safe motherhood

Your pregnancy - 29-40 weeks

Relieving the strain

Late pregnancy is when you really begin to feel the extra weight the baby is placing on your back. Try and take a few moments throughout the day to get yourself comfortable and well aligned. Here's how to relieve the strain.

• Standing straight
Towards the end of your pregnancy, the weight of the baby pulls you forward - you may lean backwards to compensate, in doing so straining the muscles in your lower back and pelvis. Check how you are standing in front of a full-length mirror. Lengthen and straighten your back, tuck in your bottom, drop your shoulders and hold them back, then tighten your stomach muscles so that the weight of your baby is supported.

• Protecting your back
Try and be aware of how you are carrying yourself, particularly when bending, lifting or getting up quickly. Do as much as you can at a low level - kneeling to clean, make a bed or dress a toddler. If you have to lift an object, bend your knees and keep your back as straight as possible. If you're carrying heavy bags, balance them on both sides.

• Sleeping positions
You may be most comfortable lying on your side with one leg bent and supported with a cushion. Just one pillow under your head is best for your spine, but you may also want a cushion or pillow under your bump. If you are restless at night, then lying on your back with your head, shoulders and back propped up by several pillows and a pillow under your knees can help you to doze. However, never lie flat on your back in later pregnancy as it can restrict the flow of blood to your baby. When getting up from lying down, protect your back by turning on to your side, then use the strength of your thighs and arms to push yourself up, keeping your back straight.

• Strengthening your pelvic floor
Your pelvic floor muscles are essential in supporting the 'cradle' your baby-sits in. (See 'Your pregnancy - 0-12 weeks - pelvic floor exercises', for details of how to strengthen these muscles.) If you suffer from backache you can do the exercises on all fours - get down on your hands and knees and make sure your back is straight. Pull in your pelvic floor muscles and tighten up through the abdominals to pull the pelvis forward so that your back rounds up. Hold the position for a few seconds, then let go. Repeat several times so that your pelvis is 'rocking' backwards and forwards.

• Getting help
A maternity physiotherapist can help with backache problems - ask your midwife to refer you for an appointment. They can assess your situation individually and may recommend wearing a maternity belt. These can look ungainly but offer real support when you are walking or pushing a pram.

• As well as a maternity physiotherapist, you can also get help from a qualified osteopath or antenataI exercise teacher. Starting exercise classes or trying pilates and yoga early in pregnancy under the supervision of a teacher who is qualified to teach pregnant women can also prevent some of the strain on your back.

• The position of the baby in the womb and whether it is putting pressure on your back can also cause you strain. Consider your centre of gravity and try and move in a relaxed way, making sure that you are pointing your hips in front of you and not twisting your knees and lower back.