The flattening of your back, and the hormonal changes that happen in pregnancy, can cause the joints of your back and pelvis to move more. The muscles of your back, tummy and pelvic floor are designed to move and support the joints of your back and pelvis. But as your uterus (womb) grows, it can become harder for them to do their job, and this can cause irritation and pain.
Your back is slightly protected by your baby, who acts as an internal support, but this also makes you less flexible. As your baby grows, your back will feel stiffer, and bending forward and twisting from the waist will be harder to do.
Your pelvis isn’t protected in the same way, and moves more. It’s affected by the pregnancy hormones oestrogen and relaxin. These make the tough, pliable tissues that connect your bones (ligaments) more stretchy. This is one reason why pelvic pain is more common than back pain during pregnancy.
How can I protect my back and pelvis in pregnancy?
Avoid heavy lifting
If you have to lift or carry anything, hold it close to your body. Bend your knees, not your back, and try not to twist. When shopping, carry a bag in each hand. Or use a rucksack, which helps back muscles to work better.
Keeping fit and supple through gentle exercise is good for you, and can help to prevent back and pelvic pain. However, don’t overdo things. Being fit before you are pregnant won’t prevent pelvic pain from happening but if you exercise three times a week or more once you become pregnant, and throughout your pregnancy, you’ll be less likely to experience a lot of pain.
The best forms of pregnancy exercise include swimming, walking, cycling on an exercise bike, exercising on a large gym ball, aquanatal classes, pilates or yoga.
Wear comfortable shoes
Just wear what feels best. If you are used to very high heels and swap to flats, you may feel uncomfortable at first.
Improve your posture
Stand as if someone is making you taller by pulling a string attached to the top of your head. Tighten your pelvic floor muscles, and your tummy muscles will help to support your back.
Pelvic tilting can ease back strain caused by sitting or standing for long periods. When sitting, slowly work your pelvis back and forth rhythmically, without moving your shoulders, so your back becomes round, and then arched.
If you have pelvic pain, focus on the forward tilt, where you stick your chest and bottom out.
The flatter back that pregnancy causes may be one reason why so many women develop pelvic pain. Try to bend backwards regularly, particularly when you have been sitting down or bent over for a long time.
Don’t put on too much weight
Having a high body mass index (BMI) makes you more likely to develop back and pelvic girdle pain during pregnancy. Though you shouldn’t go on a diet in pregnancy, try to limit how much weight you gain. Eating a healthy, balanced diet, and exercising regularly, should help you to maintain a healthy weight.
Get into a good sitting position
Make sure that your back is well supported when you’re sitting down. You could use a cushioned support (lumbar roll) that fits over the back of your chair. Ideally, your back should be slightly arched, with your breasts pointing straight ahead, rather than down towards your bump. Part your legs slightly, to allow for your bump.
Using a birth ball encourages good posture and makes pelvic tilting easier. Sitting upright in a dining chair will help your back more than lounging in a soft chair or sofa. If you have to sit for long periods at work, try to get up and walk around every 20 minutes.
Adopt a good sleeping position
Once you reach 16 weeks of pregnancy, lying on your back when sleeping can make you feel faint. That’s because your baby is pressing on your blood vessels. Try lying on your left, with your knees bent up, with two or more pillows placed between your knees. This keeps the pressure off the muscles around your hips and pelvis. A supportive mattress and pillows are essential and can make a real difference. Get advice on what may be best for you, refer to a tempur mattress guide or visit a bed specialist.
Having rest is important, but so is keeping active. Sleeping or resting for more than eight hours has been linked to new mums having more persistent back and pelvic pain after having their baby.
How can I make day-to-day activities easier?
When you are standing from a sitting position:
- Do a few pelvic tilts.
- Sit on the edge of the chair, with your back arched, and your chest sticking out.
- Part your knees and lean forward, so that your nose is over your knees, keeping your back straight.
- Stand by pushing up with your arms, moving your head forwards and upwards, and keeping your back arched.
This method holds your back and pelvic joints locked in their most stable position.
Turning over in bed
If you are lying on your back and need to turn to your right:
- Arch your lower back, and tighten your pelvic floor muscles and lower tummy muscles.
- Bend your left knee up, turn your head to the right.
- Take your left arm over to the right of your body.
- Hold on to your bedding or mattress and pull with your left hand, taking your left knee over to the right.
- Bend your knees up as high as they will go.
Reverse this to turn to the left. If this still causes you pain, pull your parted knees up to your tummy and roll over to the side, keeping your knees as high as you can.
Getting out of bed
Try rolling onto your side. Bend both knees up as high as you can and then drop your feet over the edge of the bed. Push yourself up sideways, keeping your knees up for as long as you can. This locks out the pelvis, causing you to feel less pain.
Taking care during pregnancy can ensure you put all of your pack pain behind you.