When I hear something more than once, I make a note. When I hear something more than a dozen times, then it’s time to discuss.
“Your pelvic floor was too tight...you are too fit to have a vaginal birth.”
“Your baby is breech because you are too fit.”
What they should have said was:
“You’re too fit for the bullshit that is coming out of my mouth… “
When I first entered the birth world in 2009 (first serious conversations about birth and attended my first birth), multiple midwives, doulas, and obstetricians told me that the more fit a woman was, the more likely she would have a breech baby or the baby wouldn’t descend or a cesarean would be necessary. At the same time, I’d completed my doctorate in chiropractic and I was fascinated by human biomechanics. I was learning, shadowing, and mentoring with some of the best in the game. And since then, my appreciation and respect for human movement and potential has only evolved.
What I think these healthcare providers really meant was…
When certain muscle groups and/or muscle patterns are dominant, other muscle groups and patterns do not have the opportunity to mature or develop in a way that would support the constantly varied environment - both inside the human body and out.
Through my hands-on experience, I’ve differentiated bodies into three main sub groups:
- Tight all over with no flexibility (ex. The Tinman)
- All the range of motion and no stability (ex. Majority Yogis)
- Substantial range of motion and stability (ex. Elisabeth Akinwale)
Our physical body is heavily influenced by the environment it is in and the demand asked of it. What we do everyday - in training and in our daily lives - tends to show up in our movement patterns. You likely fall into one of the above categories, and if you’re not in the third category, you’ll need to address your movement inefficiencies before they become problematic. Yes, we can make ourselves more flexible, we can enhance our proprioception, and we can always get stronger. But if your training is largely focused on one particular area and ignores your weaknesses, you’ll end up training bad patterns which can impact your body negatively during pregnancy and even into labor.
I view pregnancy as a great exaggeration of the woman, as if she were a comic book super hero. For instance, if I was pregnant, my need to sleep would be through the roof, my love of bacon may be ridiculous, my avoidance of running might become more semi-permanent, and my chill work out vibe may be almost too chill, dude. I would live in Birkenstocks or Vans, baggie sweats, and t-shirts. What also comes with the hilarious exaggerations of our personalities and quirks are the unique experiences and notches under our belts that make us even more us. But we also experience exaggerations of our body’s movement patterns. I had a cheerleading accident and tore my ACL in college; since then, the range of motion on my left leg joints have always been an issue. Recognizing that pregnancy will only enhance these issues, I understand that while pregnant, I will need to get any asymmetries addressed on the reg.
Let’s bring it back to training. Those that train very one-dimensional or sport-specific tend to have known and unknown holes in their training. This is not bad or good, but it is something you need to be aware of, especially if you are a woman athlete having a baby.
In my experience, those athletes that are long distance runners and cyclists tended to have severely hypertonic (really tight) psoas muscles, which would in turn inhibit posterior chain (glutes, hamstrings, etc.) muscles and alter the position of the pelvis. The hypertonic psoas and altered position of the pelvis does not allow the best space for baby to move around. These runners and athletes were the women that had issues with baby’s position and pelvic floor not relaxing enough - these were the women that the midwives and OBs were talking about; but they missed the big picture. It wasn’t because they were fit; it was because their fitness hadn’t prepared them for pregnancy and labor. Interestingly enough, another population that I have personally seen a lot of breech presentations in is in stark contrast to the athletic population: the sedentary population, or those who consistently sit for more than five hours per day and have very little physical activity.
Both populations, the very one-dimensionally fit and sedentary- had issues with their psoas muscle. For my pregnant runners and cyclists and office chair lovers, we enjoy exploring the backside of their bodies (posterior chain), while at the same time relaxing and lengthening their psoas muscles. The psoas snuggles right up to the diaphragm with the help of some fascia. The diaphragm via our breath connects the mind with our physical body.
Athletes that take a more general approach to fitness rather than one-dimensional - conditioning, weightlifting, gymnastics - tend to have more range of motion in all joints, better involvement of core muscles, and increased stability throughout ankles and shoulders. Their pelvis functions more dynamically and they usually are as tight in front of the hip as they are in the back. These athletes are generally more symmetrical and balanced.
So, as a pregnant athlete, whatever your sport, you need a different strength and conditioning plan to match what you are training for; you also need a smart, intentional training program that heals you after your have had your baby, but that’s another blog. You are training for birth right now. You pick a certain training program based on certain goals: Ironman, 5K, Marathon, etc. Why not actually get on a strength and conditioning training program for birth?
Although too much fitness is an easy, new, trending topic to blame, it is not the reason. The reason appears to be more of an absent mindfulness practice, the art of awareness. The awareness that there are asymmetries- physically and non-physically- that need to be addressed. Becoming more aware opens new doors and new possibilities. Let's open them together.
“Awareness is like the sun. When it shines on things, they are transformed.”
- Thich Nhat Hanh
-LINDSEY MATHEWS, DC