• Absolute Kinetics PT

Pregnancy and Birth Prep: Yes there are options!

While pregnancy can be an exciting time, it causes a lot of changes in the body that can leave the pregnant person in a lot of discomfort and pain. Because these changes are natural, I often hear people say things like “I just have to get through a few more months” or “There is no point addressing something that is temporary”. While I understand that pregnancy is temporary and that there are a million other things on a pregnant person’s plate, I want everyone to know that you do not have to live with all of these pains and that you can actually do a lot to promote a safe and healthy pregnancy that prepares you for birth.

I wanted to take this time to explain some of the most common things I address for my pregnant patients.

Low back/SI joint/Pubic Symphysis pain: This is probably the most common complaint we see in our pregnant patients. Because it is so common, people often feel they should just “deal with it” and that it is a normal part of the process. If you are having low back pain or pain in the SI joint, there are a million things we can do to address them. Some of the most common symptoms we see are:

- Pain/discomfort in the low back, especially after sitting or standing for a long period of time.

- Pain in lower spine/buttock area when standing on one leg, turning, or walking up and down stairs.

- Pain in pubic area with walking and standing on one leg.

- Pain increases as the day goes on.

Round Ligament Pain: The round ligaments are on either side of the uterus and support the uterus in its proper position. As the uterus grows, the round ligament stretches, and we often experience pain/discomfort, usually because the pelvis is not moving how it should be. The most common symptoms we see are:

- Intense stretching/spasming feeling in lower abdomen when rolling over in bed, coughing, sneezing, etc.

- It’s more common in the right abdomen but can occur on either side.

Stress Urinary Incontinence: The pelvic floor plays a part in bowel, bladder, and sexual function. There are many reasons as to why we see pelvic floor dysfunction in pregnancy, but in general, it can be explained by the sudden increase in weight on the pelvic floor girdle from the baby growing, which causes the muscles to work overtime. They can either respond by over activating and causing fatigue, or by stretching out. Either way, people will often experience:

- Urinary leakage with sneezing, coughing, and some physical activity.

- Pain with intercourse/insertion

Meralgia Paresthetica: This fancy word means “pain in thigh” and refers to an abnormal sensation from the lateral cutaneous femoral nerve. This nerve provides sensation to the outer side of the upper thigh. During pregnancy, the nerve can get stretched or irritated if it is not able to move or function properly. Because of this, most people experience symptoms like:

- Painful/abnormal sensation along the outer thigh.

- Feeling of water being poured down the leg.

Birth Preparation: There are a lot of things we can do to prepare the body for birth. There is a lot of evidence showing that conservative techniques such as perineal massage and pelvic floor muscle training can help decrease the rate of perineal tearing during vaginal births. Even if you have a planned c-section, pelvic floor muscle training has been shown to improve birthing outcomes for both vaginal and cesarean deliveries. If vaginal birth is the goal, we start to prepare the body for birth. There are a couple of ways we can do this:

1) Perineal massage: This technique is a manual intervention that aims to stretch the perineum in order to prime the structures for birth.

2) Breathing strategies: This training is a little different than the breathing strategies you will go over in a typical pelvic health session that is focused on training the pelvic floor. During vaginal delivery, it is important for the pelvic floor muscles to be able to “get out of the way” so that the muscles of the uterus can do their job. The goal of this technique is to help the birthing person find a strategy that allows this to happen.

3) Birthing positions: If your provider allows for different birthing positions (most do now-a-days), we are able to determine which positions allow your pelvic floor muscles to be the most relaxed.

All of these techniques and strategies have shown to provide improved birthing and postpartum outcomes. Perineal tearing, either from episiotomy or natural lacerations, can impact the function of the pelvic floor muscles and causes a lot of the postpartum pelvic floor muscle dysfunction we see in new parents.

If you are pregnant and are experiencing any discomfort or just want to be prepared for birth, we want you to know that there is help. Learn how pelvic health physical therapy can better help you through pregnancy and birth by contacting us and taking advantage of our free 10 minute consultation.

Blog post written by Dr. Tyler Kornblum, PT, DPT, ATC

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