Squats and Pregnancy (Part 1): Should they be avoided?

More and more I have been asked the same line of questions, “Can I squat during pregnancy? Is it safe to squat? Why should or shouldn’t I squat?” Here are a few considerations for squatting while pregnant. As always, it’s important to work with the body you have today and do what is best for you!

Considerations for Squatting while Pregnant

1. Squatting with abducted thighs expands the pelvic outlet, the area the baby must descend from in order to be birthed but closes the pelvic inlet (3)

   1. Squatting increases the pelvic outlet by one centimeter in the transverse diameter (side to side) and two centimeters in the antero-posterior diameter (front to back). The overall result is an increase of 28% in the pelvic outlet while squatting compared to lying on the back. (1)
   2. Due to the opening of the pelvic outlet and thus closing of the pelvic inlet, deep squatting may not be recommended for babies with a breech presentation. If the baby is in a less than ideal position, it may close off the top of the pelvis and give baby less room to move around and get into the ideal position. For this reason it is generally not recommended to perform deep squats after 32 weeks unless you know the baby is head down
2. Health Considerations
   1. Pelvic organ prolapse: If you have a diagnosis of a cystocele or rectocele, then a deep squat may not be ideal until the prolapse has been corrected
   2. Hemorrhoids: Deep squatting may increase the risk of hemorrhoids due to poorly managed intra-abdominal pressure 
   3. Other health concerns as discussed with your healthcare provider
3. If you have pain during squats, please reach out! Squats should never be painful and there may be changes we can help you with to make squats pain-free.

Training for Birth: Why Should I do Squats While Pregnant?

“Squat 300 times a day and you will give birth faster” - Ina May Gaskin

We love to train for birth - doing movements that are going to help prepare you for childbirth or help with the postpartum healing processes. Squatting is one of the movements we love! The thing about squatting is that in our Western culture, we have moved away from training our bodies to squat. This is highlighted by Alternative Birth Positions which stated, “Most North American women are not used to squatting, and cannot maintain the position for long.”(6)

While the squatting position can be a great asset during labor (see Part 3- Squatting During Labor: The Research), “squatting, even unsupported can be tiring and may need to be practiced during pregnancy.” (5) The book, Pregnancy Fitness, stated that “If you haven’t been accustomed to squatting and then try to do it in labor, you may not find the success you were hoping for.” The second stage of delivery, when your cervix is fully dilated and you are pushing, can last anywhere from 20 minutes to 2 hours. You wouldn't run a marathon without training, so why not train squats in preparation for birth? 

Squats help strengthen the pelvic floor muscles in a way that is functional and natural. The muscles utilized during a squat are the same muscles needed to stabilize the core, low back and pelvic floor. Squats are a great asset to any workout regime because they help strengthen and stabilize the body in a ways that we move everyday!

Added bonus? Just because you are pregnant does not mean you do not have to have pregnancy butt (aka mom butt, pancake butt, flat butt). We believe all butts can be peaches and squats may just help build those peaches. 

References:

1. Russell, J.G.B., “The rationale of primitive delivery positions”, British Journal of Obstetrics and Gynaecology, Sept. 1982, Vol. 89, pp. 712-715.
2. Di Paolo, Julia, Montpetit-Huynh, Samantha, Vopni, Kimberly, “Pregnancy Fitness”
3. Russell, J.G.B., “Moulding of the Pelvic Outlet”, J. Obstet. Gynaec. Brit. Cwlth, Sept. 1969, Vol. 76, pp. 817-820.
4. Penny Simkin, Janet Whalley, Ann Keppler, Janelle Durham, April Bolding, Preconception: Improve Your Health and Enhance Fertility
5. Vicky Chapman, Cathy Charles, The Midwife's Labour and Birth Handbook
6. Reid, Harris., Alternative Birth Positions. CAN. FAM. PHYSICIAN Vol. 34: SEPTEMBER 1988
7. Valiani M1, Rezaie M1, Shahshahan Z2. Comparative study on the influence of three delivery positions on pain intensity during the second stage of labor. Iran J Nurs Midwifery Res. 2016 Jul-Aug;21(4):372-8. doi: 10.4103/1735-9066.185578.
8. Gupta JK1, Sood A2, Hofmeyr GJ3, Vogel JP4., Position in the second stage of labour for women without epidural anaesthesia. Cochrane Database Syst Rev. 2017 May 25;5:CD002006. doi: 10.1002/14651858.CD002006.pub4.
9. Lawrence A1, Lewis L, Hofmeyr GJ, Styles C., Maternal positions and mobility during first stage labour. Cochrane Database Syst Rev. 2013 Aug 20;(8):CD003934. doi: 10.1002/14651858.CD003934.pub3.
10. Nasir A1, Korejo R, Noorani KJ. Child birth in squatting position. J Pak Med Assoc. 2007 Jan;57(1):19-22.