Athlete Question 2: Are backbends safe during pregnancy?

First, I want to pose a question to you.  How would you like to perform or participate in circus arts after pregnancy?  A lot of what we CAN do during pregnancy isn’t unsafe, but does not set us up for optimal long-term athleticism.

Second, I’m not a huge fan of “yes” and “no” lists, but instead support you to perform “informed movement” and then you can decide what’s best for you and your baby.  However, “keep doing what you’ve always done” is not informed advice.   

To my knowledge, and literature review, there is nothing saying this position is inherently unsafe for baby.  I can’t find anything to validate that the baby will get confused on which way is up an down or other wives tales.  I’m up for being called out if this is completely wrong.  

Also, certain movements are going to feel good, serve you, and be beneficial for different people and at different parts of your pregnancy.

Okay, off of “one size fits all” pregnancy movement soap box.

Safety Considerations 

There are safety considerations with an increase in exercise, or change in position of your head below your heart, or your heart below your hips during pregnancy.  These are due to an increase in blood volume, and a decrease in resistance of your blood vessels, which can both cause a drop in blood pressure and not allow adequate blood return to your vital organs and baby.  The difficult part is strict guidelines because every person responds differently!  

My best advice regarding inversions is have knowledge of your blood pressure, heart rate, and placenta placement from your physician before practicing any inversions.  This article is NOT a blanket movement prescription.  Be aware of lightheadedness, dizziness, nausea and numbness or tingling in your extremities; these are all signs you and baby are not getting enough blood flow and are not signs to push through.

Movement Considerations

As your baby and belly grows there is a normal separation of your rectus abdominus, the muscle bellies of your six pack muscles, so the tissue in between the muscle bellies, your linea alba, gets thinner.  This is total normal and happens in 98%-100% of women in their third trimester!  For most women this heals naturally back together 6-12 weeks after birth, for others it won’t, but everyone, in my opinion, needs rehabilitation to resume optimal function of their abdominal wall postpartum.

The most superficial abdominal muscle group separates during pregnancy to accommodate for baby.  The deep abdominals, your transverse abdominis, become crucial to supporting the abdominal contents up and in and away from adding pressure to the thinned linea alba tissue.

Please check out Brianna Battles article and resources for more information specifically on abdominal separation or diastasis recti repair:

So, although the separation is normal, we want to support the tissue integrity as your belly grows and not put excessive stress on thinning tissue, I liken it to continually putting stress on tissue that is sprained.  There are some things you obviously can and can’t control when it comes to stress on your abdominal wall; the size of baby, your unique anatomy and structure, genetic tissue integrity, and forces pushing out onto the abdomen.  This often happens with heavy lifting and bearing down or large amounts of extension through your abdomen, such as arching back or back bending.

Every movement requires an appropriate amount of muscular tension necessary to complete the task at hand.  Reaching to the back seat of your car requires less abdominal tension than going into a full backbend, but both require anterior abdominal muscular tension, whether you think about it or not.  During pregnancy, the ability to create tension across your abdomen changes, therefore the tasks have to change too, in order to maintain integrity and support the thinning tissue.

Here is my recommended self-monitoring checklist to assess if stress on the abdomen is too much to support healthy tissue, which may be adding to your rehabilitation timeline postpartum.

  • Can you maintain a transverse abdominis (TrA) contraction through the movement?  The TrA hugs your pelvic and abdominal contents in, taking some pressure off of the thinning linea alba. 
  • Is this movement causing any doming or coning in the center of my belly?  This movement is now creating more force on the thinned linea alba than it can contain with adequate muscular tension.  Reduce the range of motion or load of the movement if it is causing doming or coning.

When pressure inside your abdominal cavity exceeds the tension your abdominal wall is able to create you will see doming or coning.  This is putting excessive stress on your linea alba and could be increasing the separation of your abdominal wall.  Deep core engagement not only reduces stress on your linea alba, but also maintains coordination of those deep muscles and provides feel good support to your low back.

  • Are you holding your breath to complete the movement?  Holding your breath or bearing down creates more pressure forward through your abdomen and down on your pelvic floor.  These tissues are a little more lax than normal, so this is not supporting optimal abdominal tissue or support of your bowel, bladder or uterus (read: may lead to stress incontinence).

Other areas that you can continue to focus on to maintain back bending mobility, other than your lower back and abdominal extension are, your hip extension and your upper back extension.  You can also support your growing belly and pelvic floor by working on core engagement through anti-rotation and anti-side bending activities: palloff presses, sideplanks, or pulldowns or check out my “Monday Modifications” on instagram for different levels of pregnancy and postpartum core exercises.

So, it is really up to you and your body and why this movement is important to you.  That’s the bigger question, how is back bending serving you and how can we continue to feed that part of your life while still respecting the changes happening in your body?

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