Pelvic alignment and why is it important in pregnancy?

By Dr. Alison Gault

The pelvis is a bony ring consisting of the triangular shaped sacrum at the back and the two innominate bones that make up the sides and front. The sacrum is joined to the innominate bones at the sacroiliac joints or SIJ’s. These are located at the two dimples of your low back. The two innominate bones join anteriorly at the symphysis pubis.

The pelvis plays a vital role within the skeletal system as the solid foundation for the spine. Like with a house’s foundations, if the pelvis is not level then the rest of the spine sitting on top is affected.    The pelvis has many important roles to play in pregnancy. It needs to be stable and strong to support the growing weight of the baby, uterus and placenta to ensure good gait, posture and spinal alignment. At the same time, the pelvis needs to become soft and wide to enable delivery. It is in trying to serve both of these functions that there can be some conflict.

The term ‘alignment’ refers to one of the indicators Osteopaths use in determining how well the pelvis is functioning. With a patient lying, standing or sitting straight, we compare the symmetry of particular bony landmarks of the pelvis. The position of these landmarks, as well as the quality and quantity of movement in the joints and tone of the muscles gives us a picture of how well the pelvis is functioning. Somatic dysfunction is an Osteopathic term describing when the joints and surrounding tissues are not functioning at their optimal level. (With treatment, our aim is to resolve somatic dysfunction to achieve optimal function.)

The extra strain and conflicting functions of the pelvis in pregnancy can make somatic dysfunction and the associated ‘misalignment’ more likely to occur. If pre-existing somatic dysfunction is present, the often familiar symptoms are likely to be aggravated. Many women experience pain within the low back, sacroiliac or pubic symphysis joints in pregnancy as well as tightness and discomfort in the surrounding pelvic muscles. One of the possible causes for these symptoms is somatic dysfunction of the pelvis and the associated ‘misalignment’.

Compression wear should be considered as part of your strategy for managing pelvic or low back pain during pregnancy. The compression introduced by the garment can increase stability within the pelvic joints whilst still maintaining and encouraging good muscle function.  As you sleep 8-10 hours a day on average, maybe less during pregnancy ensuring that you have the correct sleeping posture is vital in easing the pressure off the pelvis and back.  Being supported by a specific pregnancy pillow will maintain pelvic alignment during sleep and encourage you to stay in the recommended side sleeping position.