The pelvis is not a fixed entity. Sometimes we think it’s one continuous bone that is either big enough or not big enough for childbirth. Truth is, there are things we can due for pelvic opening during pregnancy.
Remember the skeleton model from school? It wasn’t exactly accurate. To be accurate, we’d need to have all the bones floating in space, held together by our soft tissues (muscles, ligaments, fascia). This means that everything is connected. Our body (including the pelvis) is amazingly adaptable. Shorten one tissue (let’s say- a tight ligament), you see a global response in the system. Open the leg a certain way- the tissues respond!
Do you know how many births I’ve attended as a doula where the birthing person was told their pelvis was too small for the baby to pass through it and they did it anyway? A lot. CPD (cephalopelvic disproportion) or true narrow pelvis, happens, but it’s very rare and usually associated with malformation of the pelvis- whether from other medical diagnoses or other causes. Yet, so many are told they have a small pelvis instead of really considering all the factors that were at play such as:
other factors like medical interventions.
And even still sometimes it’s a mystery.
Does this mean cesarean isn’t a valid option and necessary sometimes? Not at all. I am very grateful we have intervention. I was born by cesarean myself. I’m also grateful that families get to CHOOSE and I’ll never stop advocating for personal preference. BUT can we please stop blaming the pelvis size when there are many more factors at play? We can not tell what a pelvis will do during labor and delivery by assessing it when it’s not in labor and delivery.
Start with finding a neutral pelvis (a block under the hips will help). Face the front leg and hinge forward. This is external rotation and opens the top of the pelvis. Hold and breathe- our body needs time to adapt- so 10 second stretches aren’t so helpful here. Next we are going to activate a way of tapping into the nervous system to help truly change range of motion (cool, right?) press lower leg into the floor for 10 seconds. Then reverse and you’ll notice you can go deeper into the stretch! Because you’ve communicated safety to the nervous system. But during pregnancy especially, please be mindful and don’t force the stretch. Just go a tiny bit deeper. Hold for another minute.
Then switch to face the back leg. This is internal rotation, which opens the bottom of the pelvis. Note that internal rotation tends to be harder for most so go easy.. This is the time where you allow yourself to be where you are rather than where you think you should be. Hold for 2 mins. Reverse- press into the ground for 10 secs. And then right back into the stretch. Deepen by a micro amount and hold for 1 min.
Do this routine at least 3x a week and you’ll be on your way to some super mobile hips!
The pelvis is broadly divided into three sections; the inlet, the mid pelvis and the outlet. We need different movements to open up each part of the pelvis.
The inlet refers to the area of the pelvis from where the baby goes in the pelvis. When the baby is high we want to tuck the pelvis and externally rotate the legs. External rotation refers to bringing the feet together and the knees away from the midline. You can do this in a squat, kneeling, side lying, flying cowgirl…however you want!
When the baby is rotating through the midpelvis, asymmetrical pelvis is the name of the game. Asymmetrical pelvis means that both sides of the pelvis are not in the same plane or are misaligned.
The mid-pelvis is often the “sticky point” in a lot of births. It is the place where the baby has to rotate to accommodate our bony landmarks. Stairs, lunges while standing, or sitting, hands and knees with one knee higher up, side lying peanut ball- tons of options will open up the mid pelvis.
When the baby is at the outlet we want to internally rotate the leg and untuck the pelvis. Internal rotation refers to bringing the knees together and the feet away from each other. Certain types of squats, kneeling, side lying and even lying down with knees together will facilitate this.
When we break it down this way- the birth position possibilities are much greater. Because you can squat (kneel, side lie…) in a way that opens the inlet and in a way that opens the outlet, so understanding the upper leg position and the pelvic position opens us up to create space for the baby through the whole process.