Every so often, I get a new prenatal massage client who takes their first look at my massage table, then they say, “Oh, I thought you had one of those tables with a hole in it”.
Yes, such a thing exists. There are some massage tables that have a hole or some other indentation cut into them to allow extra room for a belly and/or breasts to extend beyond the flat edge of the table when lying face down. You might look at this and say “Great! Perfect for prenatal massages! Who needs their back worked on more than pregnant women?” And when I first started in massage school, I agreed. - I even started saving up for one of those tables. Then I got some real training.
Every massage therapist should come out of massage school with a basic knowledge of how to do a prenatal massage without hurting the mother or baby. However, there is a difference between a basic education and a specialist with advanced training. One of the first things I learned when pursuing my over 80 hours of advanced prenatal and infant massage certifications was that those table holes are not only not recommended, they can actually cause more harm than good.
How? Well, the human body is not stupid. Since we learned to walk upright, our bodies have learned to adapt to the forces around us, including gravity. The laws of gravity say that a heavy object will pull straight down to the center of the earth. When a pregnant woman’s belly begins to grow, there are muscles under and around the belly, particularly one known as the broad ligament, that knows to grow not only out, but also slightly down, working with gravity to support the growing belly. Now take that belly that is growing out and down, and pivot it 90 degrees as if the woman is laying flat on her stomach. The contents of that belly aren't a solid mass - things move in there, so when the stomach is then put at an angle to be affected by gravity, that heavy belly will be pulled straight down and the ligament that is designed to grow out and down, is now being pulled straight out and up. This can cause a strain on that ligament and ultimately more pain in the belly, hips, and low back.
The second reason this type of table is discouraged is because those holes are a universal size, shape, and location. Pregnant women are not a universal size or shape. The chances that that hole is going to properly fit every pregnant woman are slim to none, so how exactly is squeezing yourself into a hole not made to fit you comfortable (or safe)?
These reasons are why I use a side-lying position with specially designed pillows, bolsters, and wedges that allow a woman to relax in a more natural position with everything properly supported without adding any extra strain to anything. I can still get to the back, shoulders, and every body part that needs work without causing the already tense and strained muscles any more problems.
So why do those tables exist if they cause so many problems? Well, the purpose they were designed for is to allow people with that basic training to work on pregnant clients without having to alter their routines or work with a very limited knowledge of how to do a proper prenatal massage. They are especially found in spas where the therapists are instructed to do massages a certain way within a certain time frame, so the tables allow things to stay “as is” without having to add time to the massages, or provide the need for extra equipment or therapists with special additional skills. They are basically an excuse for therapists who don't have advanced skills to charge more for a "specialty service" without having the skills to back them up. Will those tables cause problems for every pregnant woman? Probably not. However, for something so specialized as a pregnancy massage, do you really want to take a chance? You probably should want to look into a therapist that has the skills and training to do the massage correctly, not what is easiest.
Think of those tables like iPhoto. iPhoto allows you to do some very basic editing of pictures, take away red eye, blemishes, crop, etc. They can take a so-so photo and make it ok and it is a fabulous tool for that. But if you are getting married, and need a professional photographer, what would you think if they only used a cell phone and iPhoto for your wedding pictures? You would probably prefer to hire a photographer that had a real camera, multiple lenses, and used photo editing software that would make the average person’s head spin. Prenatal Massage is the same. You could see a therapist that has a tool to make the job 'easy', or you hire a professional who knows what they are doing in depth and the end results between the two will be very different. There is a difference between “giving a pregnant woman a massage” and “Providing a prenatal massage for a pregnant client”. The difference lies in the skills and training of the therapist as well as the tools used. Leave the holes to donuts.
Side note - I know that there are alternatives to both side-lying positions and table holes such as body-positioning systems and so called “Preggo Pillows” both of these solutions claim to also allow pregnant women to lay face down, but also provide more customized and more moveable support to prevent the strain and other issues I’ve spoken about above. There isn’t as much research on them, however this is where I use personal common sense. When a pregnant woman is laying face down, even with support, she is laying ON her baby - with her whole body weight. Even with support, add in the pressure of the massage on her back, and it can’t seem good for the baby - or comfortable for the mom. However, I know therapists and women who have sworn that these systems are fabulous so I can’t condemn them the way I do table holes, but looking at simple physics and having been pregnant myself and knowing how it feels to 'roll over' on the baby, I personally would never recommend those systems.
Prenatal massage can help the pain that comes with being pregnant - a lot. But just like everything else in the world, products are created to monetize and capitalize on solving problems without actually needing the skills to solve the problem. The health care world is no different. So before you schedule your next appointment in massage - or anything else relating to your health for that mater, don't get blinded by what fancy or trendy tools will be used, but do your homework then decide for yourself if something that looks trendy is the best thing for your health and comfort.
Don't believe me? Here is more info to back me up:
