PMC Safety Rules 3 — Questions and Answers
Question 1: Which acupressure point is most commonly cited as contraindicated during pregnancy because of its labor-inducing potential?
- LI4 (Large Intestine 4)
- ST36 (Stomach 36)
- GB21 (Gallbladder 21)
- Both LI4 and GB21 (Correct answer)
Correct answer: Both LI4 and GB21
Both LI4 (located in the hand web space) and GB21 (top of the shoulder) are traditionally avoided due to potential uterine stimulation.
Question 2: A client at 10 weeks gestation is requesting deep abdominal massage. The therapist should:
- Perform light effleurage only on the abdomen
- Decline abdominal work entirely in the first trimester (Correct answer)
- Use moderate pressure if the client consents
- Refer the request to a physical therapist
Correct answer: Decline abdominal work entirely in the first trimester
Deep abdominal massage is contraindicated throughout pregnancy, and many protocols advise avoiding the abdomen entirely in the first trimester.
Question 3: What is the primary reason practitioners avoid prone positioning after the first trimester?
- Client discomfort only
- Compression of the uterus and reduced fetal blood flow (Correct answer)
- Risk of client falling off the table
- Difficulty accessing the back muscles
Correct answer: Compression of the uterus and reduced fetal blood flow
Prone positioning compresses the gravid uterus, potentially reducing blood flow to the placenta and harming the fetus.
Question 4: When documenting informed consent for a prenatal massage client, which element is MOST critical to include?
- Client's preferred music
- Acknowledgment of massage contraindications and risks specific to pregnancy (Correct answer)
- History of all prior massage sessions
- Preferred bolster placement
Correct answer: Acknowledgment of massage contraindications and risks specific to pregnancy
Informed consent must document that the client understands pregnancy-specific contraindications and risks before proceeding.
Question 5: Which of the following best describes 'supine hypotensive syndrome' in a pregnant client?
- High blood pressure triggered by lying on the back
- Drop in blood pressure caused by uterine compression of the vena cava when supine (Correct answer)
- Hypertension from excessive massage pressure
- Fainting caused by overheating during a session
Correct answer: Drop in blood pressure caused by uterine compression of the vena cava when supine
Supine hypotensive syndrome occurs when the gravid uterus compresses the inferior vena cava, reducing venous return and lowering blood pressure.
Question 6: Which trimester carries the highest risk of miscarriage, requiring therapists to exercise maximum caution and often obtain physician clearance?
- First trimester (weeks 1–13) (Correct answer)
- Second trimester (weeks 14–26)
- Third trimester (weeks 27–40)
- Risk is equal across all trimesters
Correct answer: First trimester (weeks 1–13)
The first trimester has the highest miscarriage rate, which is why many therapists require physician clearance before working with clients in this period.
Question 7: Essential oils should be used with special caution in prenatal massage because some are:
- Too expensive for general use
- Emmenagogues that may stimulate uterine contractions (Correct answer)
- Unable to penetrate the skin effectively
- Effective only on non-pregnant clients
Correct answer: Emmenagogues that may stimulate uterine contractions
Emmenagogue essential oils (e.g., clary sage, jasmine, rose) can stimulate uterine contractions and are contraindicated during pregnancy.
PMC Safety Rules 3
Which acupressure point is most commonly cited as contraindicated during pregnancy because of its labor-inducing potential?