cage, low back, and hips. Your therapist will be able to effectively address the nervous system, muscles, joints, and fascia to help reduce the physical load on the pregnant body. If you have had a treatment while lying on your side and found it to be uncomfortable, this is likely due to lack of skill and training on the therapist’s part. When positioned well on your side, the entire skeleton is held and supported by the body positioning cushions, resulting in a very comfy and relaxing position.
And in talking with colleagues who are physiotherapists specializing in perinatal care (Optimum Perinatal Health Inc), here is what they say about a side-lying position:
"Yes I would agree that side lying past 13 weeks pregnant is the best position for prenatal massage. We want to limit pressure on the uterus and the ligamentous structures supporting it. I believe it would be the safest position for mom and baby, especially when you factor in the pressure you would be using during a massage to release the posterior musculature." Gina-Marie Cerantola BSc, DPT, FCAMPT, CAFCI, CGIMS
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