What changes in the body at this stage
In nine months, the body changes more than it does in many years. The growing uterus pushes the organs upwards and sideways. The centre of gravity moves forwards, the curve of the lower back deepens and the ribs widen to make room. Hormones make the ligaments more supple to prepare the pelvis for birth.
The pelvic floor carries more and more weight. The diaphragm has less room to move. The bowel slows down. All of this is physiological, but it can bring pain, bladder leaks or discomfort.
Pelvic pain that stops you walking, climbing stairs or sleeping is common, but not normal. You do not have to grit your teeth until the birth.
What may lie at the root
Lower back and pelvic pain in pregnancy does not always come from the spine. Often the source lies in how the pelvis, hips and abdomen are adapting: a sacroiliac joint that moves less on one side, overloaded glute muscles, breathing held high in the chest, a pelvic floor that is over-compensating.
Leaking urine in pregnancy can mean the pelvic floor is weak, but it can also mean it is overly tense and tired. The right approach depends on which, so it matters to assess before handing out exercises.
Fear of birth also lives in the body. A woman who feels informed and confident in her movements experiences labour differently.
How we can support you
- Pelvic physiotherapy: assessment of posture, pelvis, breathing and pelvic floor, with exercises adapted to each trimester. An internal assessment, when indicated, is only carried out with your consent and in line with how your pregnancy is progressing. In the third trimester we prepare the perineum, teach perineal massage and practise breathing and pushing.
- Parto em Movimento (“Birth in Motion”): our birth preparation done through the body. You learn positions, movements and ways of breathing you can use in labour, with your birth partner involved.
- Acupuncture: may help relieve lower back and pelvic pain and nausea. Some points are avoided in pregnancy, and the technique is adapted to each stage.
- Osteopathy: gentle techniques, always in comfortable positions (side-lying or seated), to bring mobility to the pelvis, ribs and abdomen. Visceral work in pregnancy is done with particular care and respect for the baby’s space.
We work alongside your obstetrician, GP and midwife. These therapies complement your antenatal care and do not replace it.
When to see a doctor
Contact your obstetrician or go to A&E immediately if you have:
- vaginal bleeding or leaking fluid;
- severe abdominal pain or regular contractions before 37 weeks;
- fewer baby movements than usual;
- a severe headache, changes in your vision, or sudden swelling of the face or hands;
- fever, burning when passing urine, or back pain with fever;
- pain, heat or swelling in one leg;
- intense itching on the palms of the hands and soles of the feet.