This is another really common question I get. I've commented on it before. But below is a comment I left on a LinkedIn discussion recently on the safety of prenatal massage. The discussion was initiated by a MT asking for "opinions" on first trimester massage. There was some banter back n forth on getting doctors pre-approval for all massages, and a general discussion on education.
Here's my comment to the poster asking other MTs for feedback on first trimester massage:
There are some really great trainings out there that help you sort out the "opinions" from the "evidence." I have a practice that focuses specifically on pregnancy massage. I trained with Carole Osborne who I see posted above.
I try to keep abreast of the science and keep my pregnancy massage practice evidence-based, not opinion-based. And while there are prudent safety measures we should take for all pregnancies (as other group members have posted above), there is no evidence-based reason that I have come across to make a sweeping recommendation that ALL pregnant women avoid massage in the first trimester.
I think you are smart to ask the question and sort this out in your practice. There is so much "myth"information floating around about pregnancy, as well as prenatal massage. In my prenatal massage practice, I have worked with hundreds of pregnant women. I made the conscious decision to work with women in their first trimester, as well as higher risk pregnancies. My practice is set up for me to do this and I have taken the time to gain the needed skills and knowledge. You may decide to do it differently because of your own tolerance for risk, skill level and workplace setting, regardless of the science.
One of the reasons I decided to work with first trimester women is that I am pretty comfortable with my communication skills with my pregnant clients and have a practice where I have the luxury of spending extra time checking in with women about the progression of the pregnancy, their concerns, etc. I also have a practice in which I get to talk to my clients when they are booking their massages (obviously if you are in a spa or massage center, you may not have this option). If I have a first trimester woman (or at any point during pregnancy!) who is nervous about massage safety, I educate her on the science, which modifications I would make for her and then, if I still sense she's really nervous, I ask her to talk to her midwife/OB; I do not want to give a massage to a woman who is nervous about me touching her. That would be a stressful and counterproductive massage for everybody. In these instances, I am less asking for medical clearance, but more asking the pregnant woman to do some homework to get herself in a place where she is comfortable receiving work.
A good prenatal training is not only going to teach you general contraindications, but help you think about pregnancy -- is that really standard low back pain or early labor? Is that normal edema in your feet or something more systemic you need to check in with your doctor about? I trained with Carole Osborne's Body Therapy Associates and think she offers comprehensive and EVIDENCE-BASED contraindications for massage during pregnancy. Carole -- in her class and text book -- helps you explore what the science says, what the real risks are and what risks YOU are comfortable taking. I felt supported in so many ways -- what to ask pregnant women during intake, what supplies to have in the office, how to position them (and why), as well as treating common pregnancy complaints and preparing for birth.