Differences between regular and pregnancy massage

Differences Between Regular and Pregnancy Massage

The question I get asked most frequently is “What’s the difference between a regular massage and a pregnancy massage?”  I get it, the differences are sometimes subtle, so let me break things down for you!

The three main differences between a general massage and a prenatal massage are:

1) Treatment Goals

2) Positioning and

3) Pressure

There are a few more specific differences when it comes to massaging women who are experiencing a high risk pregnancy, but I will save discussing those for a different post.  Read on to learn more about those three differences between pregnancy and regular massage therapy!

Treatment Goals

During a regular massage, RMT’s are often working with a dysfunction (for example, a sprained ankle or a back injury).  Treatment goals are typically focused on rehabilitating the area and restoring the patient’s normal function so that they can return to their usual activities of daily living (ADL’s) quickly and comfortably. 

If the patient’s dysfunction has become chronic by the time they seek massage therapy, then the goal is to restore as much function to the area as possible and assist the patient with adapting their biomechanics to prevent further injury.  This usually means that the patient can continue their ADL’s, but perhaps in a different way or at a different frequency than they used to.  For example, a recreational athlete who has recovered from a torn ACL may need to switch from running to cycling or swimming, but they can continue a fitness routine.

Pregnancy, on the other hand, is not a dysfunction.  In fact, it is exactly the opposite.  It is the normal, physiological reproductive function of human beings (and other mammals too!).  Therefore, pregnancy massage treatment goals are all about supporting the woman’s body as it progresses towards childbirth and manifests the normal changes related to pregnancy.  A good example is that swelling of the hands and feet during pregnancy is completely normal due to the additional blood and fluid volume that support a growing fetus.  Therefore; an RMT’s treatment goal is to help move that fluid towards the core so it can be filtered and excreted.


During a regular massage, the patient will most likely be lying flat on the table, either face up (supine) or face down (prone).  Depending on the patient’s preferences and their physical presentation, their RMT may add some cushioning and support under the chest or abdomen when the client is face down.  

During a prenatal massage however, the mom-to-be requires custom cushioning and support depending on a variety of factors.  Her overall body shape, her belly size, how far along she is in the pregnancy, and what makes her feel the most comfortable. 

For a prone treatment, the massage therapist must create space for mama’s tummy in the center of the treatment table by using either a special pregnancy table, or a pregnancy cushion system like the one I use.  I prefer the cushion system as the configuration can be changed to accommodate any length of torso and belly size. 

For a supine treatment, the RMT needs the ability to incline the head end of the table and elevate the legs at the bottom of the table.  Rarely can expecting mothers lie flat on their backs beyond the first trimester because of pregnancy induced heart burn or compression of the blood vessels of the pelvis.

In addition, some mamas are uncomfortable in either prone or supine positioning and instead prefer to be side lying for their treatment.  In this case, her RMT will need enough bolsters and pillows to tuck between her knees, under her belly and under her head to keep her from tipping onto her tummy or onto her back.


During a regular massage, the depth of pressure that an RMT chooses depends on two factors; the patient’s pain tolerance, and the tissue’s tolerance.  Most clients can handle deep pressure; some (myself included) really love it.  Unless they are an infant or elderly, the muscle and joint tissue of a non-pregnant patient can also handle deep pressure.  It is firm and stable, yet pliable enough to really get in there.  After all, I subscribe to the philosophy that you have to actually be touching the muscle fibers to have a therapeutic effect.  It is a delicate thing to find the right balance between hard enough to work the deeper muscles without traumatizing the superficial skin, fascia and blood vessels.

During pregnancy massage, the therapist has to modify their pressure because moms-to-be just can’t take as much.  Women can become more pain sensitive during the first and third trimester due to increased hormones.  Their joints and connective tissues are purposefully looser because of circulating relaxin but they also become less stable.  Some muscle tension is necessary to add additional support to counteract that instability.  This means that her RMT needs to be more aware of how much pressure they use and be able to lighten it several times in the same treatment depending on the goals and areas of focus.  I find that listening closely to mama’s reactions and checking in several times each treatment are my best tools for making sure I am providing the appropriate pressure.

So there you have it; the techniques and performances may be the same, but there are some subtle yet significant differences between regular massage therapy and pregnancy massage.  To find more information  about either of them, or about the other services I provide, please visit my massage therapy services page, or contact me.