When you are pregnant, it seems like there is a never ending to-do list of things to get ready for baby; suddenly you find yourself spending many evenings lost in an internet hole researching something you never thought about before such as the most life-like nipple for a bottle, or some kind of weird mobile made in Sweden (where all the babies are happiest, right?). And then there’s the nursery, all the childbirth and infant care classes, and of course, picking out a name for your tiny human. It can be overwhelming!
Preparing the pelvis, a part of the body which plays a pretty integral role in childbirth, isn’t always found on those to-do lists. Yet, preparing your pelvis is pretty important in getting your baby in an optimal position for birth (more than just head down) as well as crucial for aiding in alleviating pelvic pain during pregnancy and labor.
If you are anything like me before I started learning about all this stuff, you may not have the most intimate relationship with the structure of your pelvis. Let’s take a look at a picture:
The pelvis is made up of three bones, the two on the sides and the triangular like bone wedged in the middle called the sacrum, a bone you probably hear your yoga teachers mentioning a lot in class. There are also three joints, the two sacroiliac joints (often referred to as SI, you may hear someone complain of SI pain, that means there is most likely an imbalance or misalignment with their sacroiliac joints) and the pubis symphisis, the joint at the front of the pelvis where the two halves meet. The harmony and alignment of these bones and joints is essential for pelvic health.
There are also many ligaments in the pelvis which work to help support the structure by connecting it to muscles. The ligaments with the most important job during pregnancy of course are those that attach the uterus to the pelvis. The Broad ligament holds the uterus from the back, attaching it to the sacrum and the two Round ligaments hold the uterus from the front, attaching to the pubis.
During labor, the bones in the pelvis will shift naturally to make room for baby, and throughout your pregnancy the ligaments are relaxed due to hormones, mainly relaxin. Great, so what do you need to prepare for if the body naturally opens up?
Well, if the bones and ligaments are misaligned before labor begins, the ligaments can pull on the uterus, leaving it imbalanced. Even though the uterus is connected to the pelvis, it still can move. An imbalance in the uterus can affect baby’s ability to move into an optimal position for birth, as well as even cause the birth canal to narrow, and guess what that most likely means: more pain.
In general, in the body, imbalance = discomfort and sometimes misalignments can lead to injury. Much of the time when a woman is experiencing pelvic pain during pregnancy or labor, it is because of a misalignment in the pelvic joints, ligaments, or bones. Luckily, there are ways to combat this, and prepare the pelvis.
Yoga is one helpful tool. Yoga is not the magic cure all for imbalances in the body, but it can certainly help!
Yoga poses to help align and prepare the pelvis
Pelvic tilts help soften and stretch the overworked pelvic joints as well as help to release strain from low back muscles. We do these a lot in prenatal yoga classes, they feel good! Practicing cat and cow or just pelvic tilts in general is also a great way to encourage your baby into a good birthing position by encouraging the little one’s heaviest parts, the back and back of the head, towards mama’s belly. You may hear these poses being recommended to help turn babies who are in a posterior position (face up) or breech (feet or butt first).
You certainly want to encourage hip mobility during pregnancy, and that will help to keep that natural openness, as well as stretch the psoas and help release pelvic ligaments that may be overly tight or even slightly torqued. However, do be aware that you are already naturally more open due to relaxin (hormones as mentioned earlier) and that being too open or over stretching can certainly cause imbalance in the pelvis as well, i.e. pain, so be sure to engage your muscles during hip openers, especially the abductors (outer hips). To do this, think about drawing the outer hips inwards, like someone put their hands on the fleshy part of your hips and are gently hugging in. It is also important to engage the core (especially lower abdominal muscles and pelvic floor muscles). A helpful visualization to find that engagement is to imagine you are zipping up a tight pair of jeans, and the low belly goes up and in.
Hip openers that may feel good to you during pregnancy include standing poses such as warrior II, side angle pose (no need to go to your deepest side bend here) and goddess or temple pose (a wide leg squat). Malasana (yogi squat) is also great, using support under the pelvis may feel most balancing and supportive (you can use blocks or a bolster, or books or pillows work too) and easier to access muscle engagement.
Pigeon can also be nice, but do use support under your hips if necessary, and if you are suffering from SI pain, this pose is contraindicated since it can only deepen the imbalance if not practiced correctly. If in doubt, just ask a yoga teacher if you are doing the pose correctly!
Agnistambhasana, or double pigeon is also a good hip opener to practice. If you are going to fold forward, try sitting up on a blanket or two to encourage your pelvis to tilt forward which will keep the lower back muscles from straining and causing pain.
It is likely that if you are pregnant, at least one person has told you that you should be doing kegels (contracting and releasing the pelvic floor), and this is certainly true. Pregnancy and labor can weaken and stretch pelvic floor muscles, and you certainly need then to push, as well as to stabilize the core. The pelvic floor makes up the bottom (the floor) of your core. I once read somewhere that pregnant women should be doing around 200 kegels a day. This might seem a little crazy, but it illustrates the importance of strengthening the pelvic floor. In yoga, this is called mula bandha, and is an action that is helpful to find core engagement in arm balances and many other poses. To do this, imagine your pelvic floor is an elevator, and as you inhale, try to relax. As you exhale, feel the elevator lifting, (or, think of the action of trying not to pee), inhale again and relax, but this time not quite fully. And then continue up to 200. Just kidding, you do not have to do 200, just as many as you can is good enough.
Besides yoga, bodywork can be helpful for finding pelvic balance and preparing for labor, as well as just being very aware of your posture as you stand, sit, and walk around, avoiding slumping. Practicing breathing into your diaphragm is great to.
To sum it up, in case this got too technical for you: a happy, balanced pelvis = less pain and discomfort and aids baby in doing their job which is getting into the best position for getting them out here. Balance is both support and open. Gotta have both. That’s why it’s called balance!