Back Pain & Pregnancy:

The Triple Whammy of Having a Child

by Larry M. Parker, MD

You don’t need me to tell you that having a child is a life-altering experience for any young woman. But as an orthopedic spine specialist, I do see a lot of young women in their first year after delivery who were not expecting to deal with low back pain as part of their childbearing experience. In fact, a recent article published in the Journal of American Academy of Orthopaedic Surgeons reports at least a 50 percent incidence of low back pain in first-time pregnancies. So why is low back pain such a common problem for pregnant and postpartum women?

To put it simply, it has to do with what I call the “triple whammy” of having a child:

• Pregnancy • Delivery • Childcare

1. Pregnancy We all understand that pregnancy is associated with weight gain (20 to 35 pounds is recommended) with most of the increased weight distributed in the abdomen. This increased abdominal weight creates an increase in lumbar lordosis (the amount of arch in the low back) which can strain the joints of the lumbar spine. Pregnancy is also associated with hormonal changes that relax ligaments and joints to prepare the pelvis for delivery which can further aggravate the lower spine and pelvis.

2. Delivery After nine months of changes to a young woman’s body associated with full-term pregnancy the big day arrives—the delivery! Delivery may involve a vaginal delivery or a Cesarean section. A natural vaginal delivery involves a massive expansion of the pelvis to allow passage of the newborn through the birth canal. A C-section requires surgically dividing the muscles of the abdominal wall. In either case, delivery of a full-term baby (or babies in the case of twins, etc.) is very traumatic to a young woman’s body.

3. Childcare So after nine months of pregnancy and the trauma of delivery, any young lady deserves a vacation but in fact, rarely if ever does that occur, because usually childcare starts immediately. Most new moms have very little time to rest and recover. Eight hours of sleep is uncommon. To make matters worse, childcare usually entails new strain on your back, such as hoisting the car seat with the baby in it into the car, carrying a heavy diaper bag over one shoulder, and more.

The “triple whammy” of pregnancy is a reality for most new mothers, and back pain can make the experience of having a child more challenging. So what can you do to tend to your back pain? And what if you have had prior back surgery? Can you reduce the risk of back pain during pregnancy? We will look at those issues next time.