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Pregnancy and Osteopathy

During pregnancy enormous physical, chemical and emotional changes take place over a relatively short period of time.  As your baby develops, there will be an increase in volume and weight held in front, making a number of distinct changes in the postural carriage of the body.  The centre of gravity moves forward.  To counteract this, the long erector spinae muscles (back muscles) begin working harder to hold the shoulders back and lift the tummy.  As a result, a dull backache may be felt from ischaemic muscles (lack of blood in the muscles).  The shape of the spine will also change with a deeper curve in the lower back (called lordosis) and the upper back can also curve backwards (called kyphosis).  This in turn can cause discomfort into the neck.

Along with postural changes and a distinctive waddle, after giving birth the abdomen disappears over night and the breasts may double in size and treble in weight.  The upper body is thrown forward and the resistance now in the back muscles is even greater.  Of course, as a mother, you will not be concerned with personal problems as your whole life centres on fulfilling the 24 hour demands of your baby.

The next few weeks are spent cradling your baby in the crook of your arm whilst nursing and feeding.  This change in posture causes a new set of muscles to be used.  Small muscles (that hold the arm in a bent position to keep the baby secure)  are internally rotated and the scapula (shoulder blade) will protract (bring the shoulders forward and curve the shoulders and upper back) placing them at an awkward angle.  In addition to causing upper back pain, there may also be pain in the front of the shoulders, arms and elbows, as the shoulder position is now restricted from a full range of motion.

The causes of back pain include:-

· The release of a hormone called relaxin causes an increase in the mobility of the joints.  This hormone assists during delivery to relax the tissues and joints to assist in the birth, but has an effect from conception.

· The weight gain during pregnancy has an effect on the spine.  Due to the centre of gravity moving forwards as the abdomen enlarges, there is a tendency to increase the lumbar spine curve, an adaptation made to accommodate this change.  This in turn puts additional stress on the back muscles and ligaments.

· Fatigue during pregnancy can often lead to poor posture which can also increase low back pain.

So how can Osteopathy help?

The safety of mother and baby is the osteopath’s first concern.  After a thorough assessment, osteopathic treatment may help to relieve the aches and pains caused by growth in size of the baby and the adaptations the mother has mad during her pregnancy.

Osteopathic treatment can ease some of the symptoms associated with pregnancy including:-

· Aches and pains (back pain, neck and shoulder pain, muscular tension)

· Groin, lower abdominal pain or pubic symphysis pain

· Nausea and vomiting

· Heartburn

· Sciatica

· Wrist pain

After birth it is advised that both mother and child return to see an osteopath for a check up and, if necessary, treatment.  Osteopathy after a pregnancy can:-

Ensure your body returns back to shape quickly

Help you regain your strength and flexibility

Check and correct any remaining strains in the back and pelvis

Treatment may be supplemented by exercises and other forms of self help which the osteopath may prescribe.  Useful tips:-

Standing – Good posture can reduce back pain.  Standing up straight and feeling that the baby is tucked into the pelvis decreases the strain on the lower back and improves the spinal posture.  You should also avoid transferring weight onto one leg for long periods of time.

Sitting – Make sure that your back is well supported, a small cushion or rolled up towel in the lower back may assist in maintaining the lumbar curve and avoid putting stress on the back muscles and ligaments.

Sleeping – Sleeping positions change during pregnancy due to the change in body shape.  Some women find it comfortable to lie on their side with a pillow under the bump and a second between the knees.  Lying flat on the back should be avoided.

Getting out of bed should be done by rolling onto one side, then pushing up through the arms into a sitting position.  The reverse to this when lying down, avoids abdominal strain.

Look after your back during pregnancy.  Take particular care when lifting and carrying – especially lifting or carrying other children.  Do not carry a small child on one hip for any length of time.

Buy a pram with handles at a comfortable height for you.