PMC Trimester-Specific Protocols 2 — Questions and Answers
Question 1: During the second trimester, which position is generally considered safest for prone massage?
- Prone with a specially designed pregnancy bolster cutout (Correct answer)
- Standard prone with extra padding under the abdomen
- Supine with knees elevated
- Side-lying with a pillow between the knees
Correct answer: Prone with a specially designed pregnancy bolster cutout
A pregnancy bolster with an abdominal cutout allows second-trimester clients to lie prone safely without compressing the uterus.
Question 2: Which of the following symptoms, if reported by a first-trimester client, is a contraindication requiring immediate physician clearance before massage?
- Mild morning nausea
- Vaginal bleeding or spotting (Correct answer)
- Lower back fatigue
- Breast tenderness
Correct answer: Vaginal bleeding or spotting
Vaginal bleeding in any trimester is a red flag that requires medical evaluation before massage can safely proceed.
Question 3: Why is deep abdominal massage contraindicated throughout all trimesters of pregnancy?
- It causes excessive relaxation of the uterine ligaments
- It risks direct pressure on the uterus and developing fetus (Correct answer)
- It increases progesterone levels too rapidly
- It triggers premature labor by stimulating the lumbar nerves
Correct answer: It risks direct pressure on the uterus and developing fetus
Deep abdominal work can apply harmful direct pressure to the uterus and fetus, making it contraindicated throughout pregnancy.
Question 4: When working with a second-trimester client in left lateral recumbent position, what is the primary benefit of this positioning?
- It prevents supine hypotensive syndrome by relieving aortic compression (Correct answer)
- It maximizes access to the lumbar spine for deep tissue work
- It reduces round ligament pain by shortening the ligament
- It improves respiratory capacity by expanding the right lung
Correct answer: It prevents supine hypotensive syndrome by relieving aortic compression
Left lateral recumbent positioning relieves compression of the inferior vena cava and aorta, preventing supine hypotensive syndrome.
Question 5: A third-trimester client reports sharp, shooting groin pain when turning over on the table. Which structure is most likely responsible?
- Piriformis muscle
- Round ligament (Correct answer)
- Inguinal ligament
- Iliopsoas tendon
Correct answer: Round ligament
Round ligament pain is common in the third trimester and is triggered by sudden movements that stretch this ligament.
Question 6: Which massage technique is most appropriate for addressing edema in the lower extremities during the second trimester?
- Deep cross-fiber friction
- Effleurage strokes directed toward the heart (Correct answer)
- Petrissage of the calf muscles
- Tapotement over the dorsum of the foot
Correct answer: Effleurage strokes directed toward the heart
Light effleurage directed proximally (toward the heart) encourages lymphatic drainage and reduces pregnancy-related edema.
Question 7: At what gestational age does the risk of supine hypotensive syndrome typically become clinically significant, requiring positional adjustments?
- 8 weeks
- 14 weeks
- 20 weeks (Correct answer)
- 28 weeks
Correct answer: 20 weeks
The uterus becomes large enough to compress the inferior vena cava in the supine position around 20 weeks gestation.
PMC Trimester-Specific Protocols 2
During the second trimester, which position is generally considered safest for prone massage?