Part 2 of 6. Pregnancy massage is modification of techniques and body positions to meet the needs of women as they undergo changes during pregnancy and the postpartum period. In this blog, we will discuss the side lying position, also called lateral recumbent, which is often used for pregnant clients in all trimesters. We will also discuss research findings on this population.

Massage therapy reduced anxiety, improved mood, promoted sleep, decreased back pain (1,2) and leg pain, and decreased depression (1) in pregnant women. The American Pregnancy Association recommends sleeping on the left side (3) because it helps blood travel from the heart to the placenta and prevents the enlarged and heavy uterus from putting pressure on the liver.

Stacey (4) found a slight connection between women in late pregnancy who slept on their backs/right sides and stillbirth. While body positions used while sleeping many hours are not the same as body positions used when receiving a 30-, 60-, or 90-minute massage, it appears that the left side is the best side.

Once your client is on her left side, ask her to slide backward until both hips and shoulders are approximately 4 inches from the table edge. Placing your hands at the appropriate distance helps the client know when to stop sliding. This placement accomplishes two things. First, it is easier to massage the back when it is closer to the table’s edge. Second, it provides extra room in front of the client for pillows which will be placed on the tabletop.


Place the first pillow beneath the client’s head. The client’s wrist can rest on this pillow. The next pillow is placed in front of the client’s chest for the arm (i.e., arm not lying directly on the table). The next pillow is needed for the client’s leg (i.e., leg not lying directly on the table). Be sure that the upper & lower extremities are the same height (e.g., shoulder, elbow, and wrist at same height and hip, knee, ankle at same height). A small pillow or towel roll are used to support the opposite ankle. When done properly, the client’s spine is in a neutral position and not rotated. Having the upper hip, knee, and ankle aligned in the same horizontal plane also reduces overstretching of the sacroiliac joint. A properly supported side-lying position also stabilizes the client; she is less likely to roll forward or backward as pressure is applied during the massage.



When re-positioning the client, remove the pillows except the pillow beneath the head. Ask your client to slide toward the center of the table before rolling over (remember that the client is close to the edge of the table). Once the client has rolled to the opposite side and has slid back 4 inches from the table edge, place the pillows in their proper positions. Be sure to remove all pillows before asking your client to get up and get dressed.

Be sure to check out my pregnancy massage video to learn more about side-lying positioning, bolstering, and draping during pregnancy.

Note: The side-lying position offers a number of advantages for non-pregnant clients too. Frail or elderly clients can lie in this position to address the back and neck. This position is appropriate in situations when lying prone is not advised such as in cases of respiratory conditions and working on clients with catheters, colostomy bags, chemotherapy ports, or other medical/surgical appliances.

** The next blog will discuss massage therapy during the second trimester. **

Picture Credits:

Side lying and Draping photos courtesy of Susan Salvo’s “Mosby’s Pathology for Massage Therapists, 3rd edition”

Articles and Journals Referenced:

  1. Field, T. (2010). Pregnancy and labor massage. Expert Rev Obstet Gynecol. 5(2). 177–181.
  2. Field, T., Hernandez-Reif, M., Hart, S., et al, (1999). Pregnant women benefit from massage therapy. J Psychosom Obstet Gynaecol. 20(1). 31-8.
  4. Stacey, T., Thompson, J.M., Mitchell, E.A., et al. (2011). Association between maternal sleep practices and risk of late stillbirth: A case-control study. BMJ. 14;342:d3403

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Dr. Susan Salvo is a massage therapist, author, educator, researcher, explorer, and perpetual student. To learn more, check out the “About Susan” tab. You can contact Susan at