Pregnancy brings about so much change—mostly wonderful changes, but a few that are less so. Sitting slouched with hunched shoulders feels comfortable. Standing up a little less straight may seem minor. However, if left unaddressed, poor posture will result in significant added stress on the body over time. Think of the difference in posture between one's own parents. Does your father stand straighter than your mother? Ever wonder why? What postural change did your mother undergo that your father did not? Ah-hah!
Initially, a baby's growth creates a slow shift in the mother's center of gravity. In order to accommodate the growing baby, the spine shifts in new directions -- a deepening of the reverse curve of the lower back, a more rounded upper back, and a shift forward in the head and neck position.
“The lovely actress Kiera Knightly comes to mind as someone who depicts this really terrible posture in an exaggerated way. Her neck is long, and it is easy to see how far forward of her body it is.” says Twin Cities Pain Clinic physical therapist Linnae Wagner. A slouchy teen can experience postural problems due to poor posture, but in pregnancy these changes are healthy and necessary to accommodate the growing baby. “For new mothers, this posture was your body’s response to a load of increasing force which offsets the center of gravity,” says Wagner. Theses changes allow a pregnant woman to continue to function in the upright position without literally being tipped over by the weight of the growing baby. Yet with the stresses of being a new mother after the birth of the baby there is little energy is left to focus on reversing the changes.
Secondly, the post-partum responsibilities result in more frequent bending and sitting on a spine with altered mechanics. The extra load of the baby inside is gone, but the spine needs time and encouragement to return to its previous state. Unless corrected, the result is continued slumped posture. Children stretch when their bodies cue them to do so - this stretches muscles needing to lengthen to keep up with growing bones. Reversing one's slumped posture will require a bit of stretching as well, but as busy adults we often ignore the impulses we have to stretch upon standing or getting out of a car. “Here in Minnesota, it's just too cold to stand outside in the parking lot and stretch before getting baby out of the car and back inside!” says Wagner.
With its altered mechanics, the spine is stressed with more frequent forward bending - picking up laundry, toys, and baby. Follow this with the rounded, slumped shoulders that develop from cuddling the baby and breast feeding and you have posture issues that need addressing.
The impact of these changes is both muscular and skeletal. “A misconception I often hear is that a woman will say, ‘all I need is to move and do some yoga.’ Yoga will address the outside issues of muscle length and tension, but it will not resolve the underlying skeletal issues,” said Wagner, PT. “For example, if you have a muscle spasm, it’s your body’s guarding mechanism. A nerve is telling that particular muscle to tighten. But we need to ask why this message is being sent to this muscle.” Stretching does not turn off muscle spasms for good. For that, one needs address the underlying tissue—turning off the message to the muscle telling it to remain tight.
If you are experiencing pain when trying to return to your former posture, or simply cannot do it, it may signal an underlying issue. Wagner recommends getting a movement-based evaluation. “Using the McKenzie Approach, I evaluate, classify and find the movement or position needed to return the spinal structure to healthy, pain-free state,” said Wagner, PT. “At Twin Cities Pain Clinic, we work with moms to help them self-manage their spinal health because we know they have busy lives.” Thus education for self-management is a large part of each patient encounter.
Here are four steps to help identify whether your posture needs a health care provider’s attention:
- Look at your standing reflection in a long mirror from the side to see if you meet good posture standards. Use a hand held mirror to see from the side.
The hole from your ear should fall over your shoulder, or the end of your collarbone.
Your shoulder should sit in line with your hip, and your hip should line up with your ankle bone.
- If you feel restricted when you bend backwards.
- If it feels like work to stand up straight.
- If bending forward is painful, or rising from the bent position or sitting is painful.
In order to alleviate the stress of so much forward bending, Wagner suggests this simple exercise (as long as it can be done without pain): sitting down, place hands on the small of your back and arch as far back as you can. Return to your upright position and repeat ten times. This can help correct slouching posture. Give yourself time to change back. If you have pain at rest or with movement, then it is likely time to get a referral to physical therapy from your provider. Be at your best with your new baby!
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Taking care of a new baby starts well before the baby is born. Good prenatal care – including a healthy diet, exercise, and abstaining from foods and activities that can harm the baby – helps ensure the health of both the mother and the newborn.
Most mothers-to-be already have a basic idea of how to eat well and encourage healthy fetal development. They know to follow the food pyramid and eat plenty of nutrients; to take nutritional supplements provided by their obstetricians, including folic acid; and to abstain from drugs and alcohol while pregnant and nursing. But doctors and nutritionists can give their pregnant patients an even more interesting list of pregnancy care tips and advice – guaranteed to grab your attention.
- Get 800 micrograms of folic acid daily before conception and 1,000 during pregnancy. Pre-pregnant and pregnant women need over twice the recommended daily value of folate for healthy cell growth and division. At 400 micrograms per serving, fortified cereals and vitamins are the best sources. Dark, leafy greens like spinach are also a great source at 100 mg per serving.
- Be careful with your seafood consumption. Avoid exotic fish like swordfish or shark with a high mercury content, and eat salmon and tuna in extreme moderation. Do not eat sushi, ceviche, or any other raw or undercooked fish.
- Beware of obscure animal products. Unpasteurized dairy products like brie or camembert cheeses can be harmful. Liver can also overload a pregnant woman’s system with vitamin A.
- Do not drink herbal tea without a doctor’s supervision. Many herbs – like red raspberry leaf – contain chemicals that can actually cause contractions!
- Avoid the cat’s litter box. Cat excrement can contain a parasite that can be harmful to the fetus. Have a family member or neighbor change the cat litter during your pregnancy, and wash your hands thoroughly after handling cats.
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