Prenatal massage in Palo Alto: what to check before you book

Yes, for a healthy, uncomplicated pregnancy. The American College of Obstetricians and Gynecologists (ACOG) answers the question with a plain yes and describes massage as a good way to relax and improve circulation.

The research points the same way, within limits. A 2021 review in the Journal of Clinical Medicine looked at 12 randomized trials of relaxation massage in pregnancy. Only 2 of them reported side effects, and those were minor and passing, such as tiredness after a session. Seven of the 12 trials left out women with complicated pregnancies or existing conditions, so the reassurance applies to uncomplicated pregnancies.

A high-risk pregnancy changes the order: talk to your doctor or midwife first, then book. MedlinePlus defines a high-risk pregnancy as one where you, the baby or both face more risk than in a typical pregnancy, and lists causes including a health condition from before or during pregnancy, a problem in an earlier pregnancy and being over 35. Check with your provider first if any of these apply:

No. ACOG names lying on your side as the best position for massage in pregnancy, and prenatal massage at W Spa is usually given that way, with pillows for support. You normally turn to the other side partway through so both sides are worked. Pillows typically go under your head, under your belly and between your knees, the same set-up ACOG suggests for sleeping on your side later in pregnancy.

ACOG notes that some massage tables have a cut-out for the belly so you can lie face down. The 2021 review is more cautious: it says pregnant women should not be massaged lying on their stomach, because many find it uncomfortable and it may get in the way of relaxing, and names lying on your side, or sitting, as the positions to use.

Lying on your back is best kept short. The review advises against staying on your back for long in pregnancy, to avoid vena cava syndrome, where the weight of the uterus presses on the large vein that carries blood back to the heart. Say so the moment any position stops feeling right.

Check with your doctor or midwife first, and tell us you are in the first trimester when you book. The research is thin for these weeks: the 2021 review reports that the women in its trials were all at least 12 weeks pregnant when the studies began.

ACOG also advises telling your therapist you are pregnant if you are not showing yet, which matters most in these weeks.

By the second trimester the lower back often starts to ache, and ACOG explains why: the growing uterus shifts your center of gravity and stretches the abdominal muscles, which changes your posture and strains your back. In the last weeks, your comfort lying on one side and your provider's advice set the limit.

Mostly the lower back, hips and legs, where W Spa's prenatal massage spends extra time. Tell your therapist where it hurts this week, because that tends to change as the pregnancy goes on.

Some areas stay light for safety reasons. The 2021 review advises against deep pressure on the legs in pregnancy, because of the higher clot risk and the chance of loosening a clot, while allowing gentle strokes to ease swelling. It also advises against massaging the abdomen. In a prenatal massage that usually means moderate pressure on the hips and back, light strokes on the legs and no work on the belly; if any stroke feels too firm, say so.

Mood, anxiety and back and leg pain, in small trials. Most of the studies in the 2021 review used massages of about 20 minutes, once or twice a week, between weeks 16 and 36 of pregnancy. In one trial, a University of Miami team led by Tiffany Field followed 84 depressed pregnant women from the second trimester; the women given two 20 minute massages a week by their partners for 16 weeks reported less anxiety, less depressed mood and less leg and back pain right after sessions.

The review also cites a meta-analysis of 4 trials that found a moderate effect on depressive symptoms, and all 4 came from Field's research group. Much of the evidence therefore rests on one team, and some of it on massage given by partners rather than by therapists. Read it as a sign that massage may help you feel better for a while, not as a promise about your pregnancy or your birth.

Book the prenatal massage instead, and mention any scent you would rather avoid. W Spa's aromatherapy massage blends essential oils into the massage oil and is a general relaxation massage; the prenatal massage is the booking built around pregnancy, with the side-lying set-up and the questions on this page.

The concern is the oils themselves. The 2021 review advises against highly concentrated essential oils during pregnancy because some are suspected of triggering contractions, while noting that massage with diluted oil, such as 2% lavender, has not been shown to cause side effects. The NHS asks pregnant women to tell their midwife, doctor or pharmacist if they use aromatherapy, and warns that not all natural remedies are safe in pregnancy.

The hot stone ($20), cupping ($20) and body scrub ($30) add-ons are paid ten-minute extras, not part of the prenatal massage. Ask your doctor or midwife before adding heat or suction during pregnancy.

How many weeks pregnant you are, then anything your doctor or midwife has flagged, then where it hurts. Mention these when you book on Fresha or by phone.

W Spa is at 441 Waverley Street, Palo Alto, CA 94301, half a block off University Avenue in downtown Palo Alto, and the phone is (650) 272-6881. We are open every day from 9:30 AM to 10 PM, and you can book prenatal massage in Palo Alto online through Fresha or by phone.

If you drive, there is street parking right outside, and the City of Palo Alto lists short-term downtown parking as free; posted signs show the time limit. Palo Alto Caltrain station is roughly a 10-minute walk along University Avenue.