• Prevention and management of pain during pregnancy

  • Many women experience pain at some point during their pregnancy, often due to the changes in force and pressure through the body and the postures that come with it. Even though it is a very common thing, there is a lot you do to help reduce pain and enhance function for an easier pregnancy and less risk of post-partum issues.

    Studies have shown that about 33-50% of pregnant women report Pelvic Girdle Pain (PGP) before 20 weeks of gestation and that the prevalence may reach 60-70% in late pregnancy (Robinson et al 2010). This study also found that PGP in early pregnancy were significantly associated with disability and pain intensity in late pregnancy.

    So, as you can see, some degree of pain is very prevalent in pregnancy, as well as commonly worsening as the pregnancy progresses. Therefore, strategies to prevent or reduce pelvic girdle pain early, are so important, yet underutilized, due to the lack of knowledge surrounding them in the general public. Physios trained in pregnancy and post-natal rehab are well placed to provide this prehab (preventative rehab) approach. Preventing or reducing pain and increased stresses to the body during this time can also make it easier to recover following pregnancy and childbirth.

    It may be useful to see a physio with training in pregnancy and post-partum rehab early on in your pregnancy, to discuss strategies for prevention, as well as discussing good posture and breathing patterns. As every body and every pregnancy is different, it is important to have a one on one assessment and discussion surrounding this, however, here are a few tips to help with decreasing pain and disability during pregnancy.

    Pelvic girdle pain prevention tips:

    • Reduce or stop single leg activities – your physio can offer individualized guidance on this
    • Decrease wide stance leg exercises
    • Work ++ on correct breathing strategies and lower ab strength – this helps in so many ways!
    • Increase hamstring and gluteal strength
    • Use a support belt if needed – either a pelvic girdle belt (usually only if you have symptoms) or a belly support belt (to help your abdominal muscles hold the weight of the baby)

    It is also important to be mindful that a lot of prolapse actually occur during pregnancy, especially towards the later stages. Prolapse is something that isn’t talked about a lot, but it is important to be aware of it and what to do to prevent it.

    Tips to help prevent prolapse during pregnancy:

    • Stand tall/good posture
    • Good breathing technique – deep, full breaths and good rib expansion (a physio is well placed to help teach this)
    • Important not to strain, including when going to the toilet
    • Meditation and relaxation – helps to relax the pelvic floor. This is also very good in preparation for birth

    Also, a quick note on correct breathing!

    This sounds like such a simple thing, yet in fact many of us have a very poor breathing technique. Things such as poor posture have a huge effect on how we breath. During pregnancy, with an ever expanding abdomen, it gets harder and harder to take a good deep breath. Learning to breath correctly, using good rib expansion and muscle control, early on in pregnancy, can make it easier to continue good breathing throughout pregnancy, therefore having potentially less pain and chance of prolapse.

    This is just a short summary of things to be aware of to help you prevent pain and prolapse during pregnancy. And as I said above, every body and every pregnancy is different, so, I recommend that one off early session with a physio trained in pre and post-natal exercise, to discuss and teach strategies, and to therefore make pregnancy and post-natal recovery that bit easier.

    Post by Caitlin Clark

    Senior Physiotherapist and Postpartum Corrective Exercise trained physio