Your back still hurts and the baby is one. What changed through pregnancy and birth, and what never changed back.
Pregnancy changes how your body carries load, and those changes do not reverse on the day the baby arrives.
Through pregnancy your hormone profile softens connective tissue across your whole body, so the pelvis can open for delivery. Then delivery itself, which is an enormous physical event even when it goes smoothly. Then the months afterwards, when those softened structures begin tightening and regaining stability.
That last part is the bit almost nobody explains, and it is where most ongoing back pain is decided.
Back pain six or twelve months after birth is common. Common is not the same as nothing to look at. Here is what is usually happening underneath it.
Everyone knows the first trimester, second and third. Fewer people talk about the fourth, which is the months after the birth, and structurally it is the most decisive of the four.
Through pregnancy your hormone profile changes the connective tissue across your body, softening joints and ligaments so the pelvis can open. That softening is not local to the pelvis. Every joint is affected.
Then the delivery. Even an uncomplicated birth is an enormous physical event. It is a marathon, run by most women with no training for it.
Then, through the fourth trimester, the hormone profile shifts back and those softened structures start to tighten and regain stability. This is the part that matters. That window is when your body settles on what stable looks like.
If you go into that window carrying an imbalance or a compensation from before, the tightening happens around it. Your body does not return to how it was. It stabilises around the pattern it is in.
And it is in that pattern for hours a day. Feeding with your head down. Slumped into a couch or propped up in bed. Held still in one position because moving would wake the baby. None of that helps a back recover from nine months and a delivery.
Most women do not come in about their back. They come in about a neck or a shoulder.
It has usually been building through long feeding windows, through carrying, and through settling, which is its own physical event. Standing, swaying, holding a weight out in front of you, sometimes for an hour, sometimes twice a night.
The back arrives second in the conversation. When it does, it is described as a band across the lower back rather than a point. Not a sharp injury. Tension and fatigue.
Underneath it, the glutes and the core are not contributing much. They have not been asked to. What should be sharing the load has stepped back, and the band of tension across the back is what stepped forward instead.
Then the nights. Broken sleep is expected. The physical cost of how it is broken is not. Whole nights shifting position trying to find one that works. A run of nights half upright in a chair through a first cold. Neither is rest, and both are hours held in a position the body did not choose.
That is what an assessment looks at. Not the sore spot she came in about.
Most women assume that once the baby arrives, everything goes back to normal, including how a body should be handled. It does not, and neither does the care.
Through the fourth trimester the approach stays much as it was through pregnancy. Low force. Adapted to a body whose connective tissue is still re-stabilising rather than one that has finished.
That is not caution for its own sake. It matches what is happening in the tissue. A structure part-way through regaining stability is not asked to absorb force it is not ready for.
It also answers the question most women are quietly asking, which is whether it is too early. The answer is not a number of weeks. It is what the body in front of us is doing on the day, and the approach is built around that.
Wake the glutes and the core up. They are the two things that have stopped contributing, and they will not restart on their own. This does not mean a gym program. It means asking them to do something on purpose, a few times a week, so the band across your back stops being the only thing holding the middle of your body together.
Load your body deliberately. Push, pull, squat, carry. Twice a week is a starting point. Ten focused minutes does more for capacity than an hour of walking, and do both if you can.
Change the sides. If the baby always sits on the left hip, and the feeding chair always turns you the same way, your body is learning an asymmetry. Deliberately swapping costs nothing and interrupts the pattern.
Fix the lifting, not the lifter. The car capsule is the worst single moment in most days: a forward reach, a twist and a load at once. Getting closer to it before you lift changes the demand more than any exercise will.
Stop measuring progress by pain alone. Pain is one signal. What you can do without paying for it the next day is a better one.
If it has been there more than a few weeks, if it is changing what you do rather than only how you feel, or if it travels into a leg, it is worth having someone look at the whole system rather than the sore part.
That is what a structural assessment is for. How you are currently loading, what is compensating for what, and where capacity has been drawn down.
You are not fragile and you are not doing it wrong. Your body did an enormous amount of work and then went straight back to work, in positions nobody would have chosen. It is worth understanding what it is carrying.
If you would like an assessment, call the clinic on 08 6280 1210 or book a visit online.
Dr Kyna Hamilton is co-founder of Wild Chiropractic in Shenton Park. She is Webster Certified, trained as a birth doula before she trained as a chiropractor, and has spent over a decade working with pregnant patients and families.
Wild Chiropractic is a nervous system-led chiropractic practice in Shenton Park, Perth.
