During pregnancy the body of the woman undergoes many changes. The meaning of this article is not to give exhausting informations about what everything happens in the body, but more about explanation how these changes affect the musculoskeletal system of the mother and whether the changes can be dealt with and replaced.
All that is happening so that the body of the mother could carry the baby, prepare for birth and breastfeeding. These big changes are fortunately appearing gradually, so that the pregnant woman could adapt to the changes. After the birth or as late as the mother ends with breastfeeding, the body of the mother will return back to the same condition as it was before the pregnancy.
BIG SYSTEMIC CHANGES
The circulatory system is changing because the pregnant woman has to manage with bigger volume of blood (the amount of blood will increase for 30 - 40%). The size of the heart and heartbeat frequency is also increasing.
Another change taking place is in the respiratory system. The breathing volume is increasing during pregnancy up to 40%. Breathing become less deeper, but more demanding. Big work has to be done by the kidneys as well because there is more metabolic waste, so because of the increased flow of liquids the kidneys also tend to get bigger. The urinary bladder has a smaller tension and it increases the retention of urine. From a fourth month onwards the urinary bladder gets smaller because of the growing uterus and increased blood supply of the surrounding organs , therefore pregnant women tend to have more frequent need to go to the toilet.
Changes such as nausea and vomiting are generally known. It is said that these problems fade away during first trimester (first three months of pregnancy). But there are mothers who have a constant feeling of hunger, they eat a lot, but they do not gain any weight, they may even reduce their weight during the first 5 months, even though they are eating enough food. On the other hand there are mothers who suffer from vomiting nearly during their whole pregnancy. Both extremes are unhealthy, and it is important to observe the health of the mother and baby as well.
With growing belly the motility (movement) of the intestines and pregnant women tend to be prone to constipation. But there are also mothers who in the last months or weeks have a need to defecate several times. The reason for that is the fact that the baby moving baby in the uterus is helping the bowel movement.
Big change by the mother is the increasing weight of the womb, which grows from 70 grams up to 1100 grams in the time of the birth. With increasing weight of the baby there are also growing demands on the pelvic floor, which works as a supportive membrane. The uterus is expanding from pelvis to the right abdominal cavity. That of course has an effect on the internal organs. Breasts are also preparing for the lactation (production and exclusion of milk from mother’s body), they increase and are more blood supplied. Their growing weight is compensated by the muscles between the shoulder blades. But if they are weak, they tend to get even weaker, and shoulders are pushed forwards.
Furthermore, with growing belly the diaphragm is pushed higher. Lungs have less space and the position of the heart also changes slightly. The diaphragm affects not only breathing but also body posture. The coordination of the diaphragm and the abdominal muscles is important part of the deep stabilizing system (muscles which partake in keeping the body straight against the gravitational force of the earth), because its function is worsened due to the changes. In addition the pelvic floor gets looser and lower. Another thing occurring is lordosis of the lumbar spine, which can hurt a lot. Incorrect body posture and forming movement problems can be very easily eliminated by regular exercising for pregnant women.
Hormones preparing woman’s body for birth are releasing the ligaments in the pelvis, soft tissues in the sacral area. Pregnant women also tend to stand wider than before (feet are further apart), pregnancy gait is another typical change.
Increasing body weight is during the pregnancy (between 10 - 15kg) is optimal and the woman will adjust to this “addition” fairly easily. Additional weight 20kg and more becomes hard to loose after the birth. Increased body weight along with released ligaments in addition affects all joints of the legs. It has the biggest impact on the foot arches which tend to get lower, and women describe their foot getting bigger up to one size during the pregnancy, and that now they have to wear bigger shoes. The depression of the longitudinal and transversal arch can be also very painful. Fortunately, a handy physiotherapist can help you with this, or you can get inspired in our article “Care for feet during pregnancy”.
Legs of pregnant women are also more prone to swellings, which is caused by pressed inferior vena cava by the uterus and increased amount of extracellular (outside the cell) liquid.
HOW CAN PHYSIOTHERAPY HELP
We will support the lowered activity of the abdominal and back muscles with kinesio tapes, which is a method of applying elastic cotton bands on the affected area. During the diagnosis and physiotherapy we will offer you ideal exercises based on kinesiological examination, which can help you from pain, which may occur due to the pregnancy changes. Group exercising is very good for future mothers, because it helps from pain, and it makes the birth easier. Exercising under supervision of experienced midwife in addition contributes to active childbearing. We also offer the option of lecture about prenatal care and preparation, which will dissolve your concerns from birth and it will give you important informations about the baby’s development and care for the baby. We will also help you from swellings on the legs with manual lymphatic drainage or pressotherapy where we can turn off the inflating chamber on the belly. It is important for you to stay during the pregnancy calm, and that you would trust that everything that is happening in you, is normal and that you and the baby will be healthy!
Author: FYZIOklinika physiotherapy Ltd., Prague, Czech Republic