Third Trimester: A Literal Pain in the Rear


As the mother of two small children, I spend about 90% of my waking hours sitting on the floor or cleaning it. But now that I'm 34 weeks pregnant, getting back up to a standing position has become a particularly painful feat that involves wincing, whining, and an occasional shriek of pain.

The culprit? Pregnancy-induced sciatica.

Like a lot of women in their third trimester, I experience sharp pain that radiates throughout my rear end, lower back, and right thigh whenever I try to do anything exciting, like getting out of the car. It feels like the fetus is pressing directly against the nerve. Along with other third trimester symptoms, including overwhelming fatigue and charley horse leg cramps, sciatica can make for a miserable final stretch.

This week, as I lay floundering on the floor, I sought some answers, and relief, about lower back pain in pregnancy.

Is it really sciatica?
"Often back pain in pregnancy is due to loosening of the otherwise fixed joints in the pelvis—the symphysis pubis and sacroiliac joints," says Charles Lockwood, MD, the Chief of Obstetrics and Gynecology at Yale-New Haven Hospital. And, bad news for active moms: Pain from this pelvic bone separation is aggravated by movement. It also tends to worsen with each baby and sometimes crutches are needed!

If that is the source of my pain, I wish I could send a memo to those separating pelvic joints: "Hey fellas! No need to loosen up down there, we're having a C-section!"

However, my doctor believes we're dealing with a sciatic issue. In which case, Dr. Lockwood tells me that there is a three-part cause: change in posture induced by pregnancy (lordosis) which stretches the nerve, increased pelvic pressure (from the fetal head, enlarging uterus, et cetera), and an actual change in the pelvic bone alignment.

Great! So how do I cure this pain so I can lift my children out of the bathtub without hollering in pain?

"Delivery is the best cure," Lockwood says.

That is truly depressing, but I know he's right. I experienced the same sciatic nerve symptoms with both of my prior term pregnancies, and the pain completely evaporated the minute the baby was born.

Next Page: How can I best survive the next five weeks?

[ pagebreak ]With my last pregnancy, I tried acupuncture and prenatal massage, which helped me sleep, but the effects only lasted a few days.

Some women I know have had success going to a chiropractor. Though the American Pregnancy Association states that chiropractic care throughout pregnancy is safe, there's something about having my body manipulated while pregnant that feels wrong.

Instead Dr. Lockwood suggested an interesting solution: switching my mattress. He advised me to use a harder mattress if I've been sleeping on a soft one, or try a feather mattress if mine is hard.

After studying our mattress, I discovered that my pregnant body had made a large indentation. Though it isn't cheap to buy a new mattress, I was able to activate the warranty on our current one. I replaced it with a brand new, extra-firm mattress, and though it's only been a few days, the difference has been remarkable. When I lie in bed at night, my lower back snaps, crackles, and pops, then finally relaxes onto the hard surface. By morning, I'm ready for another day of tackling toddlers.

The symptoms are still there—the fetus' head is still pressing against the nerve—but getting off the floor involves much less wincing. In order to maintain this less painful state, I'm getting by with Tylenol and warm (not hot) showers or baths.

In some cases, Dr. Lockwood says, a doctor will prescribe a narcotic for a woman whose sciatica is extremely painful. Luckily, that shouldn't be necessary. And I'm counting down the days until the pain will be cured forever.