As the demand for pregnancy massage has increased over the past few decades, various products have come on the market aiming to make delivering that massage simpler. There are now special tables you can purchase or pillows that go on top of a table that have special cut-out sections for a pregnant belly and breasts, thus allowing a woman to lie face down throughout her pregnancy.
This sounds like a dream come true to many pregnant women who have been struggling to adapt to lying on their side as their pregnancy progresses. In fact, this is often one of the first questions prospective clients ask when they call: “Do you have a special table so I can lie face down?”
Well, no, we don’t.
What do the experts recommend?
Experts in the field caution against using these tables and recommend other positions as optimal for pregnant clients, for the following reasons:
No matter how well these tables try to support the belly, they still put women into a position in which her uterus is now suspended from her low back by an already stressed ligament structure and lumbar spine. These stressed ligaments are often the cause of many pregnancy aches and pains that women are looking to alleviate in massage.
Having massage applied to you while lying face down means the therapist is leaning their bodyweight into you. This risks increasing intrauterine pressure. Not good.
Many women are very uncomfortable lying face down as they feel they are lying on top of their baby, despite the accommodations of the belly cut-out.
For women who are quite advanced in their pregnancies, it can be quite awkward to attempt to lower both your belly and breasts into these pre-cut holes, and then turn over later in the massage.
One size does not fit all. Though these holes are meant to accommodate the average woman, the variation in sizes of women’s torsos, pregnant bellies and breasts complicate the ability of these tables to support all women.
One alternative to this style of table is a large pillow that covers much of the table and provides similar cut-outs for the breasts and belly, allowing the woman to lie face down. In addition to all the above frustrations, there is not enough of an opening for the woman to breathe well and she can sometimes leave feeling suffocated.
For women experiencing increased sinus congestion in their pregnancy, a prone position will put pressure on her sinuses and aggravate this discomfort during the massage.
Most experts agree, the optimal positioning for pregnancy massage remains side-lying and semi-reclined positions; the same options women have at home.
Fortunately, however, most trained therapists have high-tech pillows and enough experience to make you a lot more comfortable than you are in your own bed (or so my clients claim). Most professional pregnancy massage therapists use specialized pillows that facilitate side-lying and semi-reclined positions. They also feature ways to work with women lying face down, but again, experts in the field discourage lying face down during a pregnancy massage.
But I really want to go face down…
While the overall recommendations for pregnancy massage are side-lying, for a healthy pregnancy and a confident mom (she’s gotten lots of massage before, she’s feeling good in this pregnancy and not too anxious), I would trust her to use her intuition whether a face down massage feels right to her. One group of women whom I think would gain some benefit from it are women who are chronic belly sleepers when not pregnant. These women often have such a hard time transitioning to sleeping on their sides. They really crave that tactile sensation and pressure so that they can relax more deeply.
More importantly: we can give a better, more thorough massage in side-lying
Experts have their opinions about safety (and we do, too), but another consideration for us is that the way we position pregnant women on their sides allows us to give a better massage.
Much thanks to Carole Osborne’s work in this area. She is one of the foremost experts in prenatal massage in North America, if not internationally. If you are a therapist looking for further training, please check out her website for both hands-on and online training options. For more in-depth discussion on pregnancy massage and positioning, please reference Carole Osborne’s Pre- and Perinatal Massage Therapy: A Comprehensive Guide to Prenatal, Labor, and Postpartum Practice, 2nd Edition.