Having a baby need not wreck your back. Here are some simple things you can do make sure you stand tall and strong as a new mum!
Ng Min Li
Physiotherapist
Backache is one of the most common pains of pregnancy. One in two pregnant women will experience back pain at some point in their pregnancy and even after. Some women experience backache as early as the first or second month but the peak of the problem is reached between the fifth and seventh months.
There are three possible reasons why back pain may occur in pregnancy:
- Physiological effects
Because of the hormonal changes that occur during pregnancy, your ligaments are softened, making the joints more mobile and unstable, and hence more susceptible to injuries. This hormonal effect may last until four to six months after the baby is born.
- Mechanical effects
Carrying the extra weight of the baby in your womb also pulls your pelvis forward. This strains both the upper and lower back.
- Weak abdominal muscles
As the tummy enlarges, the tummy muscles become stretched and weakened. If your tummy muscles are weak, there is less support for your spine.
It's a good idea to maintain your posture and learn how to strengthen your weak muscles. If you do already suffer from back pain during pregnancy, these measures will also help relief the strain on your back.
Once you know how to manage back pain yourself, you will find it a less strenuous experience caring for your newborn - not to say getting back to the daily whirlwind of a career woman.
Check Your Posture
Your posture is the first thing you have to be disciplined about. Keep your spine in a neutral position - neither swaybacked nor too flat, as the pictures show.
When you stand, remember to:
- Stand tall. Hold your head high and look straight ahead.
- Keep your shoulders comfortably back and level with your hips.
- Keep your back in a neutral position. This means you should tuck your tummy up using your abdominal muscles, and tuck your bottom under using your buttock muscles.
- Wear flat or low-heeled and well-supported shoes to reduce the stress on your spine.
- Avoid standing for long periods - take breaks or change positions. If you can't, place one foot on a low stool, alternating your feet.
When you sit, remember to:
Avoid slumping forward. Use the back of the chair or a small cushion for support. Ensure that your thighs and feet are comfortably supported by a small stool if necessary.
When you lie down, remember to:
Avoid lying down flat on your back for long periods of time. It may compress your major blood vessels, resulting in decreased blood flow to your womb and your baby.
Lying on your side is more comfortable. Place a pillow under your head and one between your legs. As your pregnancy progresses, place a flat cushion under your tummy for support. Use a firm, supporting mattress.
When you get out of bed, remember to:
To get up from a lying position, first, bend your knees and roll over to one side. Next, push up with your hands into a sitting position and lower your legs over the side of the bed. Never twist your body as you get up. Getting up in this manner will reduce the strain on your back and tummy.
When you work, remember to:
Work at a suitable height. This reduces the strain on your back. Do not stoop over low surfaces while performing housework - raise the work surface or lower yourself.
When you lift objects, remember to:
Avoid trying to move heavy objects. If you find yourself holding your breath when lifting, the object is too heavy to lift on your own and ask for help. Before you lift, get close to the object and squat down, bending your knees, not your back. Keep you back straight and hold the object close to your body. As you lift, straighten you legs.
Get Some Exercise!
Exercising during pregnancy helps you stay healthy and can reduce some of the common discomforts of pregnancy such as backaches, constipation, fatigue, and swelling.
However, special care should be taken. Always consult your obstetrician before commencing on an exercise program. General safety tips are:
- Stop exercising if you feel pain.
- Stop exercising if you feel tired and never exercise to the point of exhaustion or breathlessness.
- Avoid any activity that causes overheating or raises you heart rate to more than 140 beats per minute.
- After the first three months, avoid exercise that involves lying on your back as this decreases blood flow to your womb.
Walking, swimming and cycling on a stationary bicycle can usually be performed safely. Don't go for contact sports.
Here are some simple exercises you can do in the privacy of your own home.
1. Pelvic Rocking
Get on your hands and knees. Pull your tummy in and arch your back, bring your chin to your chest. Next, reverse the movement. Repeat 10 times. This exercise can also be done in side-lying or sitting.
2. Abdominal Bracing
Get on your hands and knees, keeping your spine in its neutral position. Pull your belly button in towards your spine. Keep your back and pelvis still and keep breathing. Hold for 5 to 10 seconds and repeat 5 to 10 times. This exercise can also be done in sitting, standing or side-lying.
3. Pelvic Floor Exercises
The pelvic floor muscles form a sling across the base of your pelvis, providing support to the pelvic organs (uterus, bladder and bowel). During pregnancy and childbirth, they are stretched considerably and can become weak, which may lead to incontinence or prolapse. Therefore, pelvic floor exercises should be performed regularly before, during and after pregnancy (Bladder Control)
4. Calf Lunges
Calf stretches can relieve leg cramps. Stand facing a wall in a lunge position and place your hands on the wall at shoulder height. Keep the back leg straight with the heel on the floor. Hold the stretch for 10 seconds. Do not jerk. Repeat with other leg, doing 5 stretches each side.
Working On Your Shape After Childbirth
For a sense of continued wellbeing, and a sense of confidence, many women try to regain your pre-pregnancy shape after childbirth.
Rather than go for wraps and diet excessively, it is important that you make time for exercise. Three important areas that need to be strengthened are your pelvic floor, tummy and back. Besides the above-mentioned exercises, you can also add the following exercises to your exercise routine.
1. Pelvic Tilting
Lie on your back with your knees bent. Flatten the hollow in your back by rocking your pelvis backwards. Pull your tummy in to make it flat as you do this. Hold for 5 seconds and relax. Repeat 10 times.
2. Crossover Abdominals
Lie on your back with your knees bent. Raise one foot off the bed and push opposite hand against the knee. Hold for 5 seconds and repeat with opposite hand and knee. Do 5 to 10 times each side. Do not hold your breath.
3. Curl Ups
Begin this only if you have mastered the above exercises and abdominal bracing. Always precede a curl up with an abdominal brace. Lie on your back and knees bent. Place your hands on your thighs, and as you breathe out, pull your belly button in and gently slide your hands up your thighs, curling chin to chest and lifting your shoulder blades off the bed. Slowly relax back. This exercise should be done smoothly, taking three to four seconds for each repetition. Aim to do 5 repetitions or as many as comfortable, slowly increasing the number.
Other Exercises
Avoid strenuous activities for the first six weeks after birth. Pregnancy-related changes in your body persist for 4 to 6 weeks after delivery. Your body needs time to recover.
The muscles, especially the pelvic floor and abdominals, need gradual toning to provide support to your joints. Remember that your ligaments and other soft tissues are still affected by pregnancy hormones and your joints are still vulnerable to injury. Avoid high impact activities like running and impact aerobics.
The best exercises for this period are swimming, walking and cycling. A postnatal exercise class run by a physiotherapist can also help you get back to shape and prepare you for more strenuous activities.
Following approval from your doctor, normal levels of sports can usually be resumed 6 to 8 weeks after delivery or 3 months after a Caesarian Section. This should be progressed gradually within limits of comfort.
References:
- American College of Obstetricians and Gynaecologists. "Exercise during pregnancy and the postpartum period" ACOG Technical Bulletin, Vol 189, February 1994
- Polden M (1988): "Pain relief in obstetrics and gynaecology" In: Wells P, Frompton V and Bowdher D (eds) Pain Management in Physical Therapy, Appleton and Lange
- PDR Family Guide to Women's Health, www.pdr.net
- "Physiotherapy Advice and Exercise in Pregnancy" Public Health Division, Health Department of Western Australia, 1999
- "Advice and Exercises after Your Baby is Born" Public Health Division, Health Department of Western Australia, 1999
Date reviewed: 28 April 2000
