PMC Trimester-Specific Protocols 3 — Questions and Answers
Question 1: Which specific area of the lower leg is considered a contraindicated deep pressure point during all trimesters due to potential stimulation of uterine contractions?
- Anterior tibialis muscle belly
- Medial aspect of the gastrocnemius
- Spleen 6 acupressure point above the medial malleolus (Correct answer)
- Fibular head lateral compartment
Correct answer: Spleen 6 acupressure point above the medial malleolus
Spleen 6 (SP6), located four finger-widths above the medial malleolus, is a traditional acupressure point associated with uterine stimulation and is avoided during pregnancy.
Question 2: A first-trimester client is in her 10th week of pregnancy and reports no complications. What is the most appropriate massage pressure level?
- No massage should be performed before 12 weeks
- Light to moderate pressure avoiding contraindicated areas (Correct answer)
- Deep tissue work is preferred to address musculoskeletal changes
- Only energy work such as Reiki is appropriate in the first trimester
Correct answer: Light to moderate pressure avoiding contraindicated areas
Light to moderate pressure is appropriate in the first trimester while avoiding contraindicated sites; blanket restrictions are not evidence-based.
Question 3: Which hormone released during massage is particularly beneficial for third-trimester clients experiencing anxiety and sleep disturbances?
- Cortisol
- Estrogen
- Oxytocin (Correct answer)
- Prolactin
Correct answer: Oxytocin
Oxytocin released during massage promotes relaxation, bonding, and improved sleep, which benefits anxious third-trimester clients.
Question 4: During third-trimester massage, why should the therapist avoid prolonged work in the supine position even with a wedge under the right hip?
- Supine position increases lumbar disc pressure more than side-lying
- Even a 15-degree tilt may be insufficient to fully relieve vena caval compression (Correct answer)
- The wedge position strains the sacroiliac joint ligaments
- Supine work stimulates the startle reflex in the fetus
Correct answer: Even a 15-degree tilt may be insufficient to fully relieve vena caval compression
A small wedge may not provide adequate tilt to fully decompress the inferior vena cava in late pregnancy, so side-lying is preferred.
Question 5: What is the recommended bolster placement for a second-trimester client positioned in side-lying for back massage?
- Bolster under the head only, with legs extended
- Bolster under the head and between the knees and ankles (Correct answer)
- Bolster under the abdomen to support the uterus
- Bolster behind the back to prevent rolling
Correct answer: Bolster under the head and between the knees and ankles
Bolsters under the head and between the knees and ankles align the spine and reduce hip and SI joint strain in side-lying.
Question 6: Which first-trimester complaint is most directly addressed through massage of the sternocleidomastoid and suboccipital muscles?
- Morning sickness nausea
- Breast tenderness
- Headaches related to postural changes and increased blood volume (Correct answer)
- Urinary frequency
Correct answer: Headaches related to postural changes and increased blood volume
Tension headaches in early pregnancy often result from postural shifts and increased blood volume, which can be relieved by cervical and suboccipital massage.
Question 7: A therapist notices pitting edema on both ankles of a second-trimester client that was not present at the last session. What is the appropriate response?
- Perform deep lymphatic drainage immediately to resolve the edema
- Note the change but continue the session normally
- Inquire about accompanying symptoms and refer to her provider if she also has headache or visual changes (Correct answer)
- Cancel the session and call emergency services
Correct answer: Inquire about accompanying symptoms and refer to her provider if she also has headache or visual changes
Sudden edema combined with headache or visual changes may indicate preeclampsia and warrants medical referral before continuing massage.
PMC Trimester-Specific Protocols 3
Which specific area of the lower leg is considered a contraindicated deep pressure point during all trimesters due to potential stimulation of uterine contractions?