Alignment Considerations During Pregnancy

Babies are changing position constantly during pregnancy and even during the birth process. However, fetal position often isn’t simply random chance, rather a result of balances or imbalances created within a pregnant woman’s uterus and pelvis. 

Gravity is at work 24/7 so lets leverage that! A woman’s ability to walk and move upright encourages baby to settle into an optimal, head down, position as long we’ve created a balanced environment. 

So when is a good time to start “balancing” things? Baby’s head down position is crucial in the final weeks of pregnancy, but a pregnant woman’s habits throughout the entire 2nd and 3rd trimesters can influence how easily baby does or does not move into a head down position. So, the short answer is, the sooner the better. 

If you are pregnant, trying to conceive or even know someone who is pregnant, these are important alignment considerations for how a woman can encourage better alignment while walking, standing, sitting and sleeping.

To quote Katy Bowman: “I’ve said this before, but it can’t be said too many times: posture doesn’t equal alignment. Posture is how something looks. Alignment is how something works. 'Good posture' is cultural and is typically horrible alignment.” So lets dive into the most important alignment considerations during pregnancy.

Primary alignment considerations:

Sitting: Pretend there is a flashlight sticking out from your belly button 90 degrees. The light should always be pointing forwards or down, never up. So, when sitting, keep your hips higher than your knees. Your spine should be straight and not slouched onto of your growing belly.

If you’re sitting on an exercise ball, ensure it’s firm enough to allow your hips to be level with or higher than your knees. 

Never slouch in a reclined position on the couch or in bed because it creates unnecessary restrictions in your sacrum.

If your job requires you to sit for several hours a day, you must be standing up hourly to encourage movement through your pelvis and sacrum. 

Standing: Again, picture the flashlight. It should always be pointing forwards to down, which will require a neutral lumbar spine position where your lower back sways forward slightly. 

Walking: The same considerations apply to walking as they do to standing. No pregnancy waddling! Your stance may widen slightly, but your toes should still point forward, not out. 

Sleeping: Sleeping in a side-lying position is optimal for fetal positioning and maternal circulation (bringing adequate blood back to your heart.) I suggest starting on your left side, then every time you wake up in the middle of the night (to use the washroom, or otherwise) switch sides to give your shoulder and hip some rest and circulation. Sleep with a pillow between both your knees and ankles. 

Additional positions to encourage alignment and balance:

Walking: Gradually work up to walking at a brisk pace, 5 kms a day. Walking strengthens the muscles of your lower back as your belly grows, stretches and lengthens your psoas muscles and serves to help balance muscles and pelvic alignment overall. 

Squatting: Spent an accumulation of 5 minutes a day in a resting squat position. Need help getting started with modifications or technique adjustments? Click here.

Still having difficulty squatting? Try this calf stretch and hamstring stretch daily which will release tension from your posterior chain and make squatting easier.

Forward leaning inversions: Spending 30 seconds once a day in this position can release tension in the ligaments of the lower uterus, reduce back, hip or tailbone pain and improve fetal positioning. This position is contraindicated if certain medical conditions exist (hypertension, stroke risk factors, glaucoma, unusually high amniotic fluid levels, problems with your placenta, heartburn, sinus infections, shoulder injuries), so please consult with your primary prenatal care provider before introducing inversions. For step-by-step instructions on how to gently get into a forward leaning inverted position and safety considerations please click here and read first before attempting. 

Thank you to Gail Tully, CPM, creator of Spinning Babies for an exceptional resource for easing fear and pain in labour and creating more natural birthing experiences and approaches to fetal positioning. A win-win for both baby and mother.

I hope you found this helpful. Make it a great week,

-Dr. Jenna