What is pelvic girdle pain?
Some pregnant folks may develop pelvic pain in pregnancy. This is sometimes called pregnancy-related pelvic girdle pain (PGP) or symphysis pubis dysfunction (SPD).
PGP is a collection of uncomfortable symptoms caused by a stiffness of your pelvic joints or the joints moving unevenly at either the back or front of your pelvis.
Symptoms of PGP
PGP is not harmful to your baby, but it can be painful and make it hard to get around.
Pregnant people with PGP may feel pain:
Some pregnant people may feel or hear a clicking or grinding in the pelvic area.
The pain can be worse when you're walking, going up or down stairs, standing on 1 leg, turning over in bed or moving your legs apart.
How to manage PGP
Pelvic floor physiotherapist, Kirstie Gordon-Loiello, and I chat about why you may be experiencing pelvic girdle pain in pregnancy, and she shows a series of exercises to help manage the pain (at 09:10 in the recording).
In my prenatal yoga classes we do exercises to help you prevent and manage pelvic girdle pain as well as other discomforts that come along with pregnancy.
Kirstie graduated from McGill University in 2009, with a Bachelor of Science in Physiotherapy. Her first passion was in orthopaedic/sports therapy. After her son was born, she developed a keen interest in pelvic health, training in women’s health, with a special focus on post-natal therapies. Her dedication to these issues has motivated and directed her professional development in taking care of Mom as a whole.
Kirstie is a licensed member of the Ordre Professionnel de la Physiothérapie du Québec (OPPQ).
To contact Kirstie or book an appointment:
Back pain in pregnancy is one of the most common complaints I get from from my prenatal yoga students and birth doula clients.
While prenatal yoga is a great way to help relieve and manage chronic back pain, it is important to consult with a chiropractor that specializes in pregnant bodies to understand the exact nature of YOUR back pain, and to get treated by a specialist.
I recently interviewed Dr. Natasha Hayden, chiropractor, to better understand:
Why is low back pain so common in pregnancy?
As the uterus grows, the centre of gravity shifts. You may have noticed feeling ‘off balance’, tripping, or falling as early as the first trimester! This change in coordination may impact your biomechanics, which could cause stress on the muscles, ligaments, and joints of the lower back and pelvis.
In addition, we usually see an increase of the lumbar lordosis, or the curvature of the lower back becomes more exaggerated. This can be caused by tight hip flexors, particularly the psoas. When curvatures of the spine are outside of the ideal range, this can cause stress on the joints of the spine. Some increase in this curvature is expected in pregnancy.
Often, the head will also move forward, which makes it feel much ‘heavier’ to the shoulders. This may result in neck or upper back pain in pregnancy.
Relaxin is a hormone with several functions, starting at conception. One if it’s roles is to ‘relax’ or soften the ligaments in preparation for birth. Our ligaments act as static joint stabilizers, so often our dynamic joint stabilizers - the muscles - will tighten in response. Sometimes they overdo it! The piriformis tends to become tight, which can result in sciatica (pain that travels down the leg) and/or low back pain.
What you can do at home to help minimize back pain
While it’s important to check in with a prenatal chiropractor in pregnancy, it’s important to know there are a lot of things you can do at home to prevent or manage low back pain in pregnancy.
Think of it like going to the dentist… ideally, we brush and floss regularly at home. But we still check in with the dentist from time to time, preferably before we are in a crisis.
assess your workstation, especially your seat. Ideally, anyone working seated has access to a sit/stand desk, as research indicates that anyone working form a desk should spend at least 30% of their workday standing. Being able to vary your work position can be hacked, by using boxes and a second keyboard to switch it up from time to time. For seating, some pregnant folks find they prefer a kneeling style chair, as it ideally positions the pelvis. But a balance ball, or balance ball chair, might be nice to switch it up a little.
Yoga is fantastic in pregnancy, to address strength, balance, and flexibility. If you’re new to yoga, I would strongly suggest working with an instructor (virtual or in person) to ensure proper positioning in poses. If however you’ve practiced yoga for many years, you can probably jump into a self-guided prenatal yoga practice. Give yourself permission in pregnancy to do what feels good in your body, and to slow down.
Many enjoy swimming in pregnancy.
Birth fit is also a popular online option for fitness training in pregnancy, but many local options are usually available from someone specialized in prenatal fitness.
Quick reminder that if you exercise a lot, and especially in hot weather, you may want to add back in electrolytes that are lost with sweat, particularly if you’re experiencing muscle cramping. This can be done via nutrition such as coconut water or melons, or many powders and drops are available if that’s easier.
I think that every birth parent would benefit from pelvic floor physiotherapy in preparation for birth, and particularly for recovery after. Massage therapy may also be of benefit. Your prenatal chiropractor can help build out your birth care team.
She also considers herself to be a care coordinator, and is excited to connect practice members with resources and providers in the community to best support them in their health and wellness journey. When not providing hands on care, you can find her working on bringing sleep equity to individuals and communities through her work at Somnolence+ and Sleep Well Network.
To work with Dr Natasha you can contact the clinic via natashahayden.ca or follow her on instagram at dr.natasha.hayden.chiropractor
For more information on sleep wellness, visit somnolenceplus.com and look for the launch of Sleep Well Network in spring 2022
This week I approached this topic in my postnatal yoga circle. It was slightly uncomfortable for me, and possibly for some moms, but we did anyways, and I'm so happy we did.
We talk so much about our physical and mental health in the postpartum period, but why do we shy away from talking about sexual health? Probably because of centuries of societal programming...
One mom said at the end of our talk today: "I'm happy we discussed this, because it makes me feel less alone". And this, my friends, is exactly the point.
When we come together in a safe space, and allow each other to be seen and heard, without judgement, we can see a part of ourselves in others, which makes us feel less alone.
If you've just had a baby and don't feel like being physically intimate with your partner, you are not alone.
If your baby is 6 or 12 months old, and you still don't feel like being physically intimate with your partner, do you are not alone.
If you feel guilty about any of this, you are not alone.
It might be helpful for you to remember that your desire and drive for physical intimacy will have its seasons. Just because you are in a low season right now does not mean that it will always be that way. After Winter, always comes Spring.
If you haven't already, it might also feel good to have this conversation with your partner. Communication is key. What needs do you have that are not being met? What needs to they have that are not being met?
You might also want to consider: if you don't want to be, or can't be physically intimate with your partner, how can you connect or be intimate in another way? What is your love language, and how can you show your partner love without being physical?
And finally, if you've been experiencing physical pain during intercourse since having a baby, know that it doesn't have to be this way. A pelvic floor physiotherapist or sexological bodyworker can help.
Lets help break the stigma around talking about sexual health!
ps. If you are looking to join one of my online postnatal yoga circles you can get more info over here.
It is only now, after watching the miracle of life unfold countless times, that I marvel at how every one of my life experiences have prepared me to be a doula. My university studies in the sciences gave me a foundation in anatomy and physiology, my professional experience as a high school teacher honed my skills as an educator, and my yoga teacher training helped me cultivate mindfulness and trust. There are also my numerous world travels which gave me an appreciation for human culture and connection, and my athletic endeavors like running and rock climbing which taught me strength and discipline. My journey to becoming a doula certainly hasn’t been a straight one, but now that I have arrived at my destination, I can’t imagine myself anywhere but here.
Doula Training and Experience
I completed both my Maternal Support Practitioner (doula) training and Fertility Specialist Certification with Bebo Mia, a school based in Toronto which trains doulas worldwide. It was a comprehensive birth and postpartum training which included a local breastfeeding workshop and a child and infant CPR course. I have also completed a Labor and Birth with Spinning Babies workshop and I use the Spinning Babies techniques in all the births I attend. In addition to my doula certifications I have a 200 hour yoga teacher training, prenatal and postnatal yoga trainings, and I love to bring my experience as a pre and postnatal yoga teacher into my work as a doula. I enjoy supporting diverse families in Montreal in both English and French.
My Birth Philosophy
I believe that birth happens best when the birthing person feels safe, secure, and supported. This is what I aim to bring to all the births I have the privilege of attending. A sense of security in birth comes from developing a connection with me in our prenatal meetings, and developing trust in your body. By discussing any fears you (and your partner) may have, and empowering you with evidence based information, you will feel more confident and secure with me by your side, allowing your body to birth exactly as you were meant to. As each expectant parent is unique, I enjoy forming authentic connections with every client, while providing personalized and grounded support for your body, mind, and spirit. During birth I see myself as your (and your partner’s) guide; supporting and encouraging you to turn inwards, and to connect with your body’s inherent wisdom. Oxytocin (the “love” hormone; also the molecule depicted in my logo below 👇) is key before, during, and after birth, so I like to create opportunities for you to feel love and joy throughout your pregnancy, birth, and during the blissful postpartum period!