Does a Tilted Pelvis Affect Delivery? A Guide for Moms-to-Be

Pregnancy is a time of incredible change to a woman’s body, which inevitably comes with dozens of questions. As you get ready to give birth, there are things you may start hearing about that could impact your labor and delivery. A modified pelvis is one worry that pops up often. What does this mean, and more importantly, will my leaning pelvis effect delivery?

This guide will walk you through all of it. We’ll describe what a tilted pelvis is, how it may impact your pregnancy, and what having one could mean for birth. By the end, you’ll have a better idea and hopefully feel more equipped as you gear up for one of life’s biggest days.

What is a Tilted Pelvis?

A tilted pelvis isn’t a medical condition, but rather the alignment of your pelvic bones. Your pelvis is not a one-boned structure but rather an aggregate of bones that can tilt forward, back or side to side. The anterior pelvic tilt is the most prevalent, in which the front of the pelvis tips forward and the back end tilts up. This will arch your lower back more.

Imagine your pelvis is a bowl of water. If you have an anterior tilt, the bowl is tilting forward, and water would be falling out of the front. If your pelvis tilts back (this is called a posterior pelvic tilt), the bowl is tipping backward. It’s also possible to have a lateral tilt, where one side of the pelvis is higher than the other — although this is less common.

A small tilt feels natural for lots of people, not doing any harm. In certain instances, a slightly more pronounced tilt can be uncomfortable and may warrant some attention – particularly when pregnant.

Common Causes of a Tilted Pelvis

A tilted pelvis may occur through a mixture of lifestyle and physical changes. Knowing the triggers can help to identify if you may be at risk.

Prolonged Sitting

One of the most frequent offenders is a lack of physical activity. Too much time spent sitting, especially with poor posture, can make some areas of your body tight while others get weak. In fact, extended periods of sitting commonly cause you to have tight hip flexors (the muscles at the front of your hips) and weak glutes and abdominals. This disparity causes the pelvis to be tilted forward in an anterior direction.

Muscle Imbalances

In addition to sitting, other things that you do, or don’t do, can lead to muscle imbalances. Weak core and glute muscles (used to keep pelvic alignment) are often developed when we don’t get enough all around exercise on a regular basis. On the other hand, those who over-exercise some muscles without stretching them properly can also develop a tilt.

Pregnancy

The physical changes of pregnancy can cause or aggravate a pelvic tilt. Your Center of Gravity Your uterus gets larger and heavier as the weeks go on, which pulls your body forward so its center of mass is no longer properly placed over your feet. To counter-balance, many pregnant people naturally shift to have a greater flare in the lower back—resulting in an anterior pelvic tilt. The hormone relaxin further relaxes ligaments all over the body, including those around the pelvis, which can make it easier for your pelvis to move out of alignment.

Previous Injuries

Injuries to the back, hips or legs can sometimes cause a tilted pelvis. The body might twist or bend differently in an effort to offset pain, which can lead to a permanent shift in the position of the pelvis.

How a Tilted Pelvis Can Affect Pregnancy

An off-kilter pelvis doesn’t always create trouble, but it can result in some unique discomforts during pregnancy.

Lower Back Pain

Lower Back Pain is the most common symptom associated with an anterior pelvic tilt. The forward tilt arches the lumbar (your lower back), which causes tension on vertebrae to increase, not to mention additional work for surrounding muscles. When you are pregnant, the extra baby weight can cause this pain to be more intense.

Sciatica

The greater curve in the lower back can also put pressure on the sciatic nerve — that long nerve running from your lower back down through both legs. This can also lead to sciatica — a sharp, shooting pain or numbness or tingling that runs down one or both legs.

Round Ligament Pain

Tilting the pelvis can also lead to round ligament pain, a sharp, jabbing discomfort in your lower abdomen or groin. The misaligned position can add extra stress to these ligaments that help support the growing uterus.

Does a Tilted Pelvis Affect Labor and Delivery?

So what, then, does any of this have to do with giving birth? Though the idea of your pelvis being “out of whack” may sound distressing, it’s worth noting that unless you have a significant tilt in your pelvis (one that causes daily discomfort), the vast majority do not carry a pelvic obstruction to vaginal birth.

Your body is incredibly adaptable. In labour, the hormone relaxin helps your pelvic joints and ligaments to stretch so you can have more space for your baby to pass through. Your body will instinctively also rock and sway this happens when the baby begins to make its way down your birth canal.

But an extreme anterior pelvic tilt can impact labor in a couple of ways:

Baby’s Positioning

Realigning your pelvis creates more ideal reproductive space for baby to get into the best position for birth — head down and facing towards your back (occiput anterior). If your pelvis is tilted forwards this can often make the baby find it more difficult to fit in to the right position, deep in your pelvis. This can cause a baby to be in a posterior position (“sunny-side up”), which possibly leads to a longer and more difficult labor or stronger back labor.

Labor Progression

In rare circumstances, a marked tilt could somewhat decrease the pelvic outlet size which might slow baby’s progress. But this is not a major cause of labor that stalls. Most bodies can compensate, she added; movement during labor — rocking, squatting or getting on all fours — may help open the pelvis and promote progress.

Keep in mind that many things affect labor, and pelvic tilt is just one piece of a much larger puzzle. Hughes and other doulas say the size and position of your baby, the strength of contractions, and your movements matter more.

Diagnosis and Management

If you suspect you have a tilted pelvis, a health care provider such as a physical therapist, chiropractor or your doctor can determine that with a physical examination. They’ll evaluate your posture and muscle balance.

The good news is that a tucked pelvis can frequently be corrected or managed with specific exercises and lifestyle modifications.

Stretches and Exercises

• Hip Flexor Stretch: Kneel on one knee (cushion under for comfort), with the other foot flat on the floor in front of you. Gently press hips forward, stretching the front of your hip. Hold for 30 seconds, then repeat on the opposite side.
• We’ll start with glute bridges: Start on your back, knees bent and feet flat on the ground. Contract your glutes and raise your hips off the ground until your body is in a straight line from shoulders to knees. Pause for a moment and lower your back down.
• Pelvic Tilts: Lying on your back with bent knees. Push your lower back down towards the floor contracting your abdominals to flatten your back and tilt your pelvis upward. Then collapse and let your back curve. This will help develop mobility and lateral awareness.
• Planks: The key to this exercise is strengthening the muscles of your core. A modified plank on your knees is both a safe and effective position while pregnant.

Professional Support

I also highly recommend working with a prenatal-specific physical therapist or chiropractor. They also can develop a tailored program of exercises and manual techniques to restore pelvic balance.

Final Thoughts: Stay Positive and Proactive

A tilted pelvis can be uncomfortable, and it may generally play a small role in your baby’s position, but it’s unlikely to make vaginal birth dangerous or impossible. Your body is made to give birth, and doctors are trained to handle different labor situations.

The best strategy is to be proactive. But if you have a lot of back pain and are convinced that your pelvis is tilted, speak with your provider. Adding postural corrective exercises and simply good posture to your day can make a dramatic impact on how you feel during pregnancy and how confident you are going into labor. Your body is resilient and in the right environment can deal with anything that’s thrown your way.