College of Massage Therapists of British Columbia (CMTBC) Practice Exam

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What position is safest for treating a third trimester pregnant patient with swollen feet?

Supine with legs above the heart
Side-lying with legs above the heart
Supine with legs level with the heart
Side-lying with legs level with the heart

The correct answer is: Side-lying with legs level with the heart

The side-lying position with legs level with the heart is optimal when treating a third-trimester pregnant patient experiencing swollen feet. This posture alleviates pressure on the inferior vena cava, a large vein that returns blood to the heart, which can become compressed in the supine position as the uterus expands. This compression can lead to decreased blood flow to the heart and the lower extremities, potentially causing dizziness or discomfort. By positioning the patient on her side, particularly the left side, circulation is optimized while also reducing any risk of hypotension that can accompany supine positioning in late pregnancy. Maintaining the legs level with the heart helps minimize swelling by preventing fluid from pooling in the lower extremities, promoting better lymphatic drainage. This position also enhances comfort and safety, which are crucial during massage therapy for pregnant clients.