November 20, 2017

Could Exercise During Pregnancy Make Labor Harder? Why a fit pregnancy doesn’t always make for the best birth plan.

First published in Well Rounded NY

When I was pregnant with my first baby, I worked out until I gave birth and looked like I had just stepped out of a pregnancy magazine. I only gained weight in my belly and my boobs, and I generally felt good. But my rigorous and rather insane fitness routine came at a steep price: a 42-hour labor.

You see, our society sees pregnancy through Hollywood eyes, in which women display pregnancy with a cute, round bump — rarely  the reality of weight gain, aches and pains, and swollen ankles. To the detriment of my well-being, I strove to attain that publicly acceptable image and was often congratulated for this feat.

But exercising too much, especially at the end of your pregnancy, can do a number on your body’s alignment. It can overly tighten your pelvic floor muscles, torque your pelvic ligaments, misalign your pelvis and constrict your psoas muscles. All of this can end up shifting your baby’s position, ultimately making birth more difficult. Since I was a prenatal yoga instructor, a Lamaze teacher and a doula, I was well versed on the dangers that over-exercising can pose to the pregnant and laboring body, but my body image obsession took precedent. And so I kept on working out until the end of my pregnancy: I took spin class 5 days a week, continued with weight training and kept on going to my advanced yoga classes. The very first time I had missed a spin class was because I was in labor, and it really ticked me off. I wish someone had told me that what I was doing could do more harm than good.

After 20 hours of labor, I knew something was wrong. My son’s heart rate never faltered and my blood pressure remained normal, but my labor wasn’t progressing. Fortunately, my doula, husband, and midwife were very hands-on in trying to help my labor move along. They walked, shifted, and shimmied my body to correct my baby’s position. By the time I fully dilated and started pushing, he was still slightly malpositioned and didn’t correct himself until four hours into pushing. Finally after almost two days of labor, my perfectly healthy baby boy was born. My body, however, had seen better days. I was extremely tired and sore, and my pelvic floor muscles felt defeated.

Sadly, this story of long, arduous labor is not uncommon. Most of the time, it has to do with the baby’s position in the pelvis. Baby needs to be well aligned in what is called “optimal fetal position.” This doesn’t just mean head down. The baby’s spine needs to be towards mama’s belly; its head should be tucked in towards its chest; and the smallest part of the head must be pushing symmetrically against the cervix. Think of how you put on a turtleneck sweater: you wouldn’t look upwards to the opening or tilt your head to the side; you would tuck your chin down and slide the neck opening over your head. The same goes for a baby coming through the cervix.

Many women don’t have a support system during birth to help baby shift and end up with a cesarean section after being pronounced ‘failure to progress’ or ‘baby too big.’

My challenging birth and recovery taught me to remind women the importance of accepting body changes and slowing down. The whole system in which I teach prenatal yoga has shifted to focus on helping women have a functional birth. Students work towards creating balance both physically and mentally and preparation for birth.

For my second pregnancy, you can bet I did things differently. Towards the end of my third trimester, I regularly saw a chiropractor to help align my pelvis, I established a more balanced and appropriate yoga practice, and I traded in my spin shoes for a maternity bathing suit. Then I pushed my daughter into the world in 6 minutes! I learned from my mistakes, and I hope you can too.

Image via George Ruiz on Flickr.

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