Prenatal Massage in the First Trimester: Is It Safe?

If you are newly pregnant and wondering whether you can get a massage — you have probably already encountered this: most spas won't see you. Many massage therapists will turn you away. Some will say wait until twelve weeks. A lot of times there isn't an explanation of why.

It is confusing. And for a woman in her first trimester — already navigating nausea, exhaustion, anxiety, and a body that feels completely unfamiliar. The message that her body cannot be touched right now is the opposite of what she needs to hear.

I hear it all too often from my clients when I ask, "have you had a prenatal massage before?"...they respond, "yes, but I left feeling worse because they were scared to touch me."

Let's look at what the research actually says.

What the research says

Both the American Pregnancy Association and the American College of Obstetricians and Gynecologists (ACOG) agree that prenatal massage is safe. Pregnant women can receive massages at any stage of pregnancy — during the first, second, and third trimester. Science 

The American College of Obstetrics and Gynecology has listed and published the known causes of miscarriage, and massage — including foot massage — is not one of them. PubMed Central 

Ten to twenty percent of women miscarry within the first twelve weeks of pregnancy — that is seventy-five percent of all miscarriages. There is no research or evidence that links massage and miscarriage. The fear is understandable. The evidence simply does not support it. Science 

Hesitancy from many women to receive a massage, or from some therapists to give one during the first trimester, is typically rooted in misinformation and conflicting advice, both of which lead to confusion. Aspen Valley Health 

So why do so many therapists refuse?

The answer is not about evidence. It is about liability. Many facilities will refuse to offer massage to a woman who is still in her first trimester because of the increased risk for miscarriage associated with the first twelve weeks of pregnancy. But increased risk of miscarriage in the first trimester is not caused by massage — it is simply the statistical reality of early pregnancy. Miscarriages happen most frequently in the first trimester regardless of what a woman does or does not do with her body. MAMAZING 

The refusal to work with first trimester clients is a protective policy for the therapist, not a protective recommendation for the client.

What a licensed perinatal massage therapist does differently

There is an important distinction between a general massage therapist and a licensed perinatal massage therapist. A perinatal therapist has received specialized training in the physiological changes of pregnancy, trimester-specific contraindications, safe positioning, and the specific needs of a pregnant body at every stage.

That training matters enormously in the first trimester. There are genuine contraindications to be aware of — not because massage causes miscarriage, but because the first trimester body is navigating significant hormonal and physical changes that require a knowledgeable, attentive approach.

Before any session I take a detailed intake — understanding where you are in your pregnancy, whether there are any complications, what your care provider has recommended, and what your body is asking for. That information shapes every decision I make during the session.

What first trimester massage actually addresses

The first trimester is one of the most physically demanding seasons of pregnancy — and one of the least supported. Nausea, fatigue, breast tenderness, headaches, anxiety, and the profound disorientation of a body in rapid transformation are all common. And yet most women are told to simply wait it out.

Studies have shown that hormone levels associated with relaxation and stress are significantly altered when massage therapy is introduced to prenatal care. Hormones such as norepinephrine and cortisol are reduced, and dopamine and serotonin levels are increased — and these changes led to fewer complications during birth and fewer instances of newborn complications such as low birth weight. MAMAZING 

Your nervous system is already doing something extraordinary in the first trimester. It is building a human being. It is rewiring itself for motherhood. It deserves support — not twelve more weeks of waiting.

My approach to first trimester massage

I work with women across the full arc of pregnancy, including the first trimester. I approach early pregnancy sessions with care, attentiveness, and a thorough understanding of what the body is navigating.

I use lighter pressure than in later trimesters. I avoid specific pressure points that are contraindicated in early pregnancy. I position you for both comfort and safety. And I stay in close communication throughout — checking in with your body and adjusting as needed.

The goal of a first trimester session is not to fix anything or push anything. It is to offer the body a genuine moment of regulation, nourishment, and being held — at a time when it is working extraordinarily hard and asking for exactly that.

When to consult your care provider first

While prenatal massage is safe for most healthy pregnancies in the first trimester, I always recommend speaking with your midwife or OB before booking if you have any of the following: a history of miscarriage or pregnancy complications, bleeding or spotting, pre-term contractions, or any condition your care provider has flagged as high-risk. Your care provider's guidance takes precedence, and I am happy to work in collaboration with your broader care team.

If you are newly pregnant and your body is asking to be held, that request is valid. You do not have to wait.

Prenatal massage is available in Newark, Delaware, serving the Delaware, Pennsylvania, and Maryland tri-state area.

90 minutes · $210

120 minutes · $280

Book at thresholdbody.com

Monica Seligmann is a Licensed Massage Therapist, Prenatal Yoga Teacher, Doula, and Feminine Embodiment Coach based in Newark, Delaware. She is the founder of The Threshold Body — bodywork, yoga, and ritual for women at every threshold of womanhood.