But why suffer? Research has shown that there are several therapies and strategies that can ease the pain and get you back on track.

First, call your doctor if you are having back or pelvic pain to be sure you are not going into labor or are having a medical issue that needs to be addressed.

The root of the problem

Though the pain can occur at any point during your pregnancy, it is more common in the later stages, as your weight goes up. Women who are most at risk are those who are overweight or have had back pain prior to pregnancy. In addition:

Most pregnancy weight gain is distributed around your abdomen. This puts pressure on your back as your center of gravity shifts forward.

As your baby grows and your pelvis starts to spread, certain pregnancy hormones make your joints less stable, leading to pain in the back.

The extra weight of your baby also changes the center of gravity of your body. This increases the postural strain, causing back pain.

Relief is on the way

Back and pelvic pain are hard to prevent completely. But, there are things you can do to lessen its severity or frequency.

Research has shown that the following therapies, when combined with standard treatment, have been more effective at easing these conditions than standard treatment alone.

• Acupuncture. This is an ancient Chinese healing technique that involves the insertion of fine needles into specific points in the body. It is usually safe and painless when done properly. Several studies have shown that acupuncture, when used with more traditional treatments, may give some relief from back and pelvic pain. Check with your doctor before you start any acupuncture treatment. Always look for a qualified practitioner who is licensed or certified.
• Stabilizing exercises, such as stretching and light movement, have been shown to decrease muscle spasms. This leads to easier labor, delivery and recovery after childbirth.  They can also help strengthen and stretch muscles that support the back and legs and promote good posture. This keeps the muscles of the back, the abdomen, the hips and the upper body strong.

Before you start any exercises, check with your doctor, who can advise you on the proper exercises and suggest any restrictions, if needed.

• Water gymnastics is geared toward expectant mothers from their 20th week right up to birth time. The classes, known as “aqua-natal” classes, are generally conducted in a warm hydrotherapy indoor pool. They are thought to help ease back or pelvic pain for the following reasons:
  • Exercising in water relieves stress on weight-bearing joints and allows increased freedom of movement.
  • When the body is immersed in water it experiences hydrostatic pressure – a sort of inward squashing force. This can often significantly reduce swelling on the lower limbs and also help relieve joint pain.
  • Check out your local “Y” or gym to see if classes are offered in your area. Check with your doctor first to make sure these classes are right for you.

Other strategies

Pregnant women have also reported these strategies to be helpful:

• Squat to pick up something versus bending over.
• Avoid high heels and other shoes that do not provide adequate support. High heels also shift your center of gravity forward.
• Avoid sleeping on your back.
• Take a warm bath, or apply a warm jet of water from a showerhead to your back.
• Get plenty of rest. Elevating your feet is also good for your back.
• Sleep on your left side and use a support pillow under your knees and/or your tummy.

Though back or pelvic pain is common in pregnancy, you do want to contact your doctor right away if you are having any of the following:

• Severe back pain
• Pain that does not improve
• Back or pelvic pain that goes along with any vaginal bleeding or urinary problems
• Increasingly severe or sudden onset of back pain
• Rhythmic cramping pains – a possible sign of preterm labor
• Back and pelvic pain can be an uncomfortable side effect of pregnancy, but you don’t have to let it rule your life. Take these measures to ensure some control over your condition for a happier, healthier pregnancy.

(Source: MyOptumHealth, 2011)

This age-old practice keeps you limber, tones your muscles, and improves your balance and circulation, with little, if any, impact on your joints. It focuses on teaching you to relate to your busy, hectic and stressful lifestyle. It is about changing your attitude towards life.

Yoga is also beneficial because it helps you learn to breathe deeply and relax, which will come in handy as you face the physical demands of labor, birth, and motherhood. One of the first things you learn in a yoga class is how to breathe fully. The breathing technique known as ujjayi requires you to take in air slowly through your nose, filling your lungs, and exhale completely until your stomach compresses.

Learning how to do ujjayi breathing primes you for labor and childbirth by training you to stay calm when you need it most. When you’re in pain or afraid, your body produces adrenalin and may decrease the production of oxytocin, a hormone that makes labor progress. A regular yoga practice will help you fight the urge to tighten up when you feel pain, and show you how to relax instead.

The benefits of yoga aren’t limited to your physical well-being. Taking a prenatal yoga class is a great way to meet other pregnant women. Being in a positive, supportive environment with others like you can give you a regular emotional boost and keep you motivated to continue exercising.

First-trimester tips

Make sure your instructor knows you’re expecting. You probably don’t have many restrictions this early in your pregnancy, but remember drinking lots of water before, during, and after exercising to keep your body hydrated. If you’re a pro at yoga, recognize and accept that your regular routine will require modifications as time goes on. If you’re feeling pain or discomfort, choose an alternative position.

Second-trimester tips

Your joints are beginning to loosen up now, so proceed with caution. Be aware that your sense of balance will not be the same. Don’t try to hold poses for a long time, and remember to sink into yoga positions slowly and carefully to avoid injury. Take your time and don’t overdo it. Avoid lying flat on your back now to keep blood flowing properly to your uterus.

Third-trimester tips

You’re probably feeling less graceful now that your tummy is bigger, so perform standing poses with your heel to the wall or use a chair for support. Props such as blocks and straps can also help you move through different poses with greater stability. Don’t hold poses for a long time; it’s important to keep moving.

Best poses for pregnancy

Cobbler’s or Tailor’s pose (baddha konasana):
This sitting pose helps open the pelvis. Place pillows or rolled-up towels under your knees to avoid hyperextension of your hips.

• Sit up straight against a wall with the soles of your feet touching each other.
• Gently press your knees down and away from each other, but don’t force them apart.
• Stay in this position for as long as you’re comfortable.

Pelvic tilt or Cat-Cow:
This position helps relieve back pain, a common problem during pregnancy.

• Get on your hands and knees, arms shoulder-width apart and knees hip-width apart, keeping your arms straight, but not locking the elbows.
• Tuck your buttocks under and round your back as you breathe in.
• Relax your back into a neutral position as you breathe out.
• Repeat at your own pace.

Squatting:
Focus on relaxing and letting your breath drop deeply into your belly.

• Stand facing the back of a chair with your feet slightly wider than hip-width apart, toes pointed outward. Hold the back of the chair for support.
• Contract your abdominal muscles, lift your chest, and relax your shoulders. Then lower your tailbone toward the floor as though you were going to sit down on a chair. Find your balance, most of your weight should be toward your heels.
• Take a deep breath and, exhaling, push into your legs to rise to a standing position.

Side-lying position:
This is a good resting pose for the end of a practice.

• Lie on your left or right side with your head resting on your arm or a blanket.
• Put a body pillow or blanket roll between your thighs to give your hips some support.
• If you’re in a yoga class, your instructor may guide you through some breathing exercises.

Other good poses during pregnancy

Also try the standing postures Warrior I (virabhadrasana I), Warrior II (virabhadrasana II), and Tree (vrksasana). These poses help strengthen your joints and improve your balance. Warrior poses can also ease backache and sciatica. Downward-Facing Dog (adho mukha vrksanasana) can energize your whole body, but it’s best not to do this position in your third trimester. Your yoga instructor may recommend variations on any of these classic poses.

Yoga precautions during pregnancy

You may want to skip any movements that require you to lie flat on your back for longer than a few minutes, especially after the first trimester. If you’ve never done a headstand or shoulder stand before, don’t start trying now. Use caution or avoid these poses altogether during the third trimester. Skip positions that stretch the abdominal muscles too much, such as deep forward and back bends and deep twists. You’re more apt to tear and strain muscles now because the pregnancy hormones that allow the uterus to expand also loosen other connective tissue.

Aerobic exercise strengthens your heart and lungs and helps maintain muscle tone. As long as you choose exercises that are low-impact and you keep one foot on the ground at all times to minimize stress on your joints, you should be able to continue your routine throughout most of your pregnancy.

Although exercise DVDs you can do at home are good when you’re pressed for time (or just too tired to make it to the gym), consider joining an aerobics class designed especially for expectant moms. You’ll enjoy the company of other pregnant women and the expertise of an instructor who understands how to keep you and your baby safe. If you’re already joining a regular aerobics class, let your instructor know that you’re pregnant; he or she can suggest ways to modify movements that may be unsafe for you.

First-trimester tips

Dress in comfortable and breathable clothing. If you’re not comfortable carrying on a conversation, stop; that’s a sign you’re exercising too intensely.

Second-trimester tips

Keep a bottle of water close by during class; dehydration can cause muscle cramps and in extreme cases even premature contractions. Drink one cup before you exercise; one cup for every 15 minutes of exercise; and one or two cups after you finish your workout.

Remember that it may be harder to keep your balance as your tummy expands. Use caution as you move across the floor. Prenatal water aerobics is a great and safe option for you too. It is still a workout for your heart and body, but without the stress on your joints or the risk of injury.

Third-trimester tips

By now your pregnant belly is probably hampering some of your movements. If it feels too tricky or uncomfortable to bend or reach, just march in place. It’ll keep your heart rate up while you take things a little easier. It’s also best to avoid bending over, spinning, or any turning movements that may make you dizzy and cause you to lose your balance.

Swimming is a great type of exercise because it uses both of your large muscle groups (arms and legs). Though low-impact, it provides good cardiovascular benefits and allows pregnant women to feel weightless despite the extra kilos you’re carrying. It is also very safe to do with low chances of getting injured.

Swimming also improves circulation, increases muscle tone and strength, and builds stamina. When you swim, you’ll burn calories, sleep better, and handle pregnancy’s physical and emotional challenges better.

Safety tips

Swimming is one of the safest forms of exercise. If you did swim regularly before you got pregnant, you should be able to continue without much modification. If you didn’t swim or exercise at all, you should still be able to swim, but check with your doctor or midwife first. You’ll need to start slowly and stretch well before and after entering the water.

When you’re in the water, it can be easy to forget to stay well-hydrated. A good guideline is to drink one cup before you start your swim, one cup for every 15 minutes of exercise, and one or two cups after you get out of the pool.

First-trimester tips

If you can summon the energy, swim for at least 30 minutes daily. Swimming in the early morning may counteract nausea and energize you for the rest of the day.

Second-trimester tips

Your pregnancy won’t require you to cut down on swimming as you grow because it’s easy on expectant moms. You probably won’t need to modify your regime, but a maternity swimsuit may be more comfortable as your tummy gets bigger.

Third-trimester tips

The water supports your joints and ligaments as you exercise, preventing injury and also protecting you against overheating. The breast stroke is particularly beneficial in the third trimester, because it lengthens the chest muscles and shortens the back muscles, two areas that typically become misaligned as your body changes during pregnancy. Use a snorkel to relieve the pressure on your neck.

Best strokes for pregnancy

The breaststroke is probably your best bet while pregnant, it doesn’t require rotation of the torso and requires less exertion. Also, it helps counteract the increased strain in the back due to the belly weight of pregnancy. While pregnancy forces the spine and shoulders to round forward and the pelvis to tilt out of alignment, the breaststroke gently strengthens the muscles and counteracts that tendency.

Another good stroke is the backstroke. Because the water reduces the effects of gravity on your body, you can lie on your back to do the backstroke without risking the impaired blood flow.

Walking is a safe activity to continue throughout all nine months of pregnancy and one of the easiest ways to start exercising. Walking is one of the best cardiovascular exercises for pregnant women because it’s easy to do, keeps you in shape, makes you feel good. All of that is done without putting too much pressure on your knees and ankles. If you haven’t been active before, you should start by walking 20 – 25 minutes a day. After getting used to it you can safely keep going for 30 minutes or more.

First-trimester tips

Make sure you have walking shoes that support your ankles and arches. Protect your skin with sunscreen, wear a sun hat and carry a spray bottle filled with water for cooling off. Bring drinking water with you to avoid dehydration, which can cause contractions and raise your body temperature. This can be dangerous for you and your baby. An alternative is to go for a walk in a mall or on a treadmill at the gym or at home.

Second-trimester tips

Continue to wear supportive shoes, protect your skin from the sun, and avoid dehydration. When you walk, keep your hips under your shoulders to avoid a sway in your back, and look ahead. Swing your arms for balance and to make more of your workout. You may want to find a friend to join you on your walks and keep you motivated.

Third-trimester tips

Keep up your walking regimen as long as you can, but avoid hiking trails or uneven terrain that could put you off balance. As you get closer to your due date, you might also want to consider walking on a track. Not only is the surface easier on your body, but you might feel safer knowing that you won’t get stuck far from home or your car in case of an emergency.

Warning signs

Never walk until you feel exhausted or breathless. Pushing yourself to the limit will make your body use oxygen that should be going to your baby.

All these activities can be done with a friend, no matter her being pregnant too, or not. This way you can keep an eye on each other and have a fun way to stay healthy and in shape.

Regular exercise is safer than occasional bursts of exercise and remember to always warm up gradually and make sure you cool down properly after exercise especially by stretching.

Eat and drink for two! You will need about 300 extra calories a day and it is very important to drink enough fluids. Always keep a bottle of water and wear comfortable clothing when exercising in hot weather.

Avoid lying flat on your back after the first trimester. This position keeps blood from flowing to your brain and uterus, and can make you dizzy, short of breath, or nauseated. Keep moving by switching positions or walking in place. Standing motionless for long periods, when you’re lifting weights or doing yoga poses, can also decrease blood flow to the uterus.

Always call your doctor if you experience one or more of the following symptoms during exercising:

• pain anywhere, but especially in your back or pelvic region
• shortness of breath
• dizziness or feeling faint
• excessive fatigue
• difficulty walking
• contractions
• fluid leaking from your vagina
• decreased fetal movement
• rapid heartbeat while at rest

Biking – is not a dangerous thing to do, though it should be pursued more cautiously during your pregnancy, especially in your second and third trimester.

Running – is not a good idea if you have never done it before your pregnancy. Walking is a safer option for beginners.