10 Top Tips During Pregnancy

Having gone through two pregnancies myself in the past three years I've had first hand and recent experience in dealing with the physical demands of pregnancy. Combining my own experience of back and pelvic pain with my knowledge and insights from my Physiotherapy practise I am able to offer you these ten top tips to help you cope.

Symphysis pubis dysfunction is another type of pelvic pain, commonly seen in association with low back pain in pregnancy and this article is also suitable for this pain condtion.  

1. POSTURE:

Your posture will change during pregnancy especially as your pregnancy progresses and as your baby grows. Your centre of gravity changes and moves more forwards, as such you tend to lean backwards to compensate for this and to avoid falling over. This can pinch the lower back region and make your back muscles work very hard which can lead to back pain during pregnancy.

When standing remember these tips:

• Head up straight & tuck your chin in slightly
• Shoulders back & your chest forward
• Knees straight but not locked
• Weight balanced evenly on both feet
• Lower tummy gently tightened which helps support your bump and flattens the lower back slightly
• Avoid standing in the same position for too long
• Alternate resting one foot at a time on an small elevated surface for short periods
• Take regular breaks from prolonged standing

Related article - Pregnancy Posture

The image above represents the natural tendency to lose good posture due to the increasing weight of the baby.

• Centre figure; displaying the problematic postural changes which are not desired
• Right side figure (3rd from left) shows the better way to stand; tucking your tummy muscles inwards and keeping shoulders high and slightly back.  

2. SITTING

Sitting can become uncomfortable during pregnancy and the things you perhaps once did without realising it can become awkward and challenging!

Follow these simple tips:

• Sit back in the chair with your bum touching the back of the seat
• As above, head level, back straight & shoulders back
• Knees at approximately right angles with your hips
• Feet flat on the floor, use a small foot rest if required
• Do not cross one leg over the other
• You may need a back support at the small of your back – a small cushion, rolled towel or a lumbar roll work well. Try a rolled towel first and see if this is comfortable
• Try to avoid sitting for longer than 20-30 minutes. Get up, move around, even if it is just to stand up at your desk

Going from sit to stand is important. Go to the edge of your seat, have equal weight going through both feet, lean forwards from your hips and use your arms to push yourself up while straightening your knees.

3. SHOES

Footwear is very important during pregnancy. A key element is to keep shoes broad with a low heel. Too high a heel can stress the lower back by increasing the arch in the back too much and the probability of falling over is also higher when pregnant. Wedge shoes are a good compromise and also a runner type shoe is good to wear around the house as they give good support and shock absorbency. Foot size may also change during pregnancy, especially around the fifth/sixth month, so this is important to bear in mind and wear the appropriate fitting shoes.

4. REST / PACING

It is important to keep up activity levels while pregnant but it is equally important to listen to your body and take time to rest. Pace yourself with activities, especially as your pregnancy progresses. For example, balance work with adequate activity levels, household chores and social events. Don’t try to do everything all at once, spread active events out.

5. OLDER CHILDREN

If you have older children, take care with lifting them, putting them into their car seats and the like. When lifting them, keep them close to you if possible, bend your knees & hips keeping your back straight and draw in the lower tummy which aids in supporting you.

6. LIFTING

As above, take care when lifting, even the smallest of objects. Use the same technique as outlined in point 5. Know your limits and it is okay to ask for help. It is essential! Also take care loading & unloading the dishwasher and washing machine. Apply the same principles for lifting and if necessary kneel down on both knees. It may take a little longer but it is better for your back and pelvis.

7. EXERCISE

It is safe to continue with your usual exercise programme and it is also safe to take up a low impact exercise regime during a normal non complicated pregnancy. In fact, it has been proven that exercise during pregnancy is effective in the prevention of low back pain.

Forms of exercise that are particularly good are walking, swimming and Pilates. Speak to your Chartered Physiotherapist about the best form of exercise that would suit your specific needs.

If you experience any of the following signs, you may need to stop exercising: feeling faint or light headed, vaginal bleeding, nausea or vomiting, strong pain especially from your back or pelvis and reduced movement of the baby.

Useful further reading - Exercise During Pregnancy

8. PELVIC PAIN IS NOT NORMAL

Pelvic pain and back pain are common during pregnancy but it does not make them normal. It is important to realise that these discomforts are not always issues you simply have to grin and bear. It is estimated that 50% of pregnant women will suffer from back pain during their pregnancy, and only 50% of these will seek advice from a health care professional. A thorough assessment with your Chartered Physiotherapist is essential to differentially diagnose the cause of the pain. Early identification and management gives the best outcome.

Further reading - Pregnancy Related Pain

9. WEAR A PELVIC BELT

Pelvic belts or sacro iliac joint belts are effective for preventing and treating back and pelvic girdle pain during pregnancy especially if you spend a lot of time on your feet during the day. I personally found the belt fantastic and on my second pregnancy it really helped prevent the degree of pelvic girdle dysfunction that I had suffered on my first pregnancy. It is important to get the correct size for you and to be instructed on how to wear it properly. Speak with your Chartered Physiotherapist about prescribing you with a pelvic belt.

10. CHANGING POSITIONS

It is important to change position in the correct manner which can prevent back pain. If you have pain being mindful of the way in which you alter your position can avoid aggravating it.

The following are some key points:

Getting out of bed

• Roll on your side keeping the knees together as you roll towards the edge of the bed. Use your arms to push yourself up to a seated position while you slide your legs to the ground.

Sit to stand

• Scoot to the edge of your seat. Feet hip width apart and slightly behind knees. Have equal weight go through each foot, lean forwards from your hips and use your arms to help you to stand up

Take care when stepping off a step or the like. To slip while pregnant can have an impact on the pelvis and can be a cause of pain.

Further reading - Pregnancy & Exercise

Conclusion

If you have severe back pain, contact your health care provider and you may be prescribed with appropriate medication for pain relief such as paracetamol.

It is also important to bear in mind that back pain might be a sign of pre-term labour.

If your back pain is associated with other symptoms such as vaginal bleeding, fever or a burning sensation during urination there may be an underlying problem that would need to be investigated and addressed.

If you are worried about your pain, contact your health care provider immediately. The above tips are guidelines only and cannot be specific to each individual.

by Lorraine