It’s no secret that having a child (especially for the first time) means big changes in the lives of the new parents. But even before the baby arrives, big changes are already underway in the pregnant mother’s body—changes that usually make it possible for her to carry her developing child for nine months and to give birth safely when the time comes.

As a woman’s pregnancy progresses, the combined effects of these physical changes become clearer. Some may simply be awkward, inconvenient or uncomfortable while others can be very painful and even debilitating.

Since no two women experience pregnancy in quite the same way (and no two pregnancies are exactly alike), it’s impossible to create a comprehensive, one-size-fits-all guidebook. However, it is possible to describe in more general terms many of the physical changes that occur and to recommend ways that expectant mothers can help protect their health and maintain their quality of life. The remainder of this article will highlight some issues related specifically to spinal health during pregnancy and offer some useful suggestions.

Pregnancy is hard on a woman’s entire musculoskeletal system, but it’s particularly hard on her back. This is because of a combination of changes that adds to the stress placed on her muscles, bones, and joints while at the same time changing her posture and making her less stable on her feet.

• WEIGHT GAIN is one of the most obvious changes associated with pregnancy. While the amount of weight a woman actually gains can vary substantially, a woman with a normal BMI prior to becoming pregnant can expect to be carrying 25 to 35 additional pounds by the time she gives birth. This means that a typical woman (her average weight in the U.S. is 156 pounds) will be about 20% heavier when she delivers her child. That’s 20% more weight for her back to support.
• POSTURE also changes significantly as a woman’s pregnancy progresses. So not only is she carrying more weight over time, she’s also carrying it differently as her center of gravity moves forward. This shift places additional strain on the muscles and connective tissues of the woman’s lower back.
• PELVIC STRESS increases along with the baby’s weight throughout a woman’s pregnancy and often becomes more intense during the third trimester as the baby drops in anticipation of labor. This can trigger sensations ranging from general heaviness and pressure to debilitating pain. It can also result in additional postural changes and reduced activity.
• HORMONES that are released during pregnancy (including one appropriately called “relaxin”) make cartilage, ligaments and other soft tissues more flexible in preparation for childbirth. While this additional flexibility is critical when the big day comes, it can affect a woman’s stability when standing or walking and can also cause her joints—including those in her back—to feel “loose” or “wobbly”.

If you’re pregnant and experiencing pain in your back or pelvis, you should know that you’re far from alone. Between 57% and 69% of women complain of lower back pain during pregnancy and roughly 80% report pelvic pain of some sort. However, you should also know that there are some things you can do. Maintaining a healthy weight, paying attention to your posture and staying active can all contribute to a healthy, more comfortable pregnancy and an easier delivery. Consult your healthcare provider to find out which types of exercises might be most helpful to you in maintaining your strength and mobility at each stage of your pregnancy. A growing number of health clubs offer low-impact yoga and in-pool fitness programs designed especially for expectant mothers.

Managing the discomfort and aches and pains of pregnancy is important. However, many women (and too many healthcare providers) assume that these things are just part of the experience. Perhaps that’s why only about 32% of women report these types of symptoms to their primary doctor and only about 25% of primary doctors recommend seeking treatment for the pain.

The good news is that larger numbers of healthcare professionals are starting to recognize the value of chiropractic care and massage therapy in addressing pregnancy-related symptoms both before and after childbirth. Chiropractic treatments can be particularly effective for pregnancy-related back pain, with the majority of women reporting immediate relief or relief after just a few visits. In a small study of 17 women:

• Sixteen of 17 (94%) saw clinically important improvements in low back pain with chiropractic care.
• The average pain rating went down from 5.9 to 1.5 (on a scale of 0 to 10).
• It took an average of 1.8 visits and 4.5 days to get clinically significant relief.