The MamasteFit Podcast Episode 136 – Understanding Pelvic Mechanics

Gina: Welcome to the MamasteFit Podcast. In this episode, we’re going to be talking all about pelvic mechanics and why it’s really important as a birth worker to understand, how does a pelvis open, and what we can do prenatally and during labor to create more space for birth.

In this episode, we’re going to be talking all about pelvic mechanics and why it’s important to know what pelvic mechanics is, and why it matters as a birth professional. And so, what is pelvic mechanics?

The first thing in understanding with pelvic mechanics is how does the pelvis open, and what type of movements correlate to different types of opening within the pelvis? And so this podcast episode, and this video, is not going to be a breakdown, necessarily, of pelvic mechanics- we have a ton of other videos on our YouTube channel, and we have an entire course for professionals all about how to create space within the pelvis with different exercises, different labor positions, different types of movements, both manual movements that you can do as the professional and movements that like the client or patient can do. So we have an entire course that breaks it down, ’cause it’s really hard to explain the concept in a audio podcast, or in a video podcast where you’re just staring at our beautiful faces- ’cause we did put makeup on today, so, admire, admire. Look at my wing! I learned some hooded eye wing techniques.

Roxanne: Oh yeah. Gina is very proud of it.

Gina: I’ve been buying all of this makeup, and I would like to utilize it in some way. But they’re all like super bright, glitter, which you know, may not be appropriate for every day. I have more of a muted gold.

Roxanne: I don’t wear…

Gina: Gold shadow.

Roxanne: I just have lipstick.

Gina: Anyways! Back to the important topic, which is not, how does Gina do her hooded eye wings?

Roxanne: I mean, you want that video…

Gina: If you want that tutorial…

Roxanne: Let us know.

Gina: I don’t know if I’m the one that should do it, but I can make it. I have gotten some requests to do a messy bun hair tutorial, which is in the… the, uh…

Roxanne: Queue.

Gina: …list, the queue! The queue of things to do. Anyways, back to pelvic mechanics.

So this episode, we’re not going to talk specifically on what movements create space, but rather why it’s important, and, in our personal and professional experience, how understanding the pelvis and its movement capabilities has helped to support better birth outcomes, better pregnancies. Because, having a good moving pelvis and a pelvis that can change position really well equals a more comfortable pregnancy, ’cause it’s not all about birth preparation and the birth. Like we also want to move comfortably throughout our pregnancy, navigate labor with movement ease, and then help to support us for recovery postpartum. So we’re going to be breaking down the why it’s important to understand. And so if you are a professional and you want to learn the what concepts, check out our new pelvic mechanic scores. Depending on when you’re listening to this, if it’s before November 24th, 2025, we’re in pre-sale. 50% off right now. If it’s after November 24th, 2025, it is full price, so find a coupon code, which will be listed at the end of this episode for 10% off. So if you wanna learn the what, check out our new professional course or join us in person with our monthly in-person workshops that we have in various places throughout the world.

Roxanne: Throughout the world, hopefully.

Gina: Hopefully.

Roxanne: Jinx

Gina: On our, it’s on our roster.

Anyways, so what is pelvic mechanics? The first thing in understanding pelvic mechanics is there’s different types of movements that correlate to different types of opening within the bony structure of the pelvis, in addition to the muscles that help to support creating space within the pelvis.

The pelvis has three levels to it. We have the inlet, where the baby’s going to first enter, or engage, into the pelvis. We have the middle of the pelvis, which is the mid pelvis. This is where baby is rotating. There’s tons of muscles and ligaments and connective tissues that baby’s also navigating through in this space. And, then we have the pelvic outlet, which is the very bottom of the pelvis. And this is where baby’s going to be vacating the premise, and being born and crowning and all that. Expelled, or ejected.

Roxanne: Ejected!

Gina: From the pelvis.

Roxanne: So aggressive.

Gina: With these different… it feels aggressive sometimes!

With these different pelvic levels. There’s different types of movements that help to create different types of space within them. So there’s no one movement that opens the entire pelvis.

Roxanne: What?!

Gina: I know, wild. So there’s no one best birth preparation exercise. So just doing deep squats and butterfly poses and all of those other wide legged, externally rotated positions is not the only birth preparation exercise that we should be doing. And there’s no one labor position that’s going to open the entire pelvis. So we shouldn’t all just do deep squats the entire time. We shouldn’t all just put a peanut ball between our knees and just hope for the best. There’s different types of positions and movements that we can do throughout pregnancy and during labor to help create different types of space within the pelvis to release different types of tension within the pelvic floor as well.

‘Cause spoiler, there’s also not one best pelvic floor exercise, or stretch.

Roxanne: Why not?

Gina: It would be so much easier if everything was just do a deep squat.

Roxanne: Yeah.

Gina: And then you were good to go.

And so let’s discuss why it’s important as a birth professional, especially if you are a community birth supporter- so you support home births, freestanding birth center, maybe you’re at a hospital that has lower interventions available to you, if you are like a birth doula, you’re a non-medical birth support person- why it’s important to understand these different movement mechanics. And we can start with pregnancy, because we don’t need to wait till labor to hope that everything works out. And when we’re navigating labor, we don’t have to just cross our fingers and hope that everything progresses really well, or just transfer. Like we, there’s so much that we can do movement-wise to help support somebody’s birth experience and to support their pregnancy.

So during pregnancy, we wanna be incorporating different types of movements to improve how well the pelvis moves, to improve the tension and balance within the pelvic floor. And then also to support the surrounding musculature-’cause it’s not just pelvis and the bony structure, there’s all of this stuff that attaches and supports baby within that space that we also need to be thinking about.

And so one of the first concepts that’s important to understand is we have normal asymmetry within our bodies that doesn’t necessarily equate to a problem. But, understanding these asymmetries is really helpful because when we do start to experience issues, it’s probably correlated to sinking a little bit too deeply into that asymmetrical pattern. And so our organs are not symmetrical. Our diaphragm is not symmetrical, and so the way that our body is set up is not perfectly down the line, balance on both sides. We’re going to have a little bit of shifting of weights and rotations and positions that doesn’t mean a problem.

So for a lot of us, we put more weight into the right leg- the organs are denser on this side, the diaphragm is larger on this side, and so we tend to shift a little bit to the right. This correlates to that right pelvic half kind of rotating backwards a little bit so we have a little bit more tuck on that right hip, in addition to more internal rotation, so that hip is coming into a closed position. So you can almost think like that pelvis is rotating a little bit more to that femur on that side. So we tend to stand a little bit more on this side. This tends to correlate to more internal rotation through the right leg. That right anterior or front part of that pelvic floor has a little bit more overactivity ’cause it’s really pulling us into that internally rotated position. We tend to be slightly more compressed on that right side body, so if somebody’s having more like rib pain or discomfort on that right side, it could be just from that compression that’s happening there. And then that continues up the chain.

On the left side, since we tend to favor the right leg a little bit more, we tend to favor a little bit more of an open hip position on the left leg- so a little bit more external rotation. So almost like the toe is pointing out, and we are moving the pelvis away from that left femur. So with this more open position, this is going to tighten the back half of the pelvic floor on the left side. That left inner thigh and hamstring might be a little bit more lengthened. We might have a little bit more extension or lengthening in the left side body, and then we tend to be rotated a little bit to the left as well.

So we have these different kind of patterns up our body- which are normal, it doesn’t mean that there’s a problem- and then we add on pregnancy, which is going to exaggerate a lot of these movements because our joints have more laxity, so there’s a little bit more movement in our joints. We tend to also have a little bit more weight to the front ’cause our baby is growing and that tends to pull us into extension, or arching in the back a little bit more. We also have this normal additional curvature in the lumbar spine or the lower back as females that comes to help us accommodate that extension and that additional weight forward. And so during pregnancy we tend to exaggerate extension, a little bit more arching in the back, and we tend to exaggerate a little bit more of an open hip position on both sides- or like really favor a lot of weight into that right leg.

And so this can kind of correlate to different discomforts during pregnancy- but it doesn’t always equal a problem either. So if you don’t have any pelvic pain, you feel really comfortable throughout your pregnancy, you got no bladder issues, no constipation, like you’re feeling, like generally fairly balanced and good, the asymmetry that you have is not an issue. Now, if you are struggling with constipation, you have tailbone pain, maybe SI joint pain, any sort of pelvic pain, you have lower back pain, you feel like you have to pee all the time, maybe you’re leaking, feeling heaviness- these are all signs that that asymmetry, we’re probably sinking a little bit too much into it.

And so as a birth professional or a perinatal professional, so somebody that is helping to support you throughout pregnancy, if you can identify that these are issues and understand that they’re probably linked to asymmetry, we can help to support our clients to feel so much more comfortable, so much faster and more efficiently as well. So instead of, “Oh, you have bladder issues, or you’re feeling heaviness, let’s do Kegel to strengthen that pelvic floor to lift it up,” we can think, “Okay, maybe you have heaviness ’cause that right anterior pelvic floor is really firing a lot, so maybe we need to offload that half with some like inner thigh releases, groin releases. Maybe I need to help you shift into that left hip better, more efficiently. Maybe I need to decompress the right side body.” And so understanding pelvic mechanics and these normal asymmetries can help clients be more comfortable throughout their pregnancy.

And Roxanne, you have been dealing with SPD pain, or front pelvic pain, and I think some SI joint pain. What are some strategies that you’ve been utilizing that relate to pelvic mechanics that’s been helping you feel more comfortable?

Roxanne: I’m, one, working with the pelvic floor PT, so like they just tell me what to do, which makes it easier. But I think I definitely favor all of those same things, all of those same patterns. And I find that’s also why I’ve had previous issues with like constipation and GI things that now make more sense, but they’re just exacerbated in pregnancy as well.

So like all of those similar asymmetries, because I’m now like overcompensating, almost, in all of those things- like my left inner thigh is weaker, and my right is tighter, so that is one of the reasons that my SPD usually gets more irritated. And then it also like the, within some things, sometimes it is like the position of the baby that makes it even worse.

So strengthening my inner thigh with like ball squeezes on my left side with that little hip shift- not little, but it feels little in my body- it really helps a lot with my pubic bone pain. And then as well it’s also helping with my SI joint pain on my right side because I don’t really externally rotate on my right leg at all, and that’s one of the reasons why my right inner thigh is so tight and so externally rotating to stretch that inner thigh while also focusing on like glute strength are the things that I’ve been focusing on in this pregnancy to help with those pains. But I also know that it’s affecting like my pelvic floor and my ability to lengthen in those areas with like my left posterior and my right anterior. That is also affecting potentially my baby’s position. So he is in a funky position, and I think in previous pregnancies I probably also had funky positions in labor and in pregnancy that probably also were exacerbated based off of like the things that I was doing in pregnancy, or wasn’t addressing in pregnancy. So those are the things that I’ve been addressing in my current body, in my current pregnant body to hopefully minimize issues in labor because I’ve had things in previous labors that I think were related to my baby’s inability to engage and rotate at the end.

Gina: Yeah. So for me in this last pregnancy, I was having a lot of bladder urgency, so I would pee and then feel like I still had to pee or was peeing constantly, which could be related to that right anterior, or right front quadrant, kind of firing a little bit more and pulling that back half of my pelvis forward, which was pushing onto my bladder. And it was also pushing my baby forward over the pubic bone as well, and so that additional pressure on the bladder and sensation in that right anterior pelvic floor was causing this feeling of urgency with my bladder.

And so I also worked with our in-house pelvic floor PTs, who really do focus on asymmetry, and they have a really good understanding of pelvic mechanics. And so we did some releases to offload the right pelvic floor. We did a lot of exercises which are incorporated within the MamasteFit Birth Prep Circuit, which is a free guide that you can get, and we’ll link below this YouTube video and this podcast episode. So we did a lot of releases to offload that right anterior pelvic floor, and this actually allowed my baby to engage and led to my fastest labor ever because I addressed this prenatally. So I didn’t wait until labor to figure out, “Okay, how do I get my right anterior pelvic floor to release and to let go?” which can be hard for folks that the first time they meet a patient or a client is in labor, which like a labor and delivery nurse, the first time you’re going to meet this patient is likely when they show up in labor. And so the preparation portion is really important for somebody that is working with clients prenatally- so your providers, so like OBs and midwives that are seeing patients throughout their pregnancy. I know that time is really limited though in the appointment, so it’s probably really hard to be like, “Also while you’re at it, can you throw in some hip shifts and some inner thigh releases!”

So that’s really hard and so that’s why we have these free guides so that you can be like, “Hey, I’m your provider. I don’t have time to talk to you because… healthcare in America, whole nother conversation. Here’s a quick like free guide that you can grab online and these exercises are going to help to prep you for birth.” That’s a really easy thing to do.

Roxanne: And that’s like, that is the reality of like your visits are limited. You don’t have an hour long visit with your provider every single time. So it’s like key things to know, like what to bring up. What pains are you having? As well as like providers, us knowing, like when someone says, “Yeah, I feel like I’m peeing all the time,” yes, like in pregnancy urgency increases because you have more fluid and whatever like physiologic changes, but if someone is like, “Yeah, I feel like I’m peeing all the time, and then when I go, I don’t really like pee much,” rule out that they don’t have a urinary tract infection, but also it could be related to that pelvic floor and knowing that is a sign. If you don’t have time in your 20 minute appointment to go over things for them to do- which many of us do not- that is when like having tools to then give them to be able to address that. If someone has pubic bone pain or like lower back pain, it’s not like we just ignore it in your pregnancy. We still give you tools for all of those pains, just like we would, and hopefully by understanding pelvic biomechanics and the pelvic floor, you would be able to be like, “Oh, you’re having this pain, this could affect your pregnancy, but also your birth so addressing it now could be really beneficial.” Because that pregnancy preparation portion is so important and we have such a big impact on that with your prenatal visits. Just like other, like, movement professionals that like deal with this prenatal time is like, it’s not just what can you do during labor? It’s what can you do during pregnancy that can impact labor? But like also, what are things that we can still do in labor that can still be beneficial?

The prenatal portion is so important to be able to identify what are key things that I’m seeing as a professional or a provider that usually indicates this happening in their labor, and what could we have done prenatally to maybe mitigate that? And we know now, like there are things with the pelvic floor. Like if you’re having urgency and you’re peeing all the time, but when you go pee, you don’t pee very much and you don’t have an infection, maybe that’s pelvic floor related, and seeing someone could be beneficial. ‘Cause it could also end up leading to infections if you’re just like constantly peeing but you’re not fully emptying, because that could also lead to that could also be a thing that you’re saying with that tight anterior pelvic floor, it is like urgency, but it’s like you’re not able to fully empty. So like pee is just staying in your bladder, which could then lead to bladder infections. So all of this, it’s not just pelvic biomechanics is really important for preparing for birth, but it’s also like health.

Gina: Yeah. It’s to keep you comfortable throughout your pregnancy and then we don’t need to wait till birth to figure it out. And so if you have an opportunity to work with a client or a patient throughout their pregnancy, try to figure out how can I incorporate this mechanic’s work.

Now if you are a community birth provider you have hour long appointments. Your hour long appointments, in my opinion, should include preparation exercises.

Roxanne: Not every community birth has hour long appointments. Some are like 30, 30 minutes to an hour, but still.

Gina: If you are supporting birth out of a hospital where you are limited on your tools- not to say that giving birth outside of a hospital is unsafe by any means, but you only have, you don’t have a C-section at home.

Roxanne: No.

Gina: You are not going to be able to induce somebody at home. If their labor’s stalling…

Roxanne: You don’t have vacuums or forceps.

Gina: You don’t have Pitocin that you could administer to them, I don’t think. Probably not, ’cause you…

Roxanne: No.

Gina: Should be in the hospital.

Roxanne: Not for labor, no.

Gina: So if you don’t have these additional tools to help support and augment somebody’s labor that is dysfunctional, you need to be really savvy on movement mechanics, and you need to be able to educate your clients, prenatally, on how they can improve movement throughout their pregnancy. Because, if we wait until labor to address the fact that somebody’s had bladder urgency and pelvic pain and constipation their entire pregnancy, we’re going to have issues during labor. We’re going to have a baby that’s having a hard time to engage. We’re going to have a giant stool that needs to be birthed first.

Roxanne: Stool burden.

Gina: We’re going to have some asymmetry and movement issues with the pelvis. And so if you are a community birth provider and you do not have the ability to augment a labor with medicine at home, you need to be savvy on this stuff, ’cause this is how you’re going to help somebody have a vaginal birth at home without needing to transfer because baby’s like stuck, quote unquote.

Roxanne: But it’s also important because even in labor, like most of the time for a C-section, the reason is a malposition baby, so baby’s in a funny position. And it could have been like that was a position that baby needed to be in at that time, but like your body then was not able to then correct it in the appropriate amount of time. If a baby is in a malposition, Pitocin isn’t the answer most of the time to fix the dysfunctional labor pattern. It is fixing the position of the baby that will fix the dysfunctional labor pattern for most of these people.

So even like community birth, if we have a dysfunctional labor pattern, we would be doing that anyway. So understanding what positions would be beneficial in pregnancy and in labor is still beneficial whether or not you’re in a community or a hospital birth.

Gina: Absolutely.

Roxanne: And I think that that is why the why of understanding the pelvic biomechanics is so important- because one, we don’t even learn this in school. Like I, nursing school, pelvic biomechanics is not covered.

Gina: I didn’t learn any of this as a doula.

Roxanne: Yeah.

Gina: This was all stuff that is self-studied.

Roxanne: Like midwifery school, it is slightly covered. But it’s like curriculum based, so like what school you go to will cover probably more biomechanics. So like maybe my school covered it slightly more than other schools.

So it’s like this is where that continuing education of trying to improve your care that you’re giving to people. ‘Cause we’re not expecting people to be pelvic floor physical therapists and being like the expert of like pelvic floors, but having tools available to us is still really beneficial.

Gina: So when we’re thinking about pelvic mechanics prenatally, the goal is, one, can we improve the mobility of the pelvis? Can we improve the balance of the pelvic floor? And then that’s going to help to support everything else as well, because we need to think about everything else when we’re thinking about pelvic balance and pelvic mechanics and like the mobility of that.

And so incorporating different types of exercises throughout pregnancy to help improve all of that is really important. It’s going to help to support somebody’s comfort throughout their pregnancy so they don’t have to be in pain. It’s going to help to support their baby’s positioning going into birth, and it’s going to help prepare them to be able to create different types of space when labor begins. And so all of the birth prep exercises, the goal is to not force baby into one specific position, or to open the pelvis in this one specific way- the goal is to ensure that movement capability is accessible and available when labor begins. That the ability for baby to change positions is easy when labor begins ’cause there’s no kind of adhesions or restrictions or movement obstacles.

Roxanne: Yes, exactly.

Gina: And so if you are a provider or a support person during pregnancy and you have limited time with your patients, but you see them throughout pregnancy, think about what additional resources you can give them that they can take beyond your one appointment, however often you have it with them. So we have tons of free resources on our YouTube channel, on our website that we offer with our birth prep circuit. We have our prenatal fitness programs. We have an entire YouTube playlist that’s on how to be comfortable during your pregnancy, and that’s all free. The fitness programs are not free, but the birth pipe circuit and the YouTube channel resources are all free. And so if you don’t have time to walk somebody through all of this stuff, and you’re just like, “Ah,” just send them there.

And then the next thing I would recommend is to know who to network with and who to refer to in your community that’s beyond just you, ’cause you as the OB or the midwife do not need to be the only person supporting somebody during their pregnancy. There’s other practitioners out there like pelvic floor physical therapists, just physical therapists in general. We’ve got chiropractors, you’ve got acupuncturists, you’ve got massages.

Roxanne: Massage therapists!

Gina: Like, fitness trainers. There’s a lot of other people in your community that are likely available to help support your patients and your clients as well, in a way that maybe is a little bit more in depth than you. And so knowing who to refer to is really important.

Roxanne: And that’s like the hardest part as a provider.

Gina: Yeah. And this is important for a fitness trainer, this is important for a physical therapist, for a doula- for people to know, at what point do I need to refer because I can’t do it all, and that’s okay. As a doula, it is not my job to do everything, but it’s my role to make sure that I help my clients figure out where they can find certain types of information, what kind of questions can they ask to advocate for the type of care that they’re seeking.

And so if you’re seeing somebody throughout their pregnancy, understand why pelvic mechanics is important, and if somebody is telling you about this type of discomfort or pain that they’re having, know that there’s likely a solution to it. And so if it’s outside of your list, like you’ve ruled out infection and you’ve ruled out like a medical complication, what else could it be and who else could you refer to? And we break down like symptom, what does it might equal to in the pelvic mechanics course as well. So if you’re seeing these trends, it likely means these things, but we’ll give you some tips on what other things it could be as well besides just pelvic floor. Maybe it is something else that we need to look beyond for.

Now when it comes to labor with pelvic mechanics, obviously the goal would be somebody just goes into labor and their baby just engages and rotates, and then all of a sudden they’re pushing and it’s smooth. It’s six hours, like everyone just pats each other on the back and they’re just like…

Roxanne: Six hours might be a bit quick, but yeah.

Gina: Woo. It’s all done.

Roxanne: It’s very easy, yeah.

Gina: And I think in a lot of scenarios it is pretty smooth. There’s no issues, like, babies engage, they rotate. Maybe labor takes a little bit longer, it doesn’t mean that there’s a problem. And then the baby is born and then we all just move on with our new life. And I think that’s great. However, not every labor is like that.

There are a lot of laborers where there are like these little issues that kind of pop up that sometimes fix themselves, but sometimes can maybe get fixed quicker with a little bit of deliberate effort, and sometimes need a lot of deliberate effort to help resolve.

And so the goal, obviously, I think for most providers is to have a vaginal birth.

Roxanne: Yeah.

Gina: Like I think that is most of the time the goal- unless like something was identified prenatally, where a Cesarean birth was a better option and the patient decided, “Yes, this is a better route for us.” But in general, I think the goal is have a vaginal birth using as little intervention as possible, I think is what most people are trying to do. And I think for, as patients, most of the time the goal is, I would like to show up and have a baby out of my vagina with as little assistance as needed. And so with pelvic mechanics, we can do that. Not a hundred percent of the time, but like it’s going to get, put us in the, it’s going to set the conditions in our favor.

And so some common issues that understanding pelvic mechanics can be really helpful is there’s some sort of restricted space within the pelvis- not that the pelvis is too small, just there might be some mobility going on within there, maybe within the pelvic floor- and baby’s position. So there’s something going on with the space, and there’s something going on with baby, either/or, maybe both of them. And then there are other things outside of mechanics that could be correlating or co contributing towards a labor stall- somebody’s really tired, they’re starting to get sick, they’re hungry, they’re dehydrated. And in those scenarios, usually if we resolve whatever that basic need is, labor usually progresses. And if not, maybe that’s when we start thinking about Pitocin, that’s when we start thinking about additional interventions.

And so if the issue is related to baby’s position, or the space within the pelvis, this is where pelvic mechanics is going to be super, super helpful. And like you said, one of the top reasons for an unplanned C-section is baby’s in a funky position, and they were just having a hard time getting out. And I’m really glad that C-sections are available to help support that, because if babies don’t come out, it doesn’t end in a good outcome, like regardless. And so having a C-section is still a really good thing to have available to somebody. Like I, this is not trying to say like, nobody should have one ever. But we wanna set people up for success, for the best, like, outcome possible for them.

And so one of the things that could happen is baby’s position. So we’ve got a baby that won’t engage. We’ve got a baby that’s OP, so they’re facing potentially in a way that doesn’t allow them to enter into the pelvis, which I guess would be engagement. And then their asynclitic, so their head is, boop, a little tilted. So with all of those, understanding how a baby is moving through the pelvis, where they are up and down within the pelvis, can help you figure out where do I need to create more space? Where can I release some tension, both with the labor position, maybe with some manual techniques? Depending on your scope will vary which one of these tools you get, or both tools you get to utilize. And how can I help to support baby’s position so they can then vacate the premises, they can be ejected from this pelvis.

Roxanne: From the vagina.

Gina: From this pelvis.

Roxanne: Through the vaginal canal.

Gina: So if baby’s having a hard time engaging, usually they’re either not aligned to that pelvic level- so think about the pelvis as a square peg, or square hole, and the baby is a square peg, they’re meant to fit. But if my square is a diamond, it’s not going to enter into that square hole, no matter how hard I ram it, no matter how high I increase that Pitocin, it’s still not going to enter into that pelvis unless it rotates and becomes a square. The other thing would be if that square peg is aligned as a square, but it’s forward and it’s overlapping the front of my square hole, AKA, the pubic bone, it’s not going to enter into that pelvis no matter how hard I ram it down until I can change the orientation of the pelvis and get baby to move backwards. And now part of that may be I need to release and open the posterior portion of the pelvic inlet to help baby have some space to actually enter in so they’re not being pushed forward. If baby’s kind of twisted or not quite aligned to the pelvic inlet, I need to create space in the upper part of the mid pelvis to help baby begin to rotate so that they have more opportunity to change positions.

And so this is where understanding pelvic mechanics is really important. How do you create that type of space? How do you create space in the posterior inlet? How do you create space in the upper mid pelvis? And then, as part of a prenatal prep, what can we do prenatally to make sure that we can do that in labor? Now if we’re in labor, it’s too late now. Like we, we have made it here, and we have whatever we have when we show up in birth. If the posterior part of your pelvic inlet is a little bit tight, and the upper mid pelvis is maybe not as open as we would like, we need to figure out how we can create that space in labor. And so we need to be able to find more of a posterior position within the pelvis to open up the back part. Maybe that includes some manual releases, maybe that just includes some pelvic tilting and really releasing in the lats and the hip flexors. For the upper mid pelvis, can we offload that front part of the pelvic floor and pelvic inlet so that space can open up to allow baby to engage? And so these are going to be really technical types of movements that we’re going to need to guide and move somebody through to create a lot of space.

And so if you think about the Mile Circuit, and why the Mile Circuit tends to work is we invert- so we’re giving baby an opportunity to try to reposition themselves, and then we’re going to do an upper mid pelvis opener with that exaggerated side lying- so with the leg and knee moving away from midline, that’s an upper mid pelvis opener, so somebody should feel more of a stretch in their inner thigh and groin. We’re creating space on the left side to give baby an opportunity to rotate. And then we come into an upright elevated lunge position, so now hopefully baby has rotated and is aligned, and now they can drop into the pelvis. And then we have this upper mid pelvis opener and a standing position where that pelvis is tilted a little bit more forward, it’s oriented more open, and baby can finish rotating into the pelvis. That’s why the Mile Circuit works for prodromal labor, why it works for really long early labor is where baby’s having a hard time engaging. And so when you understand why the Mile Circuit works, why these different labor positions work, you can tweak it based on the scenario that you’re in. ‘Cause somebody who has an epidural is not going to get up and do an elevated lunge, and so you need to understand how do I create space in the upper mid pelvis to help that baby engage?

Now if the issue is baby is having a hard time rotating from OP, we need to think about what kind of obstacles are maybe preventing them from being able to change positions. So have we looked at the uterine ligaments? Have we looked at the round ligaments? Can we invert to create more space in the lower part of the pelvis? Do we have any tension within the abdominal wall? The hip flexors? How are those hip flexors looking? What about the side body? And so we need to think about everything that’s potentially preventing this baby from being able to rotate and how do we release that? But understanding what is potentially orienting that pelvis in that way is going to help us know what type of movements to do, either manually or guiding somebody through during labor. And then utilizing the different tools that we have. If you have internal assessments, if you can do external palpations, if you can do external like releases- that’s within your scope, then that’s a tool that you have available to you.

Now, if baby’s asynclitic, so their head’s a little bit tilted one, you need to be able to identify that. That needs to be something within your scope to identify, or to communicate with the team to identify what’s going on. Usually I see with asynclitic babies, if somebody has an urge to push, it’s like weak, where they’re like, “I feel like I’m kind of pushing…” and then once we correct the baby’s head position, it’s like. “I’m really pushing, like there’s no, no doubting that this baby is being born.” And so I had one time where the mom was having this like urge to push. It just wasn’t very productive though, like it didn’t feel like things were increasing for her. And the midwife came in and did a cervical exam and she was like, “Oh, the baby’s asynclitic, so we’re just going to have to give you some pitocin to like, get the show on the road, to get this going.” And I was like, “Let’s just do an inversion real quick!” And so we did just puppy pose, it wasn’t even like a forward leaning, it wasn’t a super intense inversion. And that was enough to help baby adjust their head position and immediately, like she did one inversion during one contraction and immediately baby’s head adjusted and she was like, like vomiting out of her vagina, her baby. Ejecting that child. And so if we hadn’t used movement, we would’ve utilized other interventions at that point, which is not necessarily bad, but it was creating a lot of anxiety for her. Like she did not want Pitocin in that moment, like she was not ready mentally for that next step. She had a different experience with her first birth that like Pitocin was a little like traumatizing for her, and she didn’t wanna do that again. She wanted to explore other options first. And so when Pitocin was brought up, she started to really panic and was like not doing… mentally unwell at this point. And I was like, “Let’s just invert for a second.” And then she had no opportunity to think anymore ’cause that baby was being ejected from her body. And so if we had not utilized, or had an understanding of pelvic mechanics, that birth story might have been different for her.

Roxanne: Yeah.

Gina: It might have gone down a really different path for her with like once Pitocin was mentioned, she was like, “I need an epidural. I can’t do that again. We’re not going to do that.” And things would have been really different. It would’ve been a different birth story and like in her perspective.

And so there are times where using additional intervention can be really beneficial, and there are times where it’s worth exploring what kind of movement can we do, what kind of releases can we do to help support babies’ movement through this pelvis, to support more space within this pelvis to make it an easier labor. Not that intervention is bad or birth options and medical interventions are bad by any means, ’cause there’s a place for it all. But I also find like the less intervention that we do, the less issues that we tend to also have.

I don’t know. What do you think?

Roxanne: I think it’s also thinking about like how invasive certain interventions that we have are. So movement’s pretty non-invasive, like you just do a movement with your body and this could potentially fix the issues. But then like Pitocin, it has to go in through an IV and we have to monitor baby, and it could limit your range of motion. Rupturing your bag of water, that’s pretty invasive and can be uncomfortable for people. So it’s like all of the interventions that we can use like in medicine, while they have a place, if we can use a non-invasive technique, why not just invert somebody? And also, we also have to think, all of the interventions that we have usually are not an immediate intervention. Like Pitocin, the nurse has to go get it out of the Omnicell or the whatever, the medical thing that you store all of your medicine, you have to put an order in, and then if they didn’t have an IV, they need an IV, and then they have to then start the Pitocin. And that takes time! It could take 15 minutes, up to 45 minutes to even get Pitocin started. So why not use something in the meantime like an inversion or a lunge?

I will say most people when I’m like, you wanna try a lunge? They’re like, “No, I don’t want to do that. That sounds like a terrible idea.” And then we do it and they’re like, “Okay, maybe that was helpful. Maybe I believe you.”

Gina: I also was that person. I was like, I don’t want to lunge.

Roxanne: Yeah.

Gina: I’m listening to my body.

Roxanne: Gina told me to lunge and I was like, “No, I don’t wanna do that. My intuitive movement says no, even though the lunge would’ve been probably very helpful in the moment. I did not wanna do it.

Gina: It’s okay.

Roxanne: So I think it’s also that listening to our intuition is important, and we don’t wanna take away from our intuition, but sometimes our intuition is telling us something and we as the professional, or their intuition is telling them something and we as the professional need to see what they’re doing intuitively as a sign for us to be like, oh, maybe we do need to intervene. ‘Cause that is the hard part as a professional, is knowing what signs there are, and when we may want to offer other options, other movement options. Especially if you are in a community birth setting, like you can’t just be like, oh, we’ll just break her water and give her Pitocin. While that’s, those are great options if somebody needs them, we don’t have them.

Gina: Yeah.

Roxanne: Other places. So if someone is doing certain movements, so like with asynclitic babies that maybe are having a trouble engaging into the pelvis, I do see, or even like they’re in the mid pelvis and they’re trying to correct that asymmetry or they’re trying to correct that asynclitic or tilted head, I find that like sometimes people are favoring one side and they’re like leaning intuitively to that side, or they’re going on their tippy toes, but it’s like not tippy toes, oh, we about to push and have a baby- it’s a different type of tippy toes. So it’s like being able to differentiate the movements that they’re doing as like normal, intuitive movements that this baby is engaging, rotating, and then coming out of the birth canal- or, is the body telling us like, this is what I need, this is what my baby is doing, and I’m trying to correct it? And how can I enhance it based off my understanding of pelvic biomechanics?

So I had a birth recently where the baby was OP and asynclitic so it was having trouble like getting engaged and starting that rotation. And we at first saw her doing tippy toes and were like, oh, she’s going to be pushing soon. So I’m very, I don’t wanna ever…

Gina: Don’t ever say it.

Roxanne: I’m not going to say it, but me and the doula like, looked at each other, were like, oh yeah, we good. And she was making different sounds, so we’re like, labors progressing perfectly. Like we don’t wanna intervene, we don’t wanna get in their head and be like, oh, the, we’re seeing issues. But then it didn’t progress, like it just stayed where she was and we’re like, oh, maybe there is something we could do. And so had we known like that tippy toes wasn’t like, oh, we, about to push tippy toes, this is baby is like asynclitic- cattywompus is probably my favorite way to describe it- we could have been like, oh, let’s try these different things to maybe help enhance the things that her body’s intuitively doing with that tippy toes. Like offering a lunge earlier, inverting and doing different things, because eventually the body can only try to fix things so long without assistance, and eventually coping is no longer the train that they’re on, and they’re now on the struggle bus.

Gina: I think it is, I think that’s something that professionals need to figure out at some point intuitively from themselves as well is when do I make these movement recommendations?

Roxanne: Exactly.

Gina: When do I offer additional help without messing with somebody mentally, without offering it too soon, but also I don’t wanna wait too long and then they’re not coping well. They’re fatigued.

Roxanne: Exactly.

Gina: They’re feeling a little defeated. And so it is a really fine line to walk and I think being able to identify the movement mechanics in somebody, how they are intuitively moving- ’cause the person that is in labor is the expert on their birth, their individual birth, they are the expert on it. And watching somebody move in labor, like as a doula is something that like I get really fortunate to be able to do, is I’m with them the whole time.

Roxanne: Yeah.

Gina: And so I have this opportunity to really watch them and observe what kind of movements do they do during their contractions? Do they favor more front to back, kind of tucky motions? This baby’s still trying to engage. How do they feel their contractions? What are their, what sensation do they report with their contractions? Like how does that contraction feel for you? Does it feel like you have two contractions back to back? Does it feel bumpy at the top? Does it feel like a single solid peak and then it releases? That’s all information for me to let me know what is going on with this baby’s position. And so I find if there’s like it feels like there’s two peaks, it feels very bumpy at the top, there’s multiple kind of squeezes- that to me is saying that this baby’s rotating, like your body’s working to rotate this baby. What can we do to help enhance that? What can we do to help support that?

And so understanding what movement patterns correlate to different trends can be incredibly helpful. And I would encourage professionals that do work with this population, especially birth workers, to just pay attention to the patterns that you notice- ’cause you probably have seen patterns even for you as like a midwife, as a nurse, for me as a doula, like I see patterns and sometimes we don’t realize that we have the dots connected and we don’t…

Roxanne: Or we have all the dots, we just need to connect.

Gina: We haven’t connected them yet. Or they already are connected and we just haven’t realized that.

Roxanne: Yeah.

Gina: And so what I would say is as you support births and, and just observe everything, and then when you have like the end, you can try to start connecting things.

So for me, like when I was a new doula, I was like, okay, this person, when they labor, they’re going front to back and they’re really tucking their hips underneath. And then they get a cervical exam and baby’s minus two. Okay. This other person was like really tucking their hips repeatedly during contractions, and when we showed up at the hospital like they were still, they were having an urge to push, but baby was minus two. Okay, I think I could connect the dots here that this front to back really tucky movement pattern means that baby is probably still high in the pelvis and still engaging. Okay. And all of my clients that kind of sway a little bit more with their contractions, all of their babies are engaged, all their babies are like zero station, minus one station. And then I have all these clients that like right before they start pushing, they start doing these like mini squats. Okay, I’m going to start connecting these dots together because nobody’s telling me this, this isn’t in like a doula class. Like I had never heard of this before, and I was like, huh. And I’m sure other doulas have noticed it too.

Roxanne: When we started sharing about like intuitive movements, people were like, oh yeah. I have noticed that!

Gina: Like I don’t think that I’m the person that like coined it, but for me, I learned it from my own observations, and then other people realized that they also observed it as well. And we all were like, huh. Very interesting. And so what’s really cool about kind of the combination of you and I together, in addition to like our PTs, is we’re all taking our little perspectives and we’re starting to combine them so that everyone has a better picture of what’s going on. Like our PTs are telling us, “Hey, all my clients that tend to have really tight posterior portions of their pelvic floor, and they have a lot of trouble coming out of extension seem to have either really long labors or they have a Cesarean birth.” And then for you, you’re like, “Huh. Whenever I do a cervical exam or when I’m pushing with somebody that’s just pushing for a long time, I notice that they have a band on the right side of the perineum, and it’s always on the right side. It’s not really on the left side, it’s usually on the right side.” Or, “I have this pattern, something that I’ve noticed.” And then we all start putting all these pieces together where, hey, we have this asymmetry where the right anterior pelvic floor, a little bit more active and pronounced. The left posterior pelvic floor or the entire posterior pelvic floor may be very tight and compressed, which is decreasing space in the back part of the pelvis. Prenatally their pelvic floor PT may have noticed their right Obturator Internus, and the right anterior portion of their pelvic floor is correlating to all of these bladder issues that they’re having, and is making it harder for that baby to engage into the pelvis. Where you as a midwife may notice this baby is still not yet engaged and this person is complaining to me about bladder urgency. I wonder if those are correlated. And then for me, as a doula, whenever, or a fitness trainer, whenever somebody is squatting, they have right hip impingement. Their right hip feels very pinchy when they find more hip flexion. That’s related to that right anterior pelvic floor! And so prenatally, with all of us noticing all of these patterns, we can all understand that this is going to impact somebody’s labor. That baby’s going to have a harder time engaging, that posterior portion of that pelvis is going to be compressed, and it’s going to be harder for them to get that baby ejected out of their pelvis. But these are all patterns that we all can connect with one another that in isolation you might not like, you might not realize, oh, there’s a right, there’s a band on the right side of the perineum. Okay, cool.

Roxanne: That’s a pattern, but I don’t know what that means.

Gina: I might notice that when this person squats, they have right hip impingement, they complain about it on the right side. Or every time they squat, they shift to the right side. They do this like swaying thing when they squat. Okay, cool. This person has asymmetry and we need to focus on the cross pattern thing. In just isolation without thinking about it, this pelvic floor PT might be like, oh, this person has bladder problems. We’re going to help their bladder problems.

But when we put it all together, we realize how this is not only going to impact somebody’s pregnancy and the comfort that they have, how it’s also going to impact their birth and potentially impact their postpartum experience. Because when we have more interventions in birth, we have more stuff to heal from postpartum, potentially. Not always. Sometimes that’s fine. But I would say the less stuff you have…

Roxanne: The longer labor is, I think.

Gina: The less stuff you got going on during birth, the less stuff you gotta heal from.

Roxanne: Yeah.

Gina: Postpartum as well.

Roxanne: I think the longer labor specifically is, makes the recovery harder.

Gina: So this is why pelvic mechanics is really important, and the good news is we share all about it in our new course.

Roxanne: Yeah.

Gina: And we combine the expertise of all of these different fields.

Roxanne: Yeah. That is the reason for continuing education of like why we need to continue to learn to improve the care that we give our clients and our patients. As well as like mentorship and collaboration with other people, like working in a mentorship group with other people who do this.

Gina: Which we also have.

Roxanne: People who also are doing the same things. Together, you can start to put the puzzle together of what are these things that we’re seeing in pregnancy, and then what is the outcomes in their births, and like, how can we address them prenatally so that they don’t have this potentially in their birth? And that is when like you can provide the best care by yourself, but if we’re not trying to grow or collaborate with others, it limits how much you can grow.

Gina: Yeah. I think about for myself as doula, I think I’m a great doula. But I am a better doula and a collaborative team when I’m at hospitals where like the midwife and the nurse are like, “Hey, let’s work together to figure out the best position to get this person in. What are your recommendations? ‘Cause I know that you’re really savvy with pelvic mechanics. This is what I see with the cervical exam. What would you recommend exactly?” I’m a better doula in a collaborative environment. Just like I would assume that like you would be a better midwife, like Hayley and Casey are better PTs in a collaborative environment when we all work together with the different types of information that we bring to help enhance whoever this person is, their experience. ‘Cause

it’s not about like, I need to demonstrate that I’m the best and that they really should be super glad they hired me because this team is out to get them. that’s not helpful, and that’s not collaborative. And for me in environments where they are, it is just a little bit more hostile towards like extra support people, I can’t do as good of a job because I’m limited on the information that I can gather, and I’m limited on the information that I can share because if somebody is not interested in hearing, hey, maybe we should help this person get into this position, they’re just like, shut up, then it’s, really going to be a disservice to the person that’s giving birth. And I think when we all remember that we’re all a part of, it’s this chosen team, that person giving birth chose all of us to be a part of this team, the better the outcomes are, the better the experience is going to be. ‘Cause it’s more than just being alive at the end. Like it’s also about how can we feel during this journey? And if your team is fighting, it’s probably not a good vibe. It’s not a good vibe at all.

So if you would like to learn more about pelvic mechanics, more than just like why should you know it? Like you wanted to learn okay, what is it? How do I create the space prenatally, during labor? What kind of signs and symptoms can we look forward to let us know that there’s these patterns happening? Check out our newly released pelvic mechanics course. If you’re listening to this on the day of release, it’s on presale right now for 50% off.

Roxanne: Grab it now.

Gina: Lifetime access, as long as the course exists.

Roxanne: All of our updates.

Gina: To all of our updates as well. If you are listening to this, after November 24th when it releases, Black Friday is coming soon, grab it for a discount for 30% off then. If you’re listening to this after Black Friday, it’s December, it’s 2026…

Roxanne: Sorry, it’s full price.

Gina: Sorry. It’s full price. Find a discount code. Right here, you can use code STORY10 to get 10% off any of our online offerings to include our professional pelvic mechanics course. I don’t know what the discount is in my head ’cause I don’t know what the price of the course is going to be. But check it out. If you wanna learn the what. What can we do to better support our clients during pregnancy to better support them during their labors, to support them beyond labor? And you’re going to learn from us as a collaborative team. From me as a perinatal fitness trainer in birth doula whose expertise is pelvic mechanics and strength training and movement during pregnancy, from Roxanne whose expertise is the medical aspect of prenatal and birth support. There’s different perspectives that we’re combining between the two of us to do that. We’ll have some guest appearances from our pelvic floor PTs and their expertise as well. And so it is a really well-rounded team that is going to be educating you on how you can better support birth outcomes, pregnancy experiences throughout somebody’s journey because this is the start of the next generation and raising and or not raising, creating a confident motherhood experience. So yeah, check it out.

Roxanne: This podcast is sponsored by Needed a nutrition company focused on the perinatal timeframe that we have both utilized and love and support. And if you wanna check them out, head to thisisneeded.com and use code MAMASTEPOD to get 20% off your first order.