During pregnancy, several areas of the body should be avoided or treated with extra caution during massage. The abdomen is the most important area to skip entirely, but specific pressure points on the ankles, hands, shoulders, and lower legs also carry risk. Deep pressure on the calves is potentially dangerous due to increased blood clot risk. Here’s a detailed look at each area and why it matters.
The Abdomen
This is the clearest restriction. Deep massage on the abdomen during pregnancy can risk placental or uterine injury, and a systematic review in the Journal of Clinical Medicine states plainly that pregnant women should not be massaged on the abdomen. Light, gentle touch on the belly (the kind you’d do yourself at home) is different from therapeutic massage pressure, but most trained prenatal therapists will avoid the area altogether to be safe.
Inner Ankles and Lower Legs
The inside of the lower leg, about four finger-widths above the ankle bone, is home to a pressure point traditionally known as Spleen 6. It sits where energy pathways connected to the uterus and reproductive organs are believed to intersect. In traditional Chinese medicine, stimulating this point is thought to trigger uterine contractions, and it’s actually used deliberately during labor to help things progress. For the same reason, it’s considered one of the most important points to avoid before you reach full term.
A second point sits behind the outer ankle bone, in the small dip between the bone and the Achilles tendon. This point is also traditionally used to promote labor and is avoided during pregnancy for the same reasons. The practical takeaway: avoid firm, sustained pressure around both sides of the ankle bones and the lower few inches of the leg.
Deep Calf Massage
This one has nothing to do with pressure points. Pregnancy puts your body into a state where blood clots form more easily, a natural protective mechanism for childbirth that also raises the risk of deep vein thrombosis (DVT), particularly in the legs. A clot can sit in a calf vein without obvious symptoms. If a massage therapist applies deep pressure to a leg with an undetected clot, the clot can break free, travel to the lungs, and cause a pulmonary embolism, which is life-threatening.
A published case report documented exactly this scenario: a pregnant woman received leg massage, and an undetected clot dislodged during the session, causing sudden breathing difficulty and cardiovascular collapse from a massive pulmonary embolism. The authors concluded that deep leg massage in anyone with potential DVT is contraindicated, and that pregnant women are at inherently higher risk. Light, gentle strokes on the legs are generally considered safe, but deep tissue work on the calves is not worth the risk during pregnancy.
The Webbing Between Thumb and Index Finger
The fleshy spot on the back of your hand between the thumb and index finger is another traditionally forbidden pressure point during pregnancy. Known as Large Intestine 4, it’s considered one of the most potent points for stimulating uterine contractions, and it’s commonly used in acupressure to help induce labor at full term. Firm, sustained pressure here is what matters. A casual hand massage or brief touch isn’t the same as targeted, deep stimulation of the point.
It’s worth noting that research on this point has produced mixed results. Studies using electrical stimulation at this point on pregnant women before surgical procedures failed to cause miscarriage, and animal studies found no increase in pregnancy loss. So the risk may be more theoretical than proven. Still, most prenatal massage therapists avoid sustained deep pressure here as a precaution, especially before 37 weeks.
The Tops of the Shoulders
The midpoint of the upper shoulder, roughly halfway between the base of the neck and the shoulder joint, contains a pressure point in the thick trapezius muscle. This point is traditionally believed to have a strong downward-directing effect that can stimulate uterine contractions. Prenatal massage therapists typically use only light pressure across the tops of the shoulders rather than the deep kneading that feels so good when you’re not pregnant.
The Lower Abdomen and Sacral Region
The lower abdomen just above the pubic bone contains another traditionally restricted point, and the sacral area (the flat bone at the base of your spine, between the hip bones) has several points along it that are also avoided. These points are believed to strongly influence the reproductive organs and promote contractions. While gentle sacral massage is commonly used during labor itself, deep pressure on the sacrum and lower back during earlier stages of pregnancy is typically avoided or kept very light.
What About First Trimester Massage?
Many massage therapists refuse to work on clients in the first trimester entirely, and you may have heard that massage can cause miscarriage. The evidence doesn’t support this. A thorough review of the research found no published evidence that massage causes miscarriage, and no study has specifically identified a physiological mechanism by which massage could interfere with early pregnancy. First-trimester miscarriage is common (occurring in roughly 10 to 20 percent of known pregnancies) and happens for chromosomal and developmental reasons unrelated to external touch.
The reason many therapists avoid the first trimester is liability, not science. If a client happens to miscarry shortly after a session, the therapist could face blame despite no causal connection. If you want massage in your first trimester, the same body-area restrictions above still apply, but the massage itself isn’t inherently dangerous to the pregnancy.
Positioning Matters Too
Where you lie during a massage matters as much as where you’re touched. After the first trimester, lying face-down on a flat table puts strain on the lower back, compresses the lumbar spine forward, and stresses the ligaments supporting the uterus. Lying flat on your back is problematic too: the weight of the uterus presses on the large vein that returns blood to the heart (the inferior vena cava), which can drop your blood pressure and reduce circulation to both you and the baby.
Side-lying is the safest position throughout pregnancy. A good prenatal massage therapist will have you lie on your side with pillows supporting your belly, between your knees, and behind your back. Some therapists use special tables with a cutout for the belly, but even these can create strain on the lower back and uterine ligaments if they don’t fit properly. If your therapist doesn’t offer side-lying positioning, that’s a sign they may not have specific prenatal training.
Choosing a Prenatal Massage Therapist
Not all licensed massage therapists are trained in prenatal work. Look for someone who has completed specific coursework in pregnancy massage, sometimes listed as “Bodywork for the Childbearing Year” or a prenatal massage certification. A trained prenatal therapist will automatically know which areas to avoid, how to position you safely, and how to adjust pressure throughout the session. They’ll also know when massage is appropriate and when underlying conditions (like preeclampsia, placenta previa, or a high-risk pregnancy) mean you should skip it entirely.