During pregnancy, the body changes a great deal both structurally and physiologically (how the body/mechanisms in the body work) to allow a baby to grow in the womb. The changes include more obvious transformations such as abdominal growth and sometimes breast growth, a changed posture, but also internal changes such as the blood supply, hormone balance, digestion, etc.
In this blog post I share the structural changes a woman's body goes through during pregnancy.
Structural changes during pregnancy
- Feet
- Knees
- Pelvis
- Hips
- Abdomen/Belly
- Core
- Lower back
- Upper back
- Head and neck
1. Feet
When we are not pregnant, the bottom of the foot has the shape of an arch. This is formed with the help of ligaments, muscles and tendons. During pregnancy, due to hormonal changes the arch of the foot is flattened. This happens because a flat foot is more flexible for a pregnant woman to walk and balance. A flat foot compared to an arched one, makes the foot longer. And it also leads to changes in knees, hips and surrounding tissues and muscles.
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| Image source: https://www.fixflatfeet.com/exercises-for-flat-feet/ |
2. Knees
During pregnancy, the knees are stressed differently than usual. This happens on the one hand due to the flatter arch of the foot, on the other hand due to the expansion/broadening of the pelvis and the changed center of gravity of the body. All these changes in the body lead to a different angle of stress on the knee, the patella (knee cap) and the muscles attached to them.
Due to the changed center of gravity of the body, movements such as sitting down or standing up can have a very different effect on the leg muscles. For example, when sitting down with a bigger belly, we have to bring our buttocks further back. Due to this, the thigh muscles have about 20% more strain on them every time we sit down. This change starts happening in the 2nd trimester.
3. Pelvis
The abdominal muscles help stabilise the pelvis. During pregnancy the abdominal muscles are stretched and weakened, and therefore cannot provide the same level of support for the pelvis. During pregnancy the muscles of the pelvis become more flexible, the pelvis itself gets between 10-15% wider and the angle of the pelvic bones change. These changes also have an effect on the joints between the bones of the pelvis.
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Image Source:
https://myloview.de/poster-anatomie-der-hufte-beckenanatomie-nr-3E45FDB |
The pelvic floor muscles help control the emptying of the bladder and bowels, prevent urinary leakage, and assist during sexual intercourse. These muscles support the baby during pregnancy, guide the baby during birth and help stabilise the pelvis. With the widening of the pelvis during pregnancy these muscles also undergo change. They get stretched as the baby grows and also during vaginal birth.
Even if a woman has a caesarean section, these muscles sometimes are stretched during childbirth. If there is a tear in the perineal muscle or an episiotomy (a cut of the perineum to assist during childbirth) the pelvic floor muscles can also get damaged.
4. Hips
During pregnancy, as the belly grows, the center of gravity of the body changes, and with this the way the muscles in the hips have to work also changes.
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Due to the changed center of gravity of the body, and the changes in the pelvis (the tilt, width and stability) the hip muscles have to adapt to these changes. The outer hip muscles of the buttocks (gluteus minimus and medius) become more active in order to keep the balance of the body especially during walking. If these muscles are not strong enough, it can lead to lower back pain as other muscles have to step in.
5. Abdomen/Belly
There are three main abdominal muscles, the rectus abdominis pair (for forward bending), the oblique muscles (for turning and bending upper body), and transversus abdominis (for stabilising the upper body). During pregnancy, the abdominal muscles expand to make room for the growing baby.
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| Image Source: https://www.babycenter.com/baby/postpartum-health/diastasis-recti_10419293 |
The straight abdominal muscle (rectus abdominis) elongates and widens in the middle and the tendon tissue between the two rectus abdominis muscles also expands. The oblique abdominal muscles and the transverse abdominal muscle are also stretched during pregnancy. The stabilisation of the upper body, which is usually the task of the transverse abdominal muscle, is supported by the oblique muscles during pregnancy.
6. Core
The core is the region of the body, that stabilises and controls the pressure inside the trunk/torso. The core muscles consist of the pelvic floor muscles at the bottom, the diaphragm at the top, the deep muscles of the back (erector spinae, multifidus, quadratus lumborum) and the inner abdominal muscles (the transversus abdominis) around the trunk. During pregnancy the structure of the core muscles changes.
7. Lower Back
The spine has three natural curves - the outward curve of the upper back (cervical lordosis), the inward curve below the cervical lordosis (thoracic kyphosis) and the outward curve of the lower back (lumbar lordosis). The lowest curve (lumbar lordosis) gets changed during pregnancy in two ways - either by increasing the curve or by flattening the curve.
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| Image Source: https://www.childrenshospital.org/conditions-and-treatments/conditions/s/spine-problems |
Some women compensate the shift in the center of gravity by tilting the pelvis forwards and pulling the ribs backwards. This results in increase of the curve (hyper lordosis). Other women compensate the change in center of gravity by tilting the pelvis backwards to be in line with the ribs, which results in flattening of the curve (flatback).
8. Upper Back
As the pregnancy progresses, the circumference of the chest increases about 2 to 3 inches to make room for the growing baby. And the diameter from front to back can grow up to 2.5 inches. The diaphragm, which is at the bottom of the lungs, rises about 1.5 inches above from its usual position.
Since the size of the breast increases and due to widening of the ribs during pregnancy, the chest becomes heavier. Due to this additional weight on the front side, the shoulders move forward and the chest muscles become tighter. This causes the upper back to curve even further forward (hyperkyphosis). Due to this change, rotating the upper body left and right becomes difficult.
9. Head and Neck
Since the forward curve in the upper body increases during pregnancy, the neck compensates by moving backwards and the head tilts upward, so that the eyes can still see everything and can maintain the same perspective.
Due to shift of the center of gravity of the head towards the front, the throat muscles and the muscles below the skull take more stress. This can lead to neck pain, upper back pain, and headaches.
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| Image Source: https://parenting.firstcry.com/articles/neck-pain-during-pregnancy-causes-remedies-and-prevention/ |
Knowing about these changes during pregnancy can help us to address various issues that arise during and after pregnancy.
After birth, most changes that happened during pregnancy gradually return to their natural state. The process of realigning and rebuilding the body can be supported by doing certain exercises.
In upcoming blog posts, I'll share some exercises and more topics about pregnancy and postpartum health.
Stay healthy and enjoy finding joy in health!