Is Your Pelvis Still in Birthing Position? Here's How to Tell
An open birthing position (aka open birthing pattern) is something many women have after birth that can hinder the healing process and cause pelvic pain, prolapse, incontinence, and potentially make subsequent pregnancies and birth more difficult.
Understanding what an open birthing position is and how to correct it is an important part of the birth healing process as well as preparing for future pregnancies and births.
How the Pelvis Opens for Birth
In the natural birthing process, the pelvis goes through different phases of opening to allow the baby to first drop down into the Pelvic Inlet from above, and then to exit the pelvis through the Pelvic Outlet below. First, the pelvis must widen at the top (the Inlet) to allow the baby to descend into the pelvis. After that occurs, the top of the pelvis narrows, the tailbone lifts out of the way, and the Pelvic Outlet widens as the baby's head makes its exit. This is completely normal and necessary to allow the baby to smoothly pass through the pelvis for birth.
If the pelvis has difficulty opening due to any tight muscles, joints, ligaments, or "hard", immobile bones, it can lead to a more difficult birthing experience. Which is why it's important to not just be in good alignment, but that all the structures and tissues in the pelvis have good mobility and strength for a more beautiful birth and faster recovery.
How to Tell If Your Pelvis Stayed Open After Delivery (Signs & Symptoms)
1. Right-Sided Back Pain, Pelvic Pain, or General Low Back Pain - if the pelvis is in an open birthing position, it can put stress on the surrounding tissues and cause pain and imbalance sometimes in the right side of the back because that is typically an area that becomes "stuck" after birth, but can also be other pelvic pain or general low back pain.
2. Pubic Symphysis Pain - during birth, the baby's head may press into the pubic bone which can lead to tenderness postpartum. If this does not go away, it could mean the bones have not moved back into pre-birth position. One thing I assess in clients is how the bones feel when I gently press into them. Often, after birth, the pelvic bones feel "harder." It may seem strange to think about, but when pushed on, bones should have a certain amount of sponginess or springiness to them. When a bone has been stressed or injured, it can "harden" and not feel as supple or spongy to push on. When pressing through the pubic and other pelvic bones, if they feel hard, not springy or spongy, this is a good indicator that they may not have returned to their pre-birth position. (note: this one is hard to tell yourself, so please feel free to reach out if you're not sure).
3. Pelvic Floor Weakness - Maybe you're having some incontinence (bowel or bladder) and can't get to the bathroom soon enough, can't get a good muscle contraction when you're trying to squeeze your pelvic floor, are having dyspareunia (pain with intercourse), or feel like your pelvis is unstable since giving birth. Or maybe you are having some prolapse symptoms which can feel like pressure, heaviness, or even a bulge in your vaginal area. These can all be due to poor support from the pelvis being in an open birth position. This can be because the ischial tuberosities ("sits bones") are splayed open and the tailbone is still pushed outward. Remember, this is a great position to get everything out of the way so a baby can pass through. But not a great position to support your pelvic muscles and organs after delivery.
4. Increased pubic symphysis, low back, or pelvic pain with subsequent pregnancies - if the bones have not returned to a pre-birthing position, it can lead to increased pain and other symptoms in subsequent pregnancies due to the balance of the pelvic structures including joints, tendons, ligaments, and muscles being out of balance.
Note: Even if you've experienced a C-section, depending on how far down the baby was in the birth canal, you could still be in an open birth position even after a Caesarean birth.
Should I Wait to Fix an Open Pelvis If I'm Planning on Having More Children?
The sooner your pelvis is functioning optimally the better. In other words, if you go ahead and have the open birthing pattern corrected, the pelvis will be "softer" and more readily able to shift as it needs to during subsequent pregnancies and births. If you wait to have and open birthing pattern addressed, the pelvis will feel "harder" and won't have as much movement. And if the pelvis doesn't have the mobility it needs to during a birth, it's possible it could make the birthing process more difficult. Remember the pelvis goes through two phases of opening during birth. First the top, or inlet, opens. Then as the baby drops down the birth canal, the lower part of the pelvis, the pelvic outlet, opens. So if the pelvis is stuck with the lower part, the pelvic outlet, open, it could potentially hinder the earlier phases of labor.
Also, pregnancy has a way of letting you know if there's something a bit off with your body. (Kind of like lemon juice has a way of letting you know there's a cut on your finger you didn't know you had. LOL!) So the added weight and pressure of a growing baby could definitely let you know if your pelvis is "stuck" as you may get symptoms of back or pelvis pain, imbalance, a more waddling gait, or other things that didn't show up during your first pregnancy. Not to mention the potential for pelvic floor weakness and prolapse due to not having the bony support in place to best support the pelvic floor and organs.
Overall, it's always best to be in the best shape and health possible before subsequent pregnancies and births, and correcting an open birth position of the pelvis is one important way to help you both heal from your last birth as well as prepare for the next one, if you're planning on more.
How to Help an Open Pelvis Close After Birth
While there are many ways to help support a balanced pelvis that you can do on your own like pelvic floor relaxation, deep breathing, hip stability exercises, and daily lifestyle habits (as shared in a previous post), an open birthing position is one of those things that is best helped with hands-on support from a birth healing specialist. The good news is, it is completely treatable with conservative treatment (no surgery or injections needed). And thankfully it usually only takes 1-3 sessions of gentle, intensive hands-on therapy to help the pelvis soften and return to its pre-birth position so you can more fully heal.
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