Chiropractor Dr Gary Fitzgerald at The Hundred Wellness Centre Dubai shares what every new mum should know about healing, movement, and long-term spinal health for safe, effective recovery.
For many new mums, back pain after childbirth is brushed off as “just part of the process.” But while discomfort is common, it’s not something you should simply accept. Pregnancy and delivery place significant strain on the spine, shifting posture, loosening ligaments, and weakening core muscles in ways that don’t instantly reset once your baby arrives.
In this expert guide, chiropractor Dr Gary Fitzgerald at The Hundred Wellness Centre Dubai explains what’s really happening to your body during and after pregnancy – and, more importantly, what you can do about it. From feeding positions to simple daily habits, small adjustments can make a big difference in how your body heals and feels in those early postpartum months.
Many new mums assume back pain after delivery is “normal.” What’s actually happening to the spine and posture during pregnancy and birth that leads to this discomfort?
There are 3 main things that happen that can lead to discomfort.
After 20 weeks pelvis shifts forward more, the weight of baby carries your forward. As a result your centre of gravity changes and this increases your curve on your lower back, which, in turn, means the muscles on the lower back have to work harder and are not as good at shock absorption.
Secondly, you start to produce 3 different hormones in 3 different levels: relaxin, progesterone and oestrogen. All 3 but particularly relaxin helps to loosen the ligaments that stabilise the spine. This leads to further instability.
Finally, later in pregnancy, part of the core called the pelvic floor start to stretch and weaken.
The combination of these 3 instances can lead to discomfort, which is normal to experience but not necessary to endure for an indefinite period postpartum.
After delivery, the ligaments, joints and muscles have been stretched and strained for a number of months. All of a sudden, they are being asked to stabilise the body again without the counterweight of the baby. This causes discrepancy in how the muscles work. They tend to over activate and as a result you experience back pain, not from pressure where baby is, but overcompensation from other muscles and joints.
What are the most common postural mistakes you see new mothers making in the first three months after giving birth?
The most common mistake I see is the feeding position the mother is in and how she is holding the baby when feeding. Shoulders tend to come forward, the mother will constantly look down at baby, which rounds the back and causes the head to drop. For those bottle feeding, they tend to hold the baby on one side (this is not as common with breast feeding.)
Other mistakes include:
- Carrying the baby on the same side of your body
- Bending over when changing the baby
- Put baby in middle of the bed when sleeping and facing the baby. This means they are always sleeping on the same side of their body.
How soon after delivery should a new mum start thinking about spinal recovery, and what gentle steps are safe in those early weeks?
With a newborn, you are busy, tired and have lots to juggle so I tend to focus on a tiered plan:
1-2 weeks: Focus on rest and recovery. Undertake simple, gentle movements such as walking as the ligaments will still be quite lax and the body is still recovering from delivery.
2-4 weeks: You can easily start doing spinal mobilisations such as rocking the hips, rolling shoulders. This fortnight should not be about exercising but mobilising and reminding body how to move throw lines of motion
6 weeks onwards: You can start doing similar exercises to those you did before pregnancy, depending on the time and availability you have. But start small. Don’t push your body too much. Remember small little bricks will build the wall but it will take time.
With a C-section, however, the time line is different. You shouldn’t really attempt anything strenuous within the first 6 weeks until all is healed. Gentle walking movements are fine, though and they will help.
Breastfeeding, bottle-feeding, and endless cuddling often involve long periods sitting-how can mums protect their neck and lower back during these moments?
Feeding is one of the major triggers for pain and discomfort but there are multiple steps you can take to protect your body.
- Sit supported back against back of armchair or back rest
- Nursing pillows are great as they allow you to lift baby higher so you are not rounding your back. Remember it should always be that the baby coming to you rather than you going to baby
- Tuc your chin in
- Flexing your muscles when you are going down to pick up the baby. This will take pressure away from the muscles.
- Never twist your body. Always sit face on.
- Hold the elbows close to body. Arms are like the body’s levers so if you hold something out in front of you, you are putting more stress on muscles.
- Changing positions frequently. Don’t always use same chair or favour feeding on same side.
If your body is supported so you can support the baby so take a few seconds before commencing the feed to check that you are sitting correctly. Have your pillow at hand and ensure you are not twisting to one side.
Some people set an alarm to get up and move during the day but I find it is better to create a habit of moving after completing a feed. For instance, once you put baby back down, walk up and down for a few minutes, roll shoulders forward and back, tilt head from one side of shoulders to the other and loosen hips.
Are there warning signs that postpartum back pain might need professional attention rather than just rest and stretching?
Most will feel some type of discomfort as muscles are trying to rebalance. But it should be limited to a dull ache that is widespread and shouldn’t register beyond 2 out of 10 pain-wise.
Seek professional help if pain is lasts longer than two weeks and there is no improvement, if it stops you from functioning and is impeding your sleep.
There are also warning signs you can view as a call to action to seek help. These include:
- Pain radiating down legs and arms
- Numbness tingling and weakness
- Difficulty walking weight bearing
- Sharp and localised pain
All of the above Indicate an orthopaedic condition rather than routine achiness. Above all, trust your instincts. You know your body so if something feels wrong, have it checked out.
Many women focus on core recovery – but how does core strength connect with spinal health and long-term posture?
Your core isn’t just your abdominal muscles. Rather it a cylinder of muscles that works like a corset to keep not just your lower back stable but your upper back too and also to help your breathing. It includes your deep abdominal muscles, your pelvic floor, back muscles and diaphragm, all of which have to work together to support the different movements you make. When the core functions well, youre protecting your back, helping posture and avoiding future issues.
After pregnancy, those muscles have been disrupted. The deep abdominal muscles have been stretched, and the pelvic floor has been under stress.
Sit-ups are only one part of the solution and in any case after delivery aggressive sit-ups should be avoided as the muscles might not be ready to counteract those movements.
Furthermore, if you suffered from Diastasis recti, the separation of muscles in abdominal area, this causes more instability. In such cases, working the core wouldn’t be beneficial but a necessity but exercising the core would need to be handled differently.
What simple daily habits can make the biggest difference to a new mum’s spine, even when she’s exhausted and short on time?
Key things can make a big difference.
- Keeping your shoulders back and down reduces tension on neck and opens up the chest for breathing
- Sitting back into against the chair supporting you ensures your muscles wont overwork
- Don’t sit with hips lower than your knees. If you do, this will rotate pelvis back and put more pressure on the spine and weaken the core.
- You will still have relaxin circulating in your body. This means your spine and joints are not as stable so reduce crossing legs
- Use a nursing pillow
- Keep the elbows close to body rather than reaching with arms out. Walk to what you want to get rather than overstretch.
- Walk daily
- Alternate which side of the body you carry/feed the baby
- Remember that bitesize chunks of movement throughout the day are more sustainable and effective for your body
I tell my patients to picture that there is a balloon on the string attached to top of their head. Allow it to slowly raise your head up. This will lengthen your whole spine and help your shoulders to drop down. This small posture check-in will help to reduce long term strains.
From carrying a car seat to pushing a stroller, new physical demands come quickly – what lifting techniques should mums learn to avoid injury?
Whenever you bend or move, do it through the hips and knees and not through the waist. By keeping elbows close to your body you will always hinge through your hips move towards what you need rather than overstretching.
Avoid twisting. If you do have to turn, pivot with your feet – let body do rotation rather than twisting with the upper part of your body.
Always engage your core.
Picking up car seat: Bring it as close to door as possible so you are not stretching. Have your feet shoulder width apart, brace your core and bend through knees and hips and not lower back.
Strollers: When walking keep a bend in your elbow as this reduce tension on upper back. If the elbows are locked and arms are straight, the force not absorbed through bend in your elbow but rather the back and neck. Always ensure your shoulders are dropped.
Emotionally and hormonally, the postpartum phase is intense. Do stress and sleep deprivation affect posture or pain levels?
Definitely. Sleep deprivation doesn’t cause problems but acts as a control to turn the volume of them up. Pain tolerance reduces and this can cause a loss and delay of tissue healing and an increase in muscle tension.
Stress causes an increase of cortisol in the body which leads to inflammation, which in turn leads muscle tension. Also, the breathing becomes shallower, which negatively affects the diaphragm and its functioning. Box breathing will help this. This process involved break breathing down into 4 sections: Inhale deeply, hold the breath, exhale and keep the exhale. Each section should be held for 4 seconds so it should take 16 seconds to do a full cycle. Repeat this for two minutes. It will help the diaphragm to relax and your other stresses to melt away.
If you had to share “10-second posture advice” every new mum could remember, what would it be – and why is it so important for long-term health?
My 10 second posture advice is breath, think, drop shoulders, balance pelvis.
- Breathe -Take a breath
- Think – how am I standing? Is my back supported? Are my shoulders forward?
- Drop shoulders – Consciously let your shoulders fall and this will reduce tension of neck and upper back.
- Balance pelvis: Ask yourself am I sitting too far forward, too far back? Am I too much to one side?
Do those 4 things and you are doing 80% of all that is needed for have good posture.
Also, think about the balloon analogy. By slowly raising your head up, you will feel lighter, the shoulders will drop, the spine lengthens. This will lead to less pain, better breathing and everything been correctly aligned.
