One in four pregnant women will experience a fall. With falls being the second most common cause of injury to pregnant women and their unborn baby. It is a very serious and widely under- recognized issue.
The development of the “big belly” during pregnancy does not appear to be the only cause for the increase risk of falls. There are a number of other physiological changes that occur during pregnancy which also contribute. The hormone relaxin creates looser joints and also slows down reflex time. Along with weight gain around the abdomen and subsequent forward tilt of the pelvis. This all changes the biomechanics of the pregnant woman while they move and stand, changing their proprioception (balance) and increasing the chance of having a fall.
Standing and walking balance will deteriorate as the pregnancy progresses with highest risk period being the 3rd Trimester. Studies have shown the ability to walk in a straight line, as well as reduced walking speed, are factors expected to be seen in women as their pregnancy progresses.
Another theory is that the neural system is compensating for the relaxed loose joints. As well as the increased body weight and subsequent higher loading forces through the joints. Muscles are told by the brain via the nerves to contract for longer to stabilise the joints under this increased load. In other words, the muscles are tense ready to brace the body in case it feels off balance. The body then does not have a chance to correct itself if it feels like it is falling as they are already in a protected state.
A strong predictor for falls, identified during research, was whether or not they remained active during their pregnancy. Those who reported a fall were predominantly sedentary whilst pregnant. It seems that staying active may help the body adjust to the changing center of pressure, increased weight, looser joints and reduced reflexes better than those who are inactive. Staying active during your pregnancy can therefore not only reduce your falls risk but it also improves your mental health and reduces the onset of Gestational Diabetes. There may be limitations for some pregnant women to remain active, so please ensure you discuss what is right for you with your GP, Obstetrician and Women’s Health Physiotherapist. .
Another measure you can take to reduce your falls risk is wearing the correct footwear. Thongs are not a good idea while you are pregnant as they are loose and make it very easy to trip over. Your feet may also feel they are bigger while you are pregnant which is due to the hormone relaxin splaying the joints (and the increased body weight). This may mean you will need larger shoes while pregnant. It is a good idea to seek advice regarding footwear options during pregnancy by a Podiatrist if you are unsure.
If you have had a fall during your pregnancy or feel you are at risk, speak to your GP or Women’s Health Physiotherapist. There are numerous ways of preventing injury to you and your child. To contact our Women’s Health Physiotherapist, Dr. Lauren Earles or to chat with our Podiatrist, Luke Bertram about footwear click here.
Westman N, Pregnancy Changes the Body: Here’s What That Means for Gait, Balance, and Falls. Lower Extremity Review.
Catena RD, Campbell N, Werner AL, Iverson KM. Anthropometric Changes During Pregnancy Provide Little Explanation of Dynamic Balance Changes. J Appl Biomech. 2019;35(3):232-239.
McCrory JL, Chambers AJ, Daftary A, Redfern MS. Dynamic postural stability during advancing pregnancy. J Biomech. 2010;43(12):2434-2439.