Volume 5 • Issue 2 • 1000189
J Yoga Phys Ther
ISSN: 2157-7595 JYPT, an open access journal
Research Article Open Access
McCullough and Hughes, J Yoga Phys Ther 2014, 5:2
Commentry Open Access
Yoga & Physical Therapy
Reflexology use during Pregnancy
Julie EM McCullough* and Ciara M Hughes
Institute of Nursing and Health Research, University of Ulster, Northern Ireland, UK
*Corresponding author: Julie EM McCullough BSc (Hons) PGDip PhD, Institute
of Nursing and Health Research, University of Ulster, Shore Road, Newtownabbey,
Co Antrim, Northern Ireland, UK, E-mail: email@example.com
Received July 09, 2015; Accepted July 10, 2015; Published July 17, 2015
Citation: McCullough JEM, Hughes CM (2015) Reexology use during Pregnancy.
J Yoga Phys Ther 5: 189. doi:10.4172/2157-7595.1000189
Copyright: © 2015 McCullough JEM, et al. This is an open-access article
distributed under the terms of the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium, provided
the original author and source are credited.
Reexology is a specialist massage whereby controlled pressure is
applied to specic points, known as reexes, mainly on the feet, but also
on the ears, face, hands and back. Each reex is believed to correspond
to particular structures or organs of the body . By applying pressure
to these points the reexologist aims to promote homeostasis and, as
a result, restore and maintain physiological and psychological health
and wellbeing . e exact mechanism of action for reexology
has not yet been established; currently modulation of the autonomic
nervous system (ANS) [3-5] and the release of endorphins following
reexology  are the most popular hypotheses. However, due to
the lack of an established model for the theoretical and physiological
underpinnings of reexology, many health care professionals (HCP)
continue to question its credibility. Nevertheless, there is a growing
body of evidence to suggest that stimulation of certain reexes can
activate the corresponding regions of the brain [4,7,8]. Reexology
may be a valuable tool as studies have reported positive eects on
quality of life, stress levels and pain levels [9-14]. A recent study has
also reported that reexology reduced low back and pelvic pain (LBPP)
and associated disability during pregnancy . Reexology is a gentle,
non-invasive treatment which may assist maternity caregivers when
certain medications, interventions and procedures are contraindicated
due to advancing gestation. erefore, this report is intended to provide
guidance for reexologists, physiotherapists and other HCP regarding
the current knowledge available from research and experts concerning
the use of reexology during the antenatal period.
Reexology during Pregnancy
To date, there has been little research investigating the eects of
reexology antenatally. Concerns over its safety during pregnancy,
particularly during early gestation, have likely been a major factor
[16,17]. Complementary and alternative medicine (CAM) therapies
such as reexology are used, or suggested, by midwives and other HCP
for a range of pregnancy-related symptoms . Midwives are keen
to incorporate such therapies as they consider them safe, compatible
with the patient centred approach and the natural nature of pregnancy
and childbirth and that CAM “can enhance their own professional
autonomy” . Likewise, women use CAM therapies during pregnancy
as they also consider them safe, natural  and oer them control over
their pregnancy and labour  and as a method of pain relief . In
fact many investigations into the use of reexology during pregnancy
have been carried out in the intranatal period during uncomplicated
labour for pain relief [23-27].
When can women use reexology during pregnancy?
All reexology treatments should be carried out by fully qualied
therapists. It is a safe and enjoyable treatment to use during pregnancy
[15,25,26,28,29] however, as with many interventions, caution is
recommended during the rst trimester . Tiran  suggests that
this is not based on any evidence, but is a precautionary measure to
protect reexologists from legal action in the event of early miscarriage.
However, the following are regarded as contraindications to treatment
and should be observed:
• A history of unstable pregnancy [30,31];
• Hydramnios (excess amniotic uid) ;
• placenta previa (grade 3 or 4) [32,33];
• A risk of deep vein thrombosis (DVT) or pre-eclampsia ;
• Enzer  also suggests that diabetic mothers should check their
blood sugar levels before and aer treatments as reexology can
aect the hormone balance.
It is important for therapists to assess clients before each treatment
as “risk” is a dynamic factor and women can change from low to high
risk . erefore, advanced training in maternity reexology, along
with a thorough knowledge and understanding of the physiology
of pregnancy, is essential for reexologists to determine a client’s
suitability to receive reexology and how to tailor treatments to suit
Reexology research during the antenatal period has investigated
women with a range of pregnancy related ailments such as low back
and pelvic pain , tiredness  and ankle oedema , however,
no studies to date have been carried out in any high-risk pregnant
populations. erefore, each pregnant client should be considered
on a case-by-case basis with the involvement of their obstetric care
Many pregnant women who use CAM therapies, such as reexology,
fail to inform their maternity health care providers . erefore, it is
imperative that the use of reexology and its mechanism of action are
well understood so that midwives and other HCP can advise, discuss
and document pregnant women’s usage . It is also very important
for maternity reexologists to explain to clients the importance of
informing any other HCP from whom they are receiving treatment
and to obtain written consent from obstetricians and midwives prior to
treating women with a high risk pregnancy.
Tiran  and Enzer  agree that, due to the purported hormone
balancing eect of reexology, women who are undergoing fertility
treatment or have become pregnant following fertility treatment should
not have reexology until the pregnancy is well established. e drug
therapy involved in stimulating ovulation or assisted pregnancy is likely
to alter the normal hormone balance to facilitate release of the egg from
the ovary or assist the embryo implantation stage. erefore, reexology
may have a negative impact on this desired eect of fertility medication
Citation: McCullough JEM, Hughes CM (2015) Reexology use during Pregnancy. J Yoga Phys Ther 5: 189. doi:10.4172/2157-7595.1000189
Page 2 of 2
Volume 5 • Issue 2 • 1000189
J Yoga Phys Ther
ISSN: 2157-7595 JYPT, an open access journal
and such women would not be suitable to receive reexology in the rst
Further larger studies on how reexology can be best employed
for pregnant women are required to determine the eects on both
mother and baby [15,37] and to provide health care professionals and
reexologists alike with sound information on treatment options during
high- and low-risk pregnancy. HCP who wish to refer or recommend
reexology to their patients should recognise that;
• Reexologists require advanced training on how to eectively
and appropriately treat pregnant women and to provide tailored
individualised treatment that is safe and eective;
• Reexologists should recognise when and when not to treat a
pregnant women and may have certain criteria which renders
some women unsuitable for treatment;
• Consent to treat women experiencing a high-risk pregnancy
should always be sought from the woman’s maternity
health care provider.
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