Why is pelvic alignment essential for a successful vaginal birth?
Updated: Jun 19
Giving birth is an intense and physically demanding experience. While every birth experience is different, our aim is to allow for the best possible experience for each unique body. Pelvic alignment is one area that can help you prepare for this, especially if you are hoping for a successful vaginal birth.
I have given birth to two children and there are things I wish I had done differently to prepare my body for the process - and I am sharing them with you today.
What is Pelvic Alignment?
Pelvic alignment does not just impact the bones of your pelvis. It also includes the many muscles and ligaments within the pelvis and attaching to the outside of the pelvis.
The muscles and ligaments on the OUTSIDE of the pelvis determine how the bones and joints of the pelvis are orientated as well as their flexibility and can actually widen or narrow the birth (pelvic) canal depending on which way they are pulling.
The soft tissue INSIDE the pelvis can also impact the flexibility of the pelvic joints but also form the walls of the birth canal. They also have the ability to influence the position of the uterus and hence the orientation of the descending baby.
Poor pelvic alignment can cause:
- Asymmetry in the ligaments that attach the uterus to the pelvis causing the uterus to lean to one side;
- The pelvic floor muscles to be tighter on one side;
- The pelvic bones to be orientated asymmetrically.
How does this impact pregnancy and birth?
The uterus is essentially a big bag of muscle and during labour is squeezes the baby down onto the cervix towards the exit of the mother's pelvis. If there is poor pelvic alignment, the pelvis is less capable of expanding to accommodate the descending baby and can cause the baby to descend on an angle. This leads to inadequate pressure on the cervix and less efficient uterine contractions.
This can sometimes result in the following:
Taking much longer for the baby to descend;
Leading to “failure to progress” (cervix taking too long to dilate);
Leading to a posterior labour (baby’s spine is on your spine) causing more pain and further prolonging;
Leading to breech or unfavourable positioning; and
Ultimately resulting in the risk of intervention including induction drugs/ pain relief/suction/forceps/episiotomies which can cause foetal distress and increase the likelihood of a caesarean section.
So HOW does a pelvis become asymmetrical?
Our bodies are always changing and adapting according to our lifestyles. For example, we sit down on chairs far more than our forebears did. This posture leads to wasting of muscles in the back of our body (mainly our gluteal *buttocks* muscles) and tightening of the muscles in the front which we call hip flexors. This leads to the infamous “sway back”.
Not only this but if this is not your first baby, then it’s likely you spend (or have spent) a great deal of time with a toddler perched on one hip, most parents have a single favoured side which leads to further pelvic asymmetry and weakening of important postural muscles.
You may have injured your back in the past or injured one knee or ankle which made you limp for some time or you may drive your car leaning to one side.
I know in my case as a chiropractor, I was constantly favouring one side of my body when working on patients, my stronger dominant right arm and hand is still more muscly than my left. And if you know me, I’ve had two extremely prolonged posterior labours!
If you have low back pain or sciatica or pubic pain in pregnancy – or even before pregnancy, this is your body sending you warning signals that your pelvis is not functioning symmetrically and optimally and may be lacking the range of motion it needs for birth.
In summary, causes of poor pelvic alignment include:
Excessive sitting eg. a desk job;
Carrying a toddler on one hip; and
Previous injuries especially if it made you limp.
What can Chiropractic do
My role is to make sure there are no obstacles that could impede the ability of a mother’s body to expand and contract to deliver her baby safely through the birth canal. This involves working with muscles and ligaments of the pelvis, joint alignment and flexibility, posture and strengthening work.
My kind of Chiropractic for pregnancy is very different from the traditional chiropractic that you may be familiar with. There is little to no need for manipulation due to the hormone relaxin that you produce when you are pregnant which makes your joints more hypermobile. I assess all the muscles and ligaments mentioned above and have a very specific way of determining whether or not your pelvis is asymmetrical and how best to return it to it’s most functional, symmetrical and flexible self – treatment that is tailored to your unique pelvis and alignment patterns.
This does not just benefit your birth outcomes but helps to avoid pain, discomfort, nerve pain (sciatica) and post-birth recovery. This usually includes releasing these muscles and ligaments as well as very specific and simple Pilates-based exercises for the muscles that are not being activated appropriately.
I also monitor abdominal separation and other pregnancy related health outcomes.
One more thing; If you are really keen to optimise your chances of a natural labour, find a midwife or doula who is trained in Optimal maternal positioning or spinning babies (as I am) who can care for you in labour and help your partner perform stretches and releases on you in labour if things are not progressing.