No published evidence shows that massage causes miscarriage. Despite widespread concern, a 2023 review in the International Journal of Therapeutic Massage & Bodywork found no physiological mechanism by which professional massage would increase miscarriage risk during early pregnancy. The fear persists largely because miscarriage is common in the first trimester, and the timing can coincide with all sorts of everyday activities, including massage.
Between 10% and 20% of known pregnancies end in miscarriage, and 80% of those losses happen in the first 13 weeks. The vast majority are caused by chromosomal abnormalities in the embryo, not by anything the mother did or experienced externally. That high baseline rate means some women will inevitably have a massage shortly before a miscarriage that was already underway, creating a powerful but misleading association.
Why Massage Doesn’t Trigger Miscarriage
The concern usually centers on a few ideas: that massage increases blood flow enough to disrupt the uterus, that it raises stress hormones, or that pressure on certain points can start contractions. Researchers have examined each of these and found none of them hold up.
During pregnancy, blood flow to the uterus is regulated by multiple mechanisms driven by the placenta. The small increases in muscle blood flow that massage produces are not enough to meaningfully change what’s happening in the uterus. No study has ever measured a change in uterine artery blood flow during or after massage. Massage also does not lower the hormones that sustain pregnancy (progesterone, estrogen, or hCG), either directly or through any secondary stress response. And while massage can temporarily raise heart rate and blood pressure slightly, there is no evidence that these transient changes increase miscarriage risk.
The Acupressure Point Concern
You may have heard that pressing certain points on the ankles or feet can trigger labor. Points like SP6 (inner ankle) and others are used in traditional Chinese medicine to stimulate uterine contractions in women who are already at full term and in active labor. Research on SP6 acupressure during labor has shown it can modestly shorten delivery time, but this involves sustained, deliberate stimulation on a body that is already hormonally primed to give birth.
In the first trimester, the uterus is not responsive to labor signals in the same way. The review authors noted that even acupressure applied with the intention of initiating labor at term often fails to do so, making it highly unlikely that casual massage over or near these points in early pregnancy would trigger contractions or miscarriage.
What Prenatal Massage Should Avoid
While massage itself doesn’t cause miscarriage, there are real safety considerations during pregnancy that have nothing to do with miscarriage risk.
Abdominal massage is the clearest concern. Direct pressure on the abdomen during pregnancy can, in rare and extreme cases, risk harm to the placenta or uterus. Kaiser Permanente and multiple clinical sources recommend avoiding belly massage entirely during pregnancy. This applies whether you’re seeing a professional or getting a massage from a partner.
Deep leg massage carries a separate risk. Pregnancy puts the body into a state where blood clots form more easily. If an undetected deep vein thrombosis (a blood clot in the leg) is present, vigorous massage could dislodge it, potentially sending it to the lungs. A published case report highlighted this as a life-threatening scenario. For this reason, prenatal massage therapists avoid deep-tissue work on the legs and use only light, gentle strokes in that area.
Certain medical conditions make massage inadvisable without clearance from a provider. Clinical trials of prenatal massage have typically excluded women with placenta previa, premature labor, blood clotting disorders, and preeclampsia. If you have any of these complications, massage is something to discuss with your OB before booking.
Positioning and Comfort
How you’re positioned on the table matters more as pregnancy progresses. In the first trimester, most positions are comfortable and safe. By about 20 weeks, lying flat on your back can compress a major blood vessel (the vena cava), causing dizziness, nausea, and a drop in blood pressure. Prenatal massage therapists typically switch to a side-lying position at that point, often with bolsters supporting the belly and between the knees. The left side is generally preferred because it allows the best blood flow to the placenta.
Some massage tables have a cutout for the belly so you can lie face down, but many therapists prefer side-lying regardless, since the cutout can still put strain on the lower back and abdomen as the belly grows.
Benefits of Massage During Pregnancy
Far from being harmful, prenatal massage has documented benefits. Studies have found that massage during pregnancy reduces cortisol (the body’s main stress hormone), which in turn is associated with less excessive fetal movement and lower rates of premature birth. Women who received regular prenatal massage also reported less anxiety, less depression, and reduced leg and back pain.
If you’re considering prenatal massage, look for a therapist who is specifically trained in prenatal techniques. They’ll know how to position you safely, which areas to avoid, and how to adjust pressure appropriately. Many therapists and spas decline to work with clients in the first trimester, not because of any proven danger, but because the high natural rate of early miscarriage creates a liability concern. This policy, while understandable from a business perspective, has unfortunately reinforced the myth that first-trimester massage is risky.