When we move, our pelvic levels change shape and size. Certain movement patterns will create more space in a certain level of the pelvis but decrease space at other levels.
There is no one movement that will open the entire pelvis! But there are quite a few that will create more space.
During pregnancy, a focus of our prenatal workouts is to ensure we have the movement capability to create space in the pelvis during birth. So, we need a prenatal workout program that incorporates the following movement patterns in all three planes of motion (front to back, lateral, and rotational):
- External Rotation
- Internal Rotation
- External and Internal Rotation Asymmetrically
- Pelvic and Spinal Mobility
You may notice that some movement patterns are difficult to find, such as internal rotation, and others are really intuitive for you, such as external rotation.
We can focus on finding both internal and external rotation, and spinal mobility during pregnancy to support opening the pelvis during birth for the best prenatal workout program!
Birth Preparation: Open Each Level of the Pelvis
The pelvis has three main levels:
- The Inlet, the top of the pelvis
- The Midpelvis, which can be broken down into the upper and lower portions
- The Outlet, the bottom of the pelvis
Each pelvic level opens with a certain type of movement pattern, and we can incorporate these movement patterns into our prenatal workout routines, either strength training, mobility work, or even yoga practice, to support movement capability for birth.
The inlet opens more with:
- External rotation of the femurs (wide knees)
- Pelvic tilting (anterior and posterior, but usually more posterior)
The midpelvis opens more with:
- Asymmetrical or one-sided external and internal rotation (open versus closed hip position)
- Swaying, or side to side movements
- Shifting weight from leg to leg
The outlet opens more with:
- Internal rotation of the femurs (knees in, ankles out)
- Space for the sacrum to move freely (no pelvic tilting)
Let’s explore these movements and how we can incorporate them as we prepare for birth!
1. External Rotation: Open the Top of the Pelvis
The top of the pelvis, the inlet, opens more with wide knees and pelvic tilting. Usually a more posterior pelvic tilt will increase the pelvic diameter, but external rotation of the femur is usually easier in an anterior pelvic tilt. So, pelvic mobility in the sagittal plane is important!
Your prenatal workout program should include movements that:
- Emphasize wider knees (such as squats)
- Pelvic and spinal mobility in the sagittal plane (front to back movement)
These movements are fairly common in workout programs, so it’s easy to incorporate.
External rotation with extension in the spine is a power position! This is the position we may find ourselves in when we lift weights or jump up! So, it’s fairly common in workout programming and usually easy to achieve even during prenatal workouts.
BUT posterior pelvic tilt with a rounded back may be difficult to find during pregnancy due to decreased mobility of the thoracic spine.
So, it’s easy to find external rotation and spinal extension, but more difficult to find a posterior pelvic tilt with spinal flexion during pregnancy. It can be important to incorporate both these power positions of external rotation and spinal extension, but also finding spinal flexion.
Watch the videos below to see some examples of movements that could be included in your prenatal fitness program. We incorporate these movements in our prenatal fitness programming to help you prepare for birth!
Strength and Mobility Exercise for External Rotation: Deep, Supported Squats
Mobility Exercise for Back Expansion: All Fours Inversion Breathing
This video is from Hayley Kava, pelvic floor physical therapist. Hayley offers a ton of amazing resources on her website and Instagram page, plus a mentorship program for professionals who want to dive deeper into these topics.
2. Asymmetrical External and Internal Rotation: Open the Middle of the Pelvis
The midpelvis opens more with asymmetrical side to side (frontal plane) and rotational movements (transverse plane). We will likely spend most of our time during labor in this pelvic level!
Movements that we will want to include in a prenatal workout program to prepare to open the midpelvis would include:
- Unilateral or single-leg movements (staggered or split stance also an option)
- Rotational movements
- Asymmetrical external and internal rotation of the hip
- Thoracic mobility
The typical thing I see missing from prenatal workout programs is this rotational and asymmetrical aspect that includes this full range of motion of the hip.
It’s easy to find external rotation, but it is rare to find a prenatal workout program that intentionally incorporates the internal rotation aspect (which is a part of your hip’s range of motion).
Feel strong and move comfortably throughout your entire pregnancy. Our program syncs to your current week of pregnancy, so you can start at any time!
- 5 Workouts Per Week
- Labor Prep Workouts
- Teambuildr App Access
In our prenatal workout program, we incorporate exercises that emphasize this internal rotation bias to:
- Strengthen the glute even more (remember, internal rotation is usually neglected as a part of the hip’s range of motion)
- Support a stronger backside = more prenatal comfort
- Increase stability and comfort of the pelvis
- Prepare to open the pelvis for birth
When preparing to open the midpelvis, we want to incorporate mobility exercises that allow us to find internal and external rotation: release the adductor and hamstring to find external, and release the glute to find internal rotation.
And then we want to incorporate strengthening exercises that are unilateral and one-sided, focusing on the hip’s full range of motion.
Watch the videos below for two examples of exercises we incorporate in our prenatal workout program to prepare you for birth.
Mobility Exercise for Unilateral External Rotation Support: Adductor Rock Back
Strengthening Exercise for Unilateral Internal Rotation: Staggered Stance RDL
3. Internal Rotation: Open the Bottom of the Pelvis
Bilateral internal rotation opens the bottom of the pelvis, the outlet, more, which can be helpful while pushing!
Internal rotation of the femur spreads the ischial tuberosities, or sitz bones, further apart from one another, creating more space laterally in the bottom of the pelvis.
Then, maintaining a neutral spine position (and being off your back) will allow the sacrum to move freely as your baby descends through the bottom of the pelvis.
Exercises to include in a prenatal workout program include:
- Hinge movements for lat engagements
- Mobility exercises focused on internal rotation of the femurs
- Relaxation breathing drills
We may forget about the relaxation aspect as we prepare for birth!
We include a daily breathing drill and labor preparation workouts towards the end of our prenatal workout program so we can focus on this release aspect in preparation for birth.
Join us for on-demand prenatal yoga classes specific to each trimester!
- 20-30 minute long on-demand yoga classes
- Trimester Specific Classes
- Pelvic Opening Yoga Flows: Prepare for Birth!
- Lifetime Access of Program
Watch the videos below for some examples of exercises you could include in your prenatal workout program to prepare for birth!
Strength Exercise for Lat Engagement and Neutral Spine Positioning: Deadlifts
Mobility Exercise for Internal Rotation: Standing Breathing Drill
4. Pelvic Tilts: Move the Spine
After the hip mobility and strengthening of finding internal and external rotation at the hip, we also need to find movement in the spine!
The pelvic position depends on the spinal position; we cannot find internal rotation if the spine is in an extended position, for example.
We may find that posterior pelvic tilting or rounding in the back is more difficult during pregnancy, so we can focus on breathing drills and thoracic mobility to help us find movement in the pelvis for birth!
In our childbirth education courses and labor biomechanics webinar, we break down how the pelvis opens and closes with different movement patterns. Understanding labor biomechanics can help you better prepare for birth physically and navigate what positions to do during labor!
This course includes our 90-minute labor biomechanics webinar recording plus our 24-page labor biomechanics quick reference guide.
- 90-min webinar
- 24-Page E-Book
- Upcoming Live Webinar & Q&A
- Watch on Mobile Device
Opening the Pelvis for Birth: Start During Pregnancy
How well we can create space in the pelvis can influence if we will experience a labor stall! If we have movement compensations or lack of range of motion that prevents us from creating more space in each pelvic level, baby may have a more challenging time navigating through the pelvis.
We can prepare for birth by ensuring the movement capability exists during pregnancy! Can we find external and internal rotation bilaterally, but also unilaterally? Can we change our pelvic and spine position? Do we have restrictions that prevent movement capability, and if so, can we address it now?
There is a lot we can do during pregnancy to prepare for birth, and one aspect is the physical preparation! Let’s start to find movement in the pelvis with our prenatal fitness programming!