Thursday, April 11, 2013


For my last blog before going on maternity leave for the first time, I felt inspired to share some reflections related to my experience during pregnancy which has enhanced my insight as a physical therapist. This may peak the curiosity of others interested in the topic of pregnancy or even on the topic of creating new physical experiences.
As I have undergone childbirth preparation classes and read material on natural childbirth in hope of promoting a birth experience as normal/natural and, believe it or not, enjoyable as possible, it has been repeatedly pointed out that the prevalent portrayal of childbirth as a painful and dangerous experience has created a fear of this experience and belief that this description is inherently true. Thankfully, there is a widespread body of resources that helps to transform these beliefs into confidence in a woman's innate ability to birth. This makes a very simple point that fear of the birth process creates resistance to and intolerance of the physical experience of labor, and that by both understanding the physiology of normal uncomplicated labor and trusting the natural ability of mother and baby to safely complete the process, this fear can be eliminated, allowing an entirely different birth experience to unfold.
So though one of the hottest topics during pregnancy is the birth itself, there is a lot of "story" about what "happens to" a woman's body during pregnancy as well. A conversation develops about the potential dangers of childbirth as well as the potential for injury due to pregnancy. This includes not only impact on the mother's body during birth but during pregnancy and in life after pregnancy. What I found novel is that while it is well established that these unfortunate perceptions of childbirth are prevalent in modern civilized societies, so might our perceptions of the experience of carrying a child before and after birth be influenced by cultural expectations. What became tangible for me was that much like I wanted to undo my learned cultural beliefs about childbirth, I could change my perception of what my body was experiencing as pregnancy progressed. Though I felt that I possessed helpful knowledge that would enable me to care for myself and "prevent injury", I still needed to believe in nature's design just a little more.
To build upon this conversation, I would like to also point out that so far the conversation is talking about the mother as a pregnant individual, not a mother and child living, moving, birthing, and continuing to live together with ease, harmony and comfort, and actually establishing a relationship (though perhaps not with a lack of new sensation and experience for both parties).
Let me illustrate what these changes in perception boil down to for me. There were times I was distressed because of pain while walking. However, as the baby grew it dawned on me that I was already the mother of this baby.Then a bigger picture emerged illustrating that just walking down the street pregnant was at this stage already an activity in our parent-child relationship. I began to realize that it made sense that I could move in a natural way (though perhaps slower) with her (yes, it's a girl!), and not only feel less pain but feel happy in my new relationship. Sensations that I felt as physical stresses (abdominal muscle strain, pubic bone pressure when I walked or sacroiliac pressure with changing positions) began to be perceived differently- as evidence that my baby was resting on certain body parts of mine or guides for me to move with more mindfulness. Feeling “out of breath” and extra work in my legs going up stairs changed into “taking in more air” for the two of us.
Now am I saying that pain is all in the mind? No. Have I enjoyed the benefits of physical therapy to prevent, prepare and manage? Absolutely! Though attention to physical wellness continues to play an important role, what has also contributed to me feeling better and better while walking and moving are perceiving things in the following ways:
1. RELAXING and trusting that my body can "carry" my baby without additional effort or injury if I let it. In the early stages I noticed that as I walked there were times I tensed muscles around my waistline and in my hips, exerting effort to “carry the baby”.  When I realized I could relax all those muscles and move in a way that was harmonious with her, I soon saw that my body did not feel added stress. 
2. Building on the point about relaxing, being sure to BREATHE PROPERLY. Though the growing uterus takes up space near the diaphragm and ribcage, the diaphragm can still do its job. A breathing pattern which primarily originates in the diaphragm and is not restricted by tension in the shoulders, ribcage, abdomen or pelvis is an essential component of efficient posture. Being able to maintain efficient breathing is a good sign that you are feeling good!
3. TAKING TIME to move, whether it’s getting up, moving in bed, walking or squatting, not just because of being heavier or that it’s “harder”, but because “moving for two” may take that extra bit of mindfulness to negotiate how to move in a way that is kind to my body. I’m not saying that you couldn’t still run in the Olympics if you wanted to, but as for me, no more running for the bus!
As a PT, I have learned important lessons from experiences as the caretaker of my own human body which enhance how I help others help themselves. Whether you are carrying a baby in your womb, a child in your arms or even bags of things in a city schlep, I invite you to create a new language for what it is you are doing. Is there some way you could create more ease for your body, create more harmony between you and the person or things you are carrying, or learn to trust your body more? Time and time again it is a relief to find out that breathing easier and relaxing more creates more efficiency, comfort and pleasure in the body. If you are unsure of how to create ease in your body - pregnant or not - schedule an appointment with a physical therapist...we can help!
Sara Chan, PT, CFMT