Does being an athlete mean you'll have a c-section?
The short answer is not necessarily.
I’ll see this posted commonly in doula groups that someone’s client is really into CrossFit or likes to lift weights and thinks their client will need a c-section.
This notion is not only incorrect, but it is also really dismissive of how our client or you may enjoy exercising. It also dismisses the numerous benefits of exercising throughout pregnancy!
As an athlete, you may favor a power position (external rotation at the hip = glute power and extension = back power). However, if you cannot find a posterior pelvic tilt (rounding in the back) and internal rotation at the hip, you may find issues during labor.
Another consideration is as an athlete your programming may favor the sagittal plane. This means that most exercises you are doing in your workouts consist of front-to-back type movements that involve extension (straightening the leg) and flexion (bending the leg). If you are mostly favoring exercises in this single plane of motion, it can affect muscular balance.
There are three planes of motion:
- Sagittal: front to back
- Examples: squats, deadlifts, Olympic lifts
- Frontal: side to side
- Examples: lateral band walks, abduction or adduction exercises, pull ups
- Transverse: rotational
- Examples: split squats with internal and external rotation; lunges with rotation
If you are an athlete, consider if you favor extension and external rotation at the hip predominately with your movement and posture. And then consider if your fitness programming favors sagittal plane motion. If the answer is yes to both of those questions, this does not automatically mean a c-section or tight pelvic floor.
However, it may be beneficial to better understand the impacts of these postural tendencies and reinforce this movement pattern and how it may affect your birth. Let’s explore that in this blog!
We incorporate exercises in our prenatal fitness programs to find internal rotation to support labor preparation! We offer our programs in an app as a list of exercises and on-demand with videos you follow as you work out at the same time. Programs are synced to your week of pregnancy or trimester so that you can start any time!
Athletic Postural Tendency: Extension & External Rotation = Power Positions
Throughout pregnancy, you may favor a specific posture related to your pre-pregnancy postural preferences. Plus, things exaggerate throughout pregnancy as the belly grows and your weight shifts!
You may favor a more anteriorly titled pelvic position, where the ribs thrust upwards, and you find more of an arch in the back.
This is sometimes more common in athletes since the extension and external rotation are power positions. Think what the “finish” of most lifts is: hip and back extension with external rotation at the hips. Aka activating the glutes to generate power.
If you favor an anteriorly tilted position (see left image), you need to pay attention to if you “live” in this posture throughout the day. Your spine is meant to move, but you may sometimes find that you are constantly putting yourself in a specific position more often than finding movement.
It can become problematic during labor if you cannot move OUT of this extended and externally rotated position into a rounded position with internal rotation at the hip without compensation.
Video: Learn How Posture Affects Baby's Rotation Through the Pelvis for Birth
Pelvic Movements During Labor
As your baby navigates through the pelvis, you can create larger pelvic diameters with movement. If you favor an externally rotated hip position, opening part of the inlet or the top of the pelvis will be fairly easy. But the pelvic inlet also requires a posterior pelvic tilt (rounded back). A posterior pelvic tilt creates more space front to back in the pelvic inlet. Limitations in a posterior pelvic tilt could make it harder for your baby to engage into the pelvis.
Then, as your baby navigates into the midpelvis, particularly the lower midpelvis, where internal rotation at the hip is needed, you may start to experience issues if you cannot find internal rotation without compensation. Additionally, a posterior pelvic tilt can make internal rotation easier to acheive, so inability to round in the back can limit your ability to find internal rotation.
The result could be a labor stall or arrest, where your baby cannot or has a lot of difficulties finishing their rotation through the pelvis.
So, what can you do?? You are enjoying lifting or doing CrossFit… should you stop?? No!! Continue to exercise BUT be sure to incorporate movements beyond just the sagittal plane with extension and internal rotation at the hip! Let’s break down what prenatal exercises you can do to increase the movement capability of your pelvis as you prepare for birth!
Prenatal Preparation: Find the Position
First, you want to focus on the position of the pelvis or your starting point. You can try to do all the things to find external or internal rotation, but if you are not positioned well, you will likely either not be able to achieve the movement or find compensation.
Typically, you favor the left hip shifted forward (more external rotation or open hip) and the right hip shift backward (more internal rotation or closed hip).
In order to correct this position be more neutral or have the ability to transition to the opposite position (what you ideally want to be able to do easily) you need to have the mobility and strength to adjust the pelvic position.
You can try to adjust the position by literally moving the pelvis into a different position. One tip is to shift the left hip BACK to bring that hip into more internal rotation and lengthen the right-side body.
However, depending on your movement patterns and movement capability, you may find that it is difficult to achieve the opposite positioning of the pelvis due to restrictions. In this case, doing mobility exercises that release the lats, hip flexors, and quads can make it easier to find the opposite setup. In the MamasteFit Birth Prep Guide, we incorporate exercises to target these common movement restrictions! Grab your free guide below.
Some strengthening tips for this common pelvic position are strengthening the left adductor and hamstring and strengthening the right glute. See the video for how I use a band to unilaterally load a lunge with this concept in mind.
Prenatal Preparation: Find Movement
This step may need to come first, or it may come second! This step involves some mobility work to release the muscles that are pulling the pelvis into its position: usually the hip flexors and the lats.
Watch the youtube video below for a walk-through of some mobility ideas.
Prenatal Exercises: Find Internal Rotation
After we have found the positioning, we can focus on strengthening.
We can incorporate a full hip range of motion from external to internal as we approach our single leg movements, such as the staggered stance RDL and the step up movement.
When we are in hip flexion, or the hip is bent towards the belly, focus on pointing the belly button to the lifted or forward thigh. This will help prompt internal rotation.
In addition, we want to focus on the femur being fixed. So as you rotate, the femur should not shift outwards; it should remain stationary as the pelvis rotates on the femur.
In the staggered stance RDL, hold a weight in the hand that is opposite the forward leg. Lower the weight towards the floor as you rotate towards the forward leg as you inhale. The weight may touch or come closer to the forward foot.
If your belly is in the way, you may need to have a wider stance with less reach towards the forward foot.
We incorporate exercises like these in our prenatal fitness program to help you prepare for birth. Our 40-week prenatal program syncs to your current week of pregnancy and can be started at any time!
Step ups are an easy way to teach internal rotation to my clients. The lifted leg is the stance leg, or the leg we want to find internal rotation. Point the belly towards the thigh, remembering the rotation is the pelvis ON the femur not the femur moving outwards.
Put weight into the leg on the box to step up and face forward (moving from internal to external rotation). Then lower to rotate back towards the front leg.
Watch the video below for an explanation of this exercise.
Find Movement to Prepare for Birth
Throughout pregnancy, we can focus on ensuring we have the movement capability to create space at each pelvic level. If we favor a more externally rotated and extended position, we may be limiting how much we can open the lower midpelvis and outlet during birth. This may result in a labor stall or arrest, where your baby can no longer descend or has a lot of difficulties doing so.
We can focus during pregnancy to find movement in the spine and pelvis so that we can find external and internal rotation to create more space in the pelvis for birth!
In our 40-week prenatal strength program, we incorporate exercises to support finding movement in the pelvis. The program syncs to your week of pregnancy, so it can be started at any time.