Reflexology is used for various pregnancy-related complaints. A three-armed, pilot randomized controlled trial assessed the changes in physiological and biochemical stress parameters. Ninety primiparous volunteers experiencing low back and/or pelvic girdle pain (LBPGP) received either six reflexology or footbath treatments or usual care. Primary outcome data included pain intensity and frequency measured on a visual analog scale (VAS), and salivary beta-endorphin and cortisol levels. About 68% women completed the intervention. A clinically important reduction of 1.63 cm occurred for VAS pain frequency after reflexology. Beta-endorphin levels increased by 8.8% and 10.10% in the footbath and usual care groups, respectively and decreased by 15.18% for the reflexology group. Cortisol increased by 31.78% in footbath group, 31.42% in usual care and 18.82% in the reflexology group. Reflexology during pregnancy seems to have a role in reducing LBPGP, and associated stress. The findings are published in Complementary Therapies in Clinical Practice.