Most UK therapists offer massage from 13 weeks, the start of the second trimester. The first trimester is generally avoided as a precaution rather than because of demonstrated risk, and many insurance policies reflect this. Positioning and pressure change as you progress, and hot stone massage, saunas and deep abdominal work are avoided throughout pregnancy.
Key takeaways
- Thirteen weeks is the usual starting point
- A precautionary industry convention rather than evidence of harm, reinforced by insurance conditions.
- The second trimester is the most comfortable window
- Nausea has usually settled, the bump is manageable, and back ache is beginning.
- The third trimester is when it is most valued
- Back pain, pelvic discomfort, swelling and disturbed sleep all peak, and sessions often move to fortnightly.
- Lying flat on your back is avoided after 20 weeks
- The weight of the uterus can compress a major vein, which is why side-lying becomes standard.
- Hot stone is out at every stage
- Raising core temperature is not advised in pregnancy, along with saunas, steam rooms and hot tubs.
- Frequency can be the same as anyone else
- There is no need to space sessions further apart in an uncomplicated pregnancy.
- Some conditions need midwife advice first
- Pre-eclampsia, bleeding, placental complications, clot history and high-risk pregnancies.
First trimester, weeks 1 to 12
Most UK therapists will decline to treat during the first trimester. It is worth understanding why, because the reason is not what most people assume.
There is no good evidence that massage causes miscarriage or harm in early pregnancy. What is true is that miscarriage is most common in this period, occurring in roughly one in five known pregnancies, and no therapist wants their treatment to become associated with an event that would very likely have happened regardless. Many insurance policies formalise this by specifying cover from the second trimester onwards.
If you want treatment in the first trimester, speak to your midwife, and expect to find fewer therapists willing. Some with specific training will treat earlier, generally using very gentle technique and avoiding the abdomen and lower back entirely.
Practically, many women in the first trimester feel too nauseous to enjoy a massage anyway.
Second trimester, weeks 13 to 27
The most comfortable window, and where most pregnancy massage happens.
Nausea has usually settled, energy often improves, the bump is present but manageable, and the postural changes that cause back ache are beginning. Side-lying positioning starts to be used from around 20 weeks, and before that some therapists will still work with you semi-reclined.
Lying flat on your back for extended periods is avoided from around 20 weeks. As the uterus grows, its weight can compress the inferior vena cava, the large vein returning blood to the heart, which reduces cardiac output and causes dizziness, nausea and breathlessness. Side-lying eliminates the problem entirely.
Monthly sessions suit most women in this trimester. Detail on positioning is in pregnancy massage positions.
Third trimester, weeks 28 onwards
Often when massage is most valued and most useful. Back pain, pelvic girdle discomfort, swollen ankles, heartburn and disturbed sleep all tend to peak, and the side-lying position with proper cushion support is frequently the most comfortable a woman has been all week.
Sessions typically move to fortnightly, and weekly in the final few weeks if back or pelvic pain warrants it. Some women prefer 45 minutes rather than 60 simply because lying still becomes harder.
Expect more time spent on hips, lower back within safe limits, legs and feet, and expect the therapist to check in more frequently about comfort. Getting up should be done slowly with help.
Contact your midwife rather than your therapist if you develop new symptoms: sudden swelling, headaches, visual disturbance, reduced fetal movements or any bleeding[1].
Treatments to avoid throughout
| Treatment | Why |
|---|---|
| Hot stone massage | Raising core temperature is not advised in pregnancy |
| Saunas, steam rooms, hot tubs | Same reason |
| Deep tissue on abdomen and lower back | Pressure and positioning both unsuitable |
| Standard Thai massage | Extensive stretching, compression and positioning |
| Some essential oils | Clary sage, rosemary and juniper among others are avoided |
| Any therapist without pregnancy training | Positioning, pressure and contraindications all differ |
Suitable alternatives include pregnancy massage, maternity reflexology, adapted lymphatic drainage for swelling with a suitably trained therapist, and Indian head massage adapted to a seated or reclined position.
How often to book
There is no need to space sessions further apart than anyone else in an uncomplicated pregnancy.
- Second trimester: monthly.
- Third trimester: fortnightly.
- Final weeks: weekly if back or pelvic pain is significant.
- After birth: from around six weeks after a straightforward vaginal birth, or once cleared at your postnatal check after a caesarean. See postnatal massage.
General frequency guidance is in how often should you get a massage, and pricing in how much a massage costs in the UK.
When to check with your midwife
Speak to your midwife or obstetrician before booking if you have:
- Pre-eclampsia or high blood pressure in pregnancy[1]
- Unexplained bleeding or abdominal pain
- A history of blood clots or deep vein thrombosis
- Placenta praevia or other placental complications
- A history of preterm labour, or a pregnancy classed as high risk
- Severe swelling that comes on suddenly, or swelling of the face and hands
- Poorly controlled gestational diabetes
- A multiple pregnancy, where some therapists prefer additional guidance
Contact your maternity unit immediately, rather than booking anything, for reduced fetal movements, bleeding, severe headache with visual disturbance, or sudden severe swelling.
Every therapist listed on Massages Bristol is checked for relevant qualifications and public liability insurance before publication[2]. Browse pregnancy massage in Bristol or the full directory.
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This article is researched by the Massages Bristol editorial team using NHS guidance, professional body standards and published research, and is checked against the practice of the qualified therapists listed in our Bristol directory. It is reviewed and updated when guidance or standard practice changes. It is general information, not medical advice: speak to your GP if you have a health condition that may affect treatment.