In the best-case scenario, a woman will prepare her body for pregnancy before she actually conceives, says Dr. Teresa Green, a licensed chiropractor at Chiropractic Health and Wellness Center in Richmond, Va. “It’s like a marathon. You’d never just show up the day of the race and run it—you’d prepare for it,” she says. “Pregnancy really should be the same way. It’s a whole different ballgame for your body to carry that much weight concentrated in your core.”Green recommends toning spinal stabilizer muscles ahead of time with yoga and Pilates so they won’t be so taxed by the burgeoning baby bump. “The key to strengthening the spine muscles isn’t repetitive movements, like when you do bicep curls,” she says. “It’s getting into a pose and holding it for a period of time.”
Yoga poses that target these muscles include the Warrior poses, Superman, Opposite Arm-Leg, and Cat and Cow. Later, take a prenatal yoga class, which strengthens muscles, alleviates pain and reduces stress—and ensure you’re practicing safely as the pregnancy progresses. Green also likes a quick but effective thoracic roll exercise with a foam roller, which can usually be done until the third trimester and then resumed after the baby is born.
Dr. Lisa M. Valle, D.O., a board-certified obstetrician/gynecologist and a laborist at Saint John’s Health Center in Santa Monica, Calif., also recommends her patients adopt healthy diets and exercise regimens beforehand and start their pregnancies at an ideal body weight. “The risk factors for having back pain during pregnancy are being overweight or having a prior history of back pain,” she says. “You want to do things that alleviate back pain if you already have it. I usually recommend yoga, sometimes Pilates, lots of walking and stretching—basically trying to be as physically active as possible. That helps a lot of patients in terms of how well they cope while they’re pregnant.”
DURING: Preventive care during those 40 weeks
As Green mentioned, weight gain around the middle of the body contributes to a lot of the poor posture and pain associated with pregnancy. A woman’s center of gravity changes, and she may round her shoulders or pull her head and neck slightly forward to compensate and maintain her balance, which stresses the lower and upper back and neck.
In addition, pregnant women produce the hormone relaxin, which relaxes the ligaments, joints and muscles of the hips and pelvis. This allows them to stretch to accommodate the growing uterus and ready the birth canal for delivery. As a result, women often feel achy and even wobbly and off-balance, causing them to alter their posture and head position as a counterbalance.
Later in the pregnancy, simple, everyday movements and activities become even more challenging—and potentially painful. Green and Valle recommend the following:
- Even if you can, don’t sit straight up in bed and get out. (The same goes for non-pregnant people.) Instead, roll onto your side, swing your feet off the bed and use your hands to push your body up—not your back or neck.
- Sleep on your side—ideally your left side, which, according to the American Pregnancy Association, increases the flow of blood and nutrients to the placenta. Side-sleeping, especially with a pillow between your legs and under your abdomen, can reduce back and hip pain. Avoid sleeping on your back or stomach.
- Wear the right shoes. Pregnant women can still look chic, but it may be time to bid a temporary adieu to the Jimmy Choos. High heels can further affect a pregnant woman’s posture, so keep the heel as low as you can go. If you still need to look professional, Green recommends footwear by Sofft and Cole Haan.
- Minimize long periods of sitting or standing. Consider converting to a standing desk at work, if possible, as standing puts less strain on the back than sitting. If sitting at a desk is a must, you may need to adjust your chair’s height and lumbar support, use a different chair temporarily, or add a pillow behind your back. Make sure the seat pan of any chair allows knees to be at a 90-degree angle to the legs and legs at a 90-degree angle to the pelvis. Take a break every 30 minutes to either rest or get up and move.
AFTER: Post-pregnancy back care
Even after you get the go-ahead from your physician to start exercising, don’t overdo it in a rush to lose the baby weight. Start slowly by walking and practicing gentle yoga and Pilates, Valle says. And don’t be surprised if back pain lingers for months afterward.
In fact, posture problems and pain can be exacerbated by the new challenges of caring for a newborn. For starters, Green says, there will be a lot of bending and lifting of the baby in and out of bassinets, cribs and car seats. When bending, avoid rounding and twisting the back, which is what many parents do when trying to gingerly place a sleeping baby in her crib. Instead, maintain an almost 90-degree angle from the spine to the hips and legs. Squat rather than bend whenever possible.
Breastfeeding can contribute to back and neck pain, as well. Even as your abdomen shrinks, the breasts’ milk production can add significant weight to the front of the body. When nursing—and also bottle-feeding—mothers tend to look down at their babies throughout the duration of a feeding as a way to bond and connect. “The head-down activity repeatedly is really stressful on the neck and upper back,” Green says. “What I usually suggest is maintaining eye contact while getting the baby settled and latched on, but avoid a continued head-down position through the entire feeding. Take breaks to let your head rest back on the chair or couch to help your neck muscles not be so strained.”
Even though it’s convenient to carry babies to and from the car in their car seats, Green recommends avoiding this as much as possible. “It’s so terrible for your body to carry that weight down one side,” she says, “particularly for a mother who’s recovering from being pregnant and then having the shift with the milk production and her abdomen changing. Put the baby in a stroller or carry the baby instead.”