İhsan ErenCat–camel
Get on your hands and knees. As you breathe out, slowly round your back upwards; as you breathe in, bring your back to a flat position, without letting your lower back sag. It is a soothing movement for low back pain.
8–10 reps2 in 3Women who have low back pain in pregnancy (more than two in three)
1 in 5Women who have pelvic girdle pain in pregnancy
150 minWeekly moderate-intensity exercise ACOG recommends in pregnancy
21%Reduction in new sick leave for low back and pelvic pain with exercise
Low back pain or pelvic girdle pain?
In pregnancy, hormones make your ligaments looser, your centre of gravity shifts forwards as the baby grows, and the load on your lower back and pelvis increases. Low back pain is felt in the lower part of your back. Pelvic girdle pain, on the other hand, is felt at the front over the pubic bone or at the back in the buttocks; it gets worse when you walk, climb stairs, stand on one leg or turn over in bed.
The pain may get worse as pregnancy goes on, and it can have a marked effect on work, daily tasks and sleep.
Everyday tips
- Keep your knees together when you turn over in bed.
- Lie on your side with a pillow between your knees.
- Sit down to put on your trousers and socks.
- Take the stairs one step at a time, and do not carry heavy loads.
- Avoid standing on one leg for long periods and crossing your legs.
- Wear supportive, low-heeled shoes.
What does exercise do?
According to a Cochrane review, more than two-thirds of pregnant women have low back pain and about one in five have pelvic girdle pain. In a meta-analysis of 11 studies involving 2,347 pregnant women, exercise during pregnancy slightly reduced the risk of low back pain and cut new sick leave due to low back and pelvic pain by 21%; however, it did not prevent pelvic girdle pain. For pelvic girdle pain, tailored exercises, changes to daily activities and, when needed, a support belt are planned together.
The American College of Obstetricians and Gynecologists (ACOG) recommends 150 minutes of moderate-intensity exercise a week in uncomplicated pregnancies. Swimming, water exercise and a stationary bike are among the options that put the least strain on your body.
Later in pregnancy, lying on your back for long periods can make you dizzy. That is why the exercises below are done lying on your side, sitting, standing or on your hands and knees. Talk to your midwife or obstetrician before you start exercising.
Exercises at home
Six safe exercises in pregnancy
Move slowly and stay within a pain-free range; avoid wide steps and movements that spread your legs apart, as these make pelvic girdle pain worse.
Bird dog
Get on your hands and knees with your back flat. Reach one arm forwards or stretch the opposite leg back; if you find it hard to keep your balance, use just the arm or just the leg. Hold for 5 seconds, then switch sides.
6–8 reps on each sideSide-lying leg raise
Lie on your side; you can put a pillow under your head and under your bump. Bend your bottom knee, then lift your top leg a little, keeping the knee straight, and lower it slowly. This strengthens the muscles at the side of your hip.
10 reps on each sideSit-to-stand from a chair
Sit towards the front of a sturdy chair with your feet hip-width apart. Stand up with your weight spread evenly over both feet, then sit back down with control.
8–10 repsPelvic floor squeeze sitting
Sit upright. Draw your pelvic floor muscles in and up and hold for a few seconds, then relax them completely. Pelvic floor exercises during pregnancy and after birth help prevent bladder leakage (urinary incontinence).
8–10 squeezes, 3 times a dayWalking
Walk on level ground at a pace at which you can still talk. If you have pelvic girdle pain, keep your steps short and break up long walks that make the pain worse.
20–30 minutes a day, can be split upFrequently asked questions
Is it safe to exercise in pregnancy?
Yes, in healthy, uncomplicated pregnancies. The American College of Obstetricians and Gynecologists (ACOG) recommends 150 minutes of moderate-intensity exercise a week. Talk to your midwife or obstetrician before you start; if there is a particular risk, your programme is adjusted to suit it.
Which activities should I avoid?
Avoid contact sports, activities with a high risk of falling, such as horse riding, skiing and gymnastics, and scuba diving. Later in pregnancy, do not exercise lying on your back for long periods. Swimming, water exercise and a stationary bike are the options that put the least strain on your body throughout pregnancy.
Does the pain go away after birth?
For most women, low back and pelvic girdle pain eases in the weeks and months after giving birth; for some, though, it can persist. If the pain carries on, a postnatal physiotherapy assessment is helpful.
Should I use a support belt?
For some women, especially those with pelvic girdle pain, a support belt can bring relief when walking. It should be used alongside exercise if needed, not instead of it.
When to seek help right away
Stop exercising and contact your doctor straight away if any of the following happens during exercise or at any other time:
- Vaginal bleeding or leaking fluid
- Regular, painful contractions, or low back pain that comes and goes in a rhythm
- Reduced baby movements
- Chest pain, breathlessness that starts before exercise, dizziness or headache
- Pain or swelling in your calf
- Low back pain with a fever, burning when you pass urine; numbness or weakness in your legs
Sources
- Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev. 2015;(9):CD001139.
- Shiri R, Coggon D, Falah-Hassani K. Exercise for the prevention of low back and pelvic girdle pain in pregnancy: a meta-analysis of randomized controlled trials. Eur J Pain. 2018;22(1):19-27.
- American College of Obstetricians and Gynecologists. Physical activity and exercise during pregnancy and the postpartum period. Committee Opinion No. 804. Obstet Gynecol. 2020;135(4):e178-e188.
- MotherToBaby. Exercise. Fact sheet.