Back pain is very common complaint during pregnancy because the rapidly enlarging abdomen requires significant postural changes to be made. These changes can give rise to discomfort and sometimes pain in the back. The best way to avoid back pain in pregnancy is to avoid placing unnecessary strain on your back, so avoid wearing high-heeled shoes, take extra care when lifting and avoid standing in one position for too long.

In the later stages of pregnancy hormonal changes help prepare the body for the impending birth, but these can also be a cause of back pain. One of these hormones is relaxin, which, as the name suggests, has a relaxing effect, acting on the ligaments to allow for expansion of the birth canal in the pelvis during birth. Relaxin also relaxes the ligaments of other joints, including the spine, thus increasing the risk of low back strain. During the latter part of pregnancy, some women can also experience an intense, sharp pain in the sacroiliac region, which may radiate into the groin. This pain is usually associated with twisting movements and is due to the effect of relaxin on the sacroiliac ligaments, which allows increased mobility in the sacroiliac joints. To prevent this, avoid twisting and be careful when you are turning over in bed in order to reduce the risk of straining the sacroiliac joints. The problem usually resolves itself after pregnancy when hormone levels return to normal.

By paying enough attention to maintaining good posture, by undertaking regular gentle exercise and by being extremely careful when bending and lifting while pregnant, the likelihood of suffering from backache can be reduced. Remember that your back is much more susceptible to strain while you are pregnant, so try and keep lifting to a minimum. If you do have to lift heavy objects, then it is even more important than usual that you face the object that you are to pick up, rather than twisting in order to reach it. Keep your back straight and your abdominal muscles tensed, bending at the knees and making the lift come from your legs rather than from your back. Always try to avoid carrying heavy items, hut if you do need to carry heavy or awkward loads, such as shopping, then divide the weight equally, carrying a similar weight in each hand. This will prevent your back being pulled to one side. If you are carrying just one bag, keep it hugged to your front, again so that you are not being pulled to one side.

After the birth
The likelihood of experiencing back problems after you have had the baby can be reduced by avoiding excessive weight gain during pregnancy, as you will therefore return to your pre-pregnancy weight soon after the birth. Regaining your abdominal muscle tone by doing regular abdominal exercises will also help to minimize the stresses on your spine. Make sure that you follow the postural advice so that your body regains its pre-pregnancy stance as soon as possible after the birth.

Posture during pregnancy
The typical posture of a woman in later pregnancy is the enlarged abdomen appears to be pulling her forwards and downwards, stretching the abdominal muscles. This causes the pelvis to tip forward, exaggerating the lumbar curve, which in turn places additional strain on the thoracic and cervical spine. As the centre of gravity moves forward, the knees extend, the shoulders become more rounded and the head thrusts forward. As the normal postural curves are lost, the ligaments and muscles supporting the spine are put under considerable strain.

During the last few months of pregnancy it is most important to check and correct your posture constantly. The key to improving your posture lies with your pelvis. If you tilt this correctly, maintaining the correct lone in your abdominal muscles, you will reduce the strain on the lumbar spine.

Try to imagine that your pelvis is a bowl that is full, almost to the brim, with liquid. When you stand with your pelvis tipped forward, the liquid runs over the top, but when you tilt your pelvis correctly the liquid is held within the bowl. Now, whenever you sit, stand or walk, remember to visualize your pelvis as a bowl full of liquid. Concentrate on keeping the liquid within the bowl and you will be more likely to hold your pelvis correctly and consequently much less likely to suffer from backache. An added advantage is that you will maintain better tone in your abdominal muscles and therefore may regain your figure more quickly after the birth.

Standing while pregnant
When you are standing for any length of time, keep changing your position regularly. Try alternately placing one foot a little in front of the other and then changing, keeping your weight evenly distributed between both legs and ensuring that your knee joints are slightly flexed. It is very important to avoid standing with most of your weight on one leg. In this position the joints of your weight-bearing leg are locked and your pelvis tilts to one side, causing considerable strain on your lumbar spine. This is a very common way for a mother to stand after the birth, with the baby supported on the weight-bearing hip. Instead, try holding the baby close to and in front of you, rather than at the side, and preferably supported by a sling.

Sitting while pregnant
As your pregnancy progresses you may find that sitting for long periods becomes increasingly uncomfortable. It is helpful therefore to keep changing your position, walking around frequently – at least every half an hour or so. It will also become increasingly difficult to stand up from a low, deep chair, causing unnecessary strain in your back and sacroiliac joints. Therefore try to choose an upright and firm chair to sit it, and you can support your lumbar spine with a small cushion, if required. Sit with both feet on the ground or with your feet raised on a foot stool. Never sit with your legs crossed at the knees, as this twists your pelvis and lumbar spine, as well as impairing the circulation in your legs. Remember to tilt your pelvis correctly, sitting up tall and straight while keeping your shoulders relaxed. Sitting correctly will help to create as much space as possible for your baby, as well as helping to relieve congestion in your pelvis and legs and reducing the strain on your spine.