Maternity Reflexology Client Consultation Form

Please complete and submit the consultation form below:



  • 1. Placenta praevia - placenta is lying unusually low in the uterus, next to or covering the cervix
    2. Placental abruption - placental lining has separated from the uterus of the mother prior to delivery. It is the most common pathological cause of late pregnancy bleeding.
    3. Bleeding
    4. Continuous Vomiting
    5. HELLP Syndrome - life-threatening liver disorder
    6. Toxaemia: Pre-Ecclampsia – Ecclampsia - high blood pressure and often a large amount of protein in the urine. Usually occurs in the third trimester
    7. Pica Syndrome and DVT – Deep Vein Thrombosis.

  • Diabetic mother
    Cardiac disorders – heart disease
    Chronic Hypertension
    Previous pregnancy problems – miscarriage
    Mother under 20 or over 35
    Asthmatic mother
    Exposure to drugs
    Previous multiple births
    Suspected RH negative mother or other genetic problems