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Updated: Feb 13

Preparing for birth involves activating and engaging both the body and the mind, often through bodywork and healing practices. In this piece, Carole Osborne, internationally recognized instructor of maternity massage therapy, discusses how prenatal massage can help increase bodily awareness, release critical birthing muscles, improve control of muscular tension, and assist with mental relaxation during labor. When taught to loved ones, prenatal massage can also provide an important avenue of emotional support for the mother to be.

As women, our physical flexibility and kinesthetic awareness equip us to actively participate in the process of birth. Muscle and joint pliability help ensure the advantages of optimal movement and positioning choices to actively birth babies.(Ricci, 2009) When hip joints are open, when adductors, hamstrings and calf muscles are supple, and when postural muscles are resilient, they respond more positively to the urge many laboring women have to walk, squat, rock, lunge, kneel, or stand during all or part of labor. To be ready for labor, any structure connecting to a birthing woman’s pelvis needs length and pliability. At the very least, women birthing vaginally must be able to open their thighs to allow the baby’s passage.

When specially trained massage therapists work with pregnant women, they safely use massage therapy methods to relax and reduce common prenatal discomforts in joints and muscles. The same techniques may also be effective in increasing flexibility. This is especially true of certain passive and assisted resisted stretching, deep tissue work, and other soft-tissue treatments. (Scheumann2007, Osborne, 2012)

Of course, many women enjoy exercise and stretching, finding these activities to be a safe and successful part of labor preparation. For these women, there are specific fitness or yoga programs led by instructors who specialize in prenatal training. The inclusion of some strengthening and aerobic exercise can help ready them for the athletic challenges of labor and birth. (Noble1,2003) However, there is great importance in consulting with a prenatal healthcare provider concerning their advisability of prenatal exercise, as well as massage therapy.

Through healing practices such as prenatal exercise and bodywork, there is huge potential to produce great benefits such as the awareness bond that is created within her body during this process. As a result of the “feedback loop” of the sensory-motor system, increased bodily awareness creates increased sensory awareness and control of muscles.(Juhan2003) Heightened familiarity with her internal landscape often  means a woman is more likely to make the labor journey with more ease, less pain, and with an adventuresome spirit.


“I believe that massage therapy helped me so much while I was pregnant. My body would relax, and I’d be so centered within myself and able to focus and go inside, which made a big difference during labor.” ~ Andrea


The variety of stimuli introduced by therapeutic bodywork and massage techniques is one way that this feedback loop becomes activated. There are modulations in depth, direction, and duration of touch, especially in Swedish, deep tissue, and reflexive modalities that most therapists use. Kinesthetic input varies with changes in speed, rhythm, and intensity of passive and active movements. All of these experiences create a rich influx of information and corresponding responses and awareness in the client’s body and mind. The result is heightened perception, new body understandings, and specifically localized awareness.

As a woman participates in prenatal massage therapy sessions, there are numerous opportunities for her therapist to help her connect with and express her physical awareness and her emotional flows. As she learns to more fully express her sensations and her needs as a client, she can improve her ability to more effectively communicate with her family and the labor professionals she employs. She is then more likely to be able to access her feelings and assert her needs during labor. Women with prior traumatic births or other physical and/or emotional histories of trauma often need particularly sensitive attention to learn effective expression. (Simkin 2009)

To birth with less effort, the musculature of the back, abdomen, and pelvic floor must remain relaxed to allow the uterus to labor without resistance. Relaxation in these areas allows the baby to press more firmly against the cervix. The laboring woman must scan for and recognize tension throughout her body. She must know how, through imagery, hypnosis, or conscious control, to release tension. Sometimes she must use specific muscles, such as the diaphragm, abdominals, or pelvic floor, in a precise, controlled manner. She can develop all of these abilities during prenatal bodywork. Education in diaphragmatic breathing, perineal self-massage, pelvic floor and abdominal strengthening are particularly useful in developing awareness and control in these vital birthing muscles. (Noble2003, Simkin 2013 )

Most clients gain self-awareness, relaxation and emotional support from receiving therapeutic bodywork and massage during pregnancy.(Field et al, 1997, 2004) This contributes to the development of a woman who is more able to access those inborn skills and intuitions that have evolved over the millennia of humanity’s existence and women’s experiences of giving birth(Samuels1996)


Teaching massage to partners and others who will attend a woman’s birth furthers their preparation for labor. These family or friends can accompany her to a session to watch and practice simple, yet effective massage movements. Some massage therapists teach a segment in a childbirth education class, a midwife’s preparatory classes, or organize separate classes for small groups of women and their loved ones to learn labor massage possibilities. Through education we can uncover the wisdom, skills and awareness within that has been waiting to emerge.

Become a doula. Click here to learn more about Birth Institute’s Holistic Doula program.

Adapted from Pre-and Perinatal Massage Therapy, Second Edition, pp 16 and 17, Carole Osborne, author.

Carole Osborne is an internationally recognized instructor of maternity massage therapy who has been in practice since 1974. Author of Pre- and Perinatal Massage Therapy, second edition, her course by the same name has prepared over 4000 massage therapists and other perinatal professionals for prenatal, labor, and postpartum work opportunities in a variety of settings. Her courses can be used for continuing education credit by nurses, doulas, and most massage therapists. She can be reached at or at (858) 633-3033  or (858) 277-8827. Her website,, has a resource section listing certified maternity massage therapists in the US, Canada, the UK and New Zealand.

Photo used with permission from Carole Osborne


  • Field T, Diego MA, Hernandez-Reif M, et al. Massage therapy effects on depressed pregnant women. Journal of Psychosometric Obstetrics and Gynecology 2004; 25:115–122.

  • Juhan D. Job’s Body: Handbook for Bodyworkers. 3sub  Edition. Barrytown, NY: Station Hill Openings, 2003.

  • Noble, E. Essential Exercises for the Childbearing Year, 4th ed., 2003 revision Harwich: New Life Images, 2003.

  • Osborne C. Pre- and Perinatal Massage Therapy, 2nd ed. Baltimore: Lippincott Williams &Wilkins, 2012.

  • Ricci S. Essentials of Maternity, Newborn, and Women’s Health Nursing. Second Edition. Baltimore: Lippincott Williams & Wilkins, 2009.

  • Samuels M, Samuels N. The New Well Pregnancy Book. New York: Fireside, 1996.

  • Scheumann  D. The Balanced Body. Baltimore: Lippincott Williams & Wilkins, 2007.

  • Simkin P. The Birth Partner, 4th ed. Boston: Harvard Common Press, 2013.

  • Simkin P. Early Trauma, Its Potential Impact on the Childbearing Woman, and the Role of the Midwife. Midwifery Today, 90, Summer, 2009.

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