During Pregnancy

1. Introduction / Plain Theory

Pregnancy is a natural and transformative process — but it also places significant physical and physiological demands on the body.
As the baby grows, the mother’s posture, breathing mechanics, and circulation adapt continuously. These changes are essential, yet they can sometimes lead to discomfort or strain when the body’s natural compensations become overloaded.

Osteopathic care offers a safe, gentle, and non-invasive approach to help the body adapt throughout pregnancy, supporting mobility, balance, and comfort.

Common reasons women seek osteopathic treatment during pregnancy include:

Low back or pelvic pain
Sciatic-type pain or hip discomfort
Rib or thoracic restriction
Neck, shoulder, or jaw tension
Breathing difficulties or shortness of breath
Swelling or fluid retention in the legs

Osteopathic treatment aims to support optimal alignment, breathing, and circulation, helping both mother and baby feel more comfortable and relaxed.

2. Typical Symptoms and Functional Impact

Musculoskeletal:

Pelvic girdle or pubic symphysis pain
Sacroiliac joint or lumbar tension
Rib and upper back stiffness as the ribcage expands
Postural fatigue or muscle tightness

Circulatory and respiratory:

Swelling in ankles or legs
Shortness of breath or restricted diaphragm motion

Functional impact:
Pain, restricted movement, and fatigue can affect daily activity, sleep, and emotional well-being.
Gentle osteopathic treatment can help maintain flexibility and reduce discomfort as the body changes through each trimester.

3. Contributing Factors / Underlying Causes

Several physiological changes contribute to pregnancy-related discomforts:

Hormonal effects: Relaxin increases ligamentous laxity to prepare for childbirth, but may also reduce joint stability.
Postural adaptation: Forward weight shift increases lumbar and pelvic load.
Circulatory changes: Blood volume increases by up to 40%, influencing venous return and lymphatic drainage.
Respiratory mechanics: Diaphragm elevation alters rib motion and breathing efficiency.
Emotional factors: Stress and sleep disruption can increase muscular tension and autonomic load.

Osteopaths work with these natural changes — not against them — to support the body’s capacity to adapt.

4. Osteopathic Approach

Osteopathic treatment during pregnancy focuses on creating space, mobility, and ease within the changing body.
It uses gentle, safe techniques that respect maternal and foetal physiology.

An osteopathic assessment may include:

Evaluation of posture, pelvic motion, and breathing patterns.
Soft tissue and myofascial techniques to reduce muscle tension and fluid congestion.
Gentle mobilisation of the spine, pelvis, and ribs to support optimal alignment.
Work with the diaphragm and lymphatic system to enhance circulation and relieve swelling.
Positioning and ergonomic advice for comfort, sleep, and daily activities.

Osteopathic care can help maintain balance and adaptability throughout pregnancy, complementing midwifery and obstetric care.

5. Scientific Evidence & References

Recent studies support the role of osteopathic and manual therapy as safe, effective complementary care for pregnancy-related pain and functional discomforts.
Research highlights improvements in pain reduction, mobility, and quality of life, with a strong safety record when applied by qualified practitioners.

References

Licciardone JC, Fulda KG, Stoll ST. Osteopathic manipulative treatment for back pain during pregnancy: a randomized controlled trial. Am J Obstet Gynecol. 2010;202(1):43.e1–43.e8. Link
Hall H, Cramer H, Sundberg T, et al. The effectiveness and safety of complementary manual therapies for pregnancy-related back and pelvic pain: a systematic review. BMC Complement Altern Med. 2016;16:104. Link
Vismara L, Menegoni F, Zaina F, et al. Effectiveness of manual therapy and exercise for pregnancy-related low back and pelvic pain: a systematic review. J Orthop Sports Phys Ther. 2020;50(7):381–391. Link
Cerritelli F, Pizzolorusso G, Turi P, et al. The effects of osteopathic manipulative treatment on pregnancy, labor, and postpartum recovery: a systematic review. J Am Osteopath Assoc. 2016;116(8):522–536. Link
Degenhardt BF, Johnson JC, Fossum C, et al. Osteopathic care of pregnant women: a pragmatic pilot study. J Bodyw Mov Ther. 2017;21(4):827–835. Link
Bordoni B, Zanier E. Anatomic connections of the diaphragm: influence of respiration on the body system. J Multidiscip Healthc. 2013;6:281–291. Link
Foti C, Marotta N, et al. Manual therapy for pelvic girdle pain in pregnancy: systematic review and meta-analysis. J Bodyw Mov Ther. 2022;29:54–61. Link
Xie Y, Chen Z, Yang Z, et al. Comparative efficacy and safety of manual therapy interventions for pregnancy-related musculoskeletal pain: a network meta-analysis. Front Med. 2024;15:1507299. Link