Next stop: Bringing your baby into this world as safely, fast and as non-eventful as possible.
There are many ways to prepare for birth but one of the best must be the physical and mechanical preparations of creating the biggest possible birth space. The pelvis and pelvic outlet is pretty inflexible with the exception of the movable sacrum at the back. The sacrum and attached coccyx is the lowest part of our spine. It is also an attachment point for the pelvic floor. The other being the pubic bone at the front. The sacrum is able to move into the birthing space and out see Fig. 1 and Fig. 2. The red arrows show the length of the pelvic floor and birthing space:
Fig. 1: Looking down into the pelvis, the sacrum is pulled back and lumbar spine (lower spine) is curving neutrally into the body.
Fig. 2: Sacrum is pushed into the birthing space and lower spine is pushed backwards, flexing the spine and causing extra pressure on the lower spine joints.
Now, ideally we all want our birthing space to look like Fig. 1, more space for baby to pass through and less trauma to the coccyx and sacrum, when baby's head pushes against them on its way out. So how does the sacrum move?
1. The muscles attaching to the sacrum from within the pelvis are the pelvic floor muscles. They run from the coccyx to the pubic symphysis at the front of the pelvis. The red arrows point to attachment points of the pelvic floor in the above figures. They also run from the sacrum to either side of the pelvic outlet, creating a hammock for internal female organs and the baby. A very tight pelvic floor will pull on the sacrum and over time will cause it to move into the birthing space, Fig. 2. This is why traditional Pelvic Floor exercises in excess are counter-productive. The more you squeeze these muscles:
- the tighter they will become,
- the more the sacrum moves into the birthing space and
- the shorter and weaker the muscles become.
Short muscles have less contractile length and produce less force. To keep the pelvic floor healthy and birthing space open, it is very important to be able to relax pelvic floor muscles completely and lengthen them.
2. One of the muscles attaching to the outside/back of your sacrum are the gluteus maximus muscles (buttocks), two of the largest muscles in the body. They are used for e.g.:
- extending the leg behind you, if you happen to walk by extending the leg behind and not lift it in front and falling onto it and
- stabilising the pelvis when pushing up from a seated or say squatting position.
Whenever the gluteus maximus is active it will pull on the sacrum and over time move it out of the birthing space as in Fig. 1.
3. The sacrum is also moved by passive positioning. If you tend to sit slouched e.g. on the sofa with pelvis tucked under, you are sitting with your upper body weight pushing onto the sacrum. Sitting like this, the sacrum is pushed into the birthing space and the pelvic floor shortens as in Fig. 2. You may also feel lower back pain as a result as this sitting position, which forces the lumber or lower spine to flex and put excess pressure on it.
To achieve optimal birthing space try the following:
* learn how to relax and lengthen your pelvic floor. If you do do pelvic floor exercises, add a relaxation at the end of each pelvic floor contraction by letting go of the pelvic floor contraction completely and gently pushing down on the pelvic floor. This will help identify the right muscles to use during birth. 2 sets of 8 pelvic floor squeezes a day are easily enough to get to know your pelvic floor. Read more detailed info on a TooTightPelvicFloor and there will be a follow up on this article on how to relax and increase length in the pelvic floor.
* incorporate squat movement into your daily routine see You don't know squat and Maui Squat for more info.
* be aware how you walk. Do you lift your leg in front and fall onto it or are you using your fully extended legs to push back and propel you forward (cue: legs behind body - using your gluteus)? See Walking or Bouncing for more info on how to walked aligned.
* DO NOT SIT ON YOUR SACRUM!! Sit on your sitting bones with your backside behind you and not underneath you. Sit on the chair the wrong way round so you lean forward (also a good way to get baby into the optimal birthing position but about this another time). Sit on the floor leaning on an exercise ball, sit cross-legged, on your heels or don't sit at all, stand, walk, squat, lie - change position as often as possible. For some more ideas have a look at Your position in life.
Enjoy your bump and good luck for the big event!
Quite a while ago now! Missing my bump(s).
