Prenatal Massage: Getting Comfortable on the Table
One of the first questions about prenatal massage positioning is simple: How am I going to lie on the table? At Sacramento Massage Studio, the answer is usually supported side-lying, with enough pillows and bolsters that you are not balancing on one hip or holding yourself in place. Getting comfortable is part of the treatment, not something you are expected to figure out once you arrive.
Supported Side-Lying Is More Than Lying on Your Side
Your head and neck are supported, a pillow or bolster is placed between your legs, and additional support can be added beneath your belly, behind your back, or under your top arm. The exact setup depends on your height, where you are feeling tension, and what feels good that day. Side-lying keeps direct weight off the abdomen while still giving the therapist good access to the back, shoulders, hips, glutes, and legs. Cleveland Clinic notes that prenatal massage is typically performed side-lying, with pillows and firm cushions used for comfort and alignment. [1]
Why We Do Not Use Belly Cutouts
Why We Do Not Use Belly CutoutsA belly cutout can sound perfect because it lets a pregnant client lie face-down in a familiar position. We do not use them, but not because every form of supported face-down positioning has been proven unsafe. A small 2018 pilot study found that carefully supported prone positioning was feasible for short periods, even late in pregnancy. However, participants were in the position for only five minutes on a purpose-designed pillow, and the researchers called for larger studies over longer periods. [2] A cutout is also a fixed shape, while bodies and pregnancies are not. Side-lying lets us adjust each point of support separately instead of asking the belly, chest, hips, and low back to fit one opening.
Switching Sides Without Losing Privacy
About halfway through the massage, the therapist will usually help you switch sides so both sides of the body can be worked. The pillows and bolsters are moved and rebuilt around you, and you can take as much time as you need to turn over. Your therapist keeps the sheet and blanket secure throughout the change, and only the area being massaged is uncovered. Switching sides also keeps one hip or shoulder from carrying your weight for the entire session.
Sometimes Face-Up Still Works
Depending on the stage of pregnancy and how your body responds, we may also do part of the massage face-up with support behind your back so you are inclined rather than lying completely flat. As the uterus grows, extended time flat on the back can place pressure on major blood vessels and may cause lightheadedness or discomfort. Even a modest incline can reduce that pressure. [3] We make that decision case by case, and we change the position immediately if it does not feel right.
Your Body Gets a Vote Every Time
The setup that felt perfect at one appointment may not feel right at the next. The same is true of pressure. Focused work around the shoulders or hips may feel wonderful one day, while tenderness or swelling may call for slower, lighter work another day. We adjust the pillows, bolsters, draping, position, and pressure throughout the massage. Prenatal massage is not a standard massage with the belly accommodated. It is a session built around the body that is on the table that day.
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References
- Cleveland Clinic. (2025). “Considering a Prenatal Massage? Here’s What To Know.”
- Dennis, A. T., Hardy, L., & Leeton, L. (2018). “The prone position in healthy pregnant women and in women with preeclampsia: A pilot study.” BMC Pregnancy and Childbirth, 18, 445.
- Cleveland Clinic. (2024). “Is It Really All That Bad To Sleep on Your Back While Pregnant?”
Tag: Prenatal Massage: The Hip and Low Back Problem
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