Article for Natural parent magazine, One of twelve of the clever bodies series.

The following article is one in a series of twelve that will explore some of the main pelvic ligaments and structures that have a role in our reproductive wellbeing, and creating comfort and pregnancy and ease in birth. The following series of articles will explore the anatomy of the varying structures, discuss how the structures change in response to pregnancy and the postnatal period, discuss how the structures might affect comfort in pregnancy and ease in birth and also investigate and discuss ways to lovingly and gently support these structures so alignment, balance and comfort are optimised.

Did you know that the clitoris is not just a single small point just under the urethra ( the pee hole) but that it actually looks like a peak of a triangle with little arms that extend down into the labia and around their vaginal opening ? Did you know that this whole area is full of nerve endings and the potential for arousal and that when aroused the whole of the clitoris swells and these swollen little arms help to make the vaginal opening more snug for love making?

Did you know that a more detailed and correct anatomy of the clitoris was only discovered in the 1990’s?

Women’s bodies, particularly our reproductive bodies often remain mysterious to their owners, admirers and to science. The dark, quiet tucked away form of the vagina has often meant that for many women their knowledge of their own bodies ( and its amazingness ) has remained dark, quiet and tucked away. Shame has been a very powerful cultural and social tool in not only keeping the knowledge of our bodies quiet but also the knowledge of the pleasure, power and capacity of our bodies silent ( because there is so much capacity for pleasure and power in our bodies).

Did you know that just like the motion and the tides our womb/ uterus is constantly moving, changing shape and position?

Female bodies swell and contract. Our puku’s ( bellies) swell and contract as our babies grow inside our bodies. During pregnancy the uterus getting as big as to carry several babies, placentas and up to a litre of amniotic fluid. Our wombs swell and contact as we birth our babies then our amazing uterus contracts right back down to the size of a small pear. Our breasts grow, expand and contract with milk and then may grow or decrease or increase in size as we age.

In anatomical drawings we often see the uterus pictured sitting upright and central. In an non pregnant state the small pear of our uterus is constantly changing shape and position depending on our cycles, love making and even if our bowel or bladder is empty or full. Just like a hot air balloon tethered to the ground by many ropes, the uterus is supported by several ligaments, fascia and by the surrounding organs themselves. As there are no hard bones inside the pelvic bowl the pelvic organs often use each other for support. Did you know that the uterus is actually attached to the bladder via fascia ? As previously mentioned when our bladder is full the uterus moves up to accommodate it and when it is empty it settles down into a different position.

Lets get to the round ligaments. The round ligaments are some of the ligaments predominantly responsible for helping the uterus maintain its position and centre and also to move with ease.

The round ligaments attach to the upper anterior quadrants of the uterus. One on each side. The ligaments travel down through the inguinal canal and the other end extends into the labia majora with the fibres coming into end in the mons pubis. However, the exact spot where the ligaments end is different in each woman. Men also have round ligaments ( Embryologically male and female babies begin the same way).

In a non-pregnant woman the round ligaments are approx. 10-12 cm long and 1 cm wide. During pregnancy the ligaments expand in both length and thickness. At the end of pregnancy the ligaments can be up to 30-40 cm long. The round ligaments are folded into the peritoneum ( the sheath that wraps everything like glad wrap in up our pelvic bowls and abdomens. The round ligament is also sheathed by the broad ligament ( another article on the broad ligament to follow).

What do the ligaments do?

The round ligaments are important in lovemaking. When woman is aroused the labia majora swell and the round ligaments contract pulling the uterus up and posteriorly, this increases the length of the vaginal canal and pulls the cervix into a tucked in posterior position to avoid it getting too ‘bumped’.

Picture showing the change in uterine position due to round ligament movement from Women's anatomy of arousal Sherri Winston 2010.

During pregnancy the round ligaments are important for helping to stabilise the uterus. The can also help the uterus remain central and avoid it twisting and rotating.

In pregnancy, when the uterus is stable and central there is lots of room for the baby to find a comfortable and easy position to route down and through for birth. Often when there is lots of room and comfort a baby will lie in the left lateral position in pregnancy and then spiral down easily through the pelvis for birth. If the round ligaments are tight or one is tight and one is loose the uterus can be pulled into a twist. In this situation there can be less room in the lower segment of the uterus. Sometimes the baby will respond trying to find the most available space by presenting in breech, posterior or by staying high in the pelvis.

During pregnancy , the pregnant person may experience round ligament pain as short, sharp, stabby, pulling usually on one side ( it can be both sides) of the lower abdomen. This is common from 18-24 weeks when the uterus is changing shape and position due to the increased growth of the baby. Round ligament pain may also feel like a deep stich on a lower left or right side and it may feel tender when the care provider / midwife tries to feel the baby’s head on abdominal palpation. Round ligament pain may be triggered by movement and may be a ‘short sharp’ experience however if you consider the amount of growth, stretch and movement of the uterus it would make sense the round ligaments, may feel achy at times when they are stretching and changing. There are so many hormones like progesterone and relaxin that assist the growth and stretch of the ligaments during pregnancy. Everything can become so soft to accommodate the movement and growth however this can mean that it can be ways to over stretch or pull the ligaments with sudden movements.

Experiencing round ligament pain in pregnancy is generally common and generally indicates a need to slow down, take it easy and offer the body some tender care and support. If a pregnant person is ever worried about lower abdominal pain it is always prudent to contact their care provider/ midwife, however the short lasting stretch or pull of one sided round ligament pain is often not indicative of greater concerns.

Tips for comfort

Soften into slower and more mindful movements. This helps to avoid over stretching and
Remain active in gentle ways like walking, and swimming. Movement always helps to keep us well.
Belly dance and rock your hips.
Wear a belly belt or firm abdominal support. ( this can help support the weight of the growing uterus).
Stand with your feet balanced.
Try to maintain stability in your pelvis by keeping knees aligned.

Spinning Babies® encourages the principles of Balance , Gravity and movement™. Spinning Babies offers several suggestions to practically support the integration Balance, gravity and movement in pregnancy.

The Spinning Babies® Three Sisters of Balance™ are perfect for support alignment and comfort in the pelvis. The Three Sisters of Balance™ can be beneficial during pregnancy and also a great tool to supporting ease in birth .

The three sister of balance™ are:

Reboso sifting
Forward leaning inversion
Side lying release.

Spinning Babies® also offers the Daily Essentials ™ the provide simple practical suggestions for maintaining body balance and wellness.

Pregnancy and birth is such an exciting time. We welcome new little beings in and also have the opportunity for welcoming in new growth, learning and body awareness. With awareness comes power . Our bodies such intelligent and powerful creatures. Our bodies have so much potential for comfort, ease and pleasure. The second article in the clever body series will cover the amazing board ligament.

‘ There is more wisdom in your body than there is in the deepest philosophy’ Friedrich Nietzsche.

The Sexy Round ligaments

The Extraordinary Bony Pelvis

Have we lost the beautiful art of yield?