Relaxing Into the Hormone RELAXIN
by Susan Moore Daniels, CNM, MSN
“My low back is so out of whack!”
“My pubic bone is screaming!”
“My knees and feet feel so uneasy!”
Yet the change can be redeeming.
RELAXIN is still a bit of a mysterious hormone, in that it hasn’t been researched to the degree of other physiologic things that influence humans. However, during pregnancy, the influence of RELAXIN hormone is understood far more for this is the time the levels are at their highest.
In humans who are born biologically female, RELAXIN hormone comes from the ovaries in tiny amounts throughout life. During pregnancy this hormone is also released by the placenta in significant amounts, as well as from cells of the bag of waters around the baby, and the cells lining of the growing uterus. For those who are born biologically male, RELAXIN hormone is secreted from the prostate and can be detected in semen. However it is rarely detected in their blood testing, meaning the detectable amount in their body is miniscule.
Interestingly, RELAXIN belongs to the same family of hormones as insulin, the important hormone secreted by the pancreas organ, important in our abilities to process sugar and other molecules that give us energy, and a very important hormone in our understanding of gestational diabetes. The control of RELAXIN release in humans is, as of this date, still not fully understood, but what is well known is that pregnant women/people have a vast array of differing symptoms in the muscles and skeleton through their pregnancy/gestating times. As I have written about in one of our previous newsletter articles, in the same way insulin resistance is on a vast spectrum of display for all of us, especially during pregnancy, and I think the same may be true for RELAXIN hormone sensitivities. You can read my previous article on gestational diabetes HERE.
As its name suggests, RELAXIN hormone relaxes certain components of our musculoskeletal system. It decreases stiffness in cartilage, tendons, and connective tissues, making our joints more loose and lax in pregnancy. It is actually a healthy thing! The purpose we believe is to promote a more gentle yet rather accelerated EXPANSION of the body to allow the necessary space for growth of a baby, and to provide more laxity within the pelvis to help a baby pass through for birth.
However, this laxity isn’t specific to the uterus and pelvis. All joints in the body are somewhat influenced by RELAXIN hormone. This creates changes in the way a pregnant woman/person walks as the body learns to move with a new range of motion from the weight forces pulling towards the front working against the spine support. For some, they can compensate and adapt just fine with only a few complaints, but for others this can cause profound achiness and discomfort in the low back, hips, pelvis, and feet. Actually depending on your display of RELAXIN sensitivity in certain joints, you might also have discomforts in your wrists and fingers, or in your knees, quite actually anywhere you may be vulnerable in your joints and musculoskeletal system.
But, the most commonly described discomforts are in the pregnant lower back, supportive pelvic ligaments, pelvic bones and hip joints, and the feet!! So what to do???? Well, there are lots of things.
TRUST: The body changes so rapidly while growing a baby, much with the same rapidity as an infant growing into a toddler, or the fast physical changes that happen in adolescence. Except in pregnancy it is all at an even faster pace!! The purpose of these fast remarkable human physical changes has endured the test of time. Your body knows what it needs to do, how it needs to change to grow and birth forth another human being. Give yourself the pause and the grace to experience all the changes while holding strong in trusting that your body is changing in the ways necessary for growing your baby.
SELF-CARE: Pregnancy brings changes on so many different levels for the body/mind/spirit, so in a wholistic approach to addressing these changes, anything you might do to nurture one aspect will likely help the other two. Soaking in a tub, with a little relaxing meditation or some music, a little aroma therapy (think rose essence, lavender, clary sage, or others) is helpful beyond measure and seems so simple. We just get so busy sometimes we forget to do the simple things first.
MOVEMENT: I have recommended YOGA to my pregnant clients for decades. We are generally more flexible in pregnancy under the influence of RELAXIN hormone, and the gentle “Yin” or restorative poses of certain Yoga practices sometimes help in amazing and magical ways to bring balance to our wholistic selves. You can sign up for a class, and/or you can do this totally on your own during your own crazy time schedule by engaging an on-line You-Tube video situation. But you don’t have to just do Yoga. You can do many types of exercise, do the things you like. It is important to just keep moving in some manner, doing something outside your usual work or daily stuff, every day.
We have started a DANCING FOR BIRTH series of classes at Dar a Luz which helps to feed the spirit in the enjoyment of dancing movements (even if you feel like you “can’t dance,” YOU CAN DO THIS TYPE OF DANCE!) and to help prepare the body in practicing movements that can be helpful in certain situations to help a baby come forth during labor and birth.
MASSAGE: Whether from your partner, a willing friend or family member, or setting up a “massage trade” with another pregnant friend, massage is such a helpful therapeutic comfort measure. The low back and sciatic region over the glutes are often the desired regions for pregnancy massage, but don’t forget the feet! They carry the impact in their every single step of the growing weight of two humans in one body more than any of our body parts. We often are asked about the safety of massage in pregnancy, specifically “what about those pressure points they might touch that could induce labor?” Well, the truth is that if those actually worked reliably don’t you think we’d use them more?? Bottom line, pregnancy massage is safe and an important therapeutic measure regarding some challenging RELAXIN hormone issues. If your particular massage therapist needs a note that we feel it is safe for your to get a pregnancy massage, no problem, we will provide that.
PHYSICAL THERAPY: In Albuquerque, we are very fortunate to have a number of Doctors of Physical Therapy (DPT) who have specialized in pregnancy and the pelvic floor. One of the RARE complications of the influence of RELAXIN hormone can be symphysis pubis dysfunction. Symphysis pubis dysfunction happens in only 1 in 300 pregnancies actually. However, I do believe that because of the spectrum of ways we may see the influence of RELAXIN hormone, that more pregnancies may be complicated with symphysis pubis discomforts. We have many local DPTs who we can refer you to for help with this situation, as well as other pelvic floor issues.
ACUPUNCTURE AND CHIROPRACTIC THERAPY: We are again quite fortunate to have several ABQ providers for these services who really like working with our Dar a Luz Community. Acupuncture and Chiropractic modalities are very different, and each option resonates with our clientele in different ways. If you already have a provider who specializes in these services, just check and make sure they are comfortable working on pregnant clients. BOTH MODALITIES ARE SAFE DURING PREGNANCY!!
MATERNITY BANDS AND TAPE: We can help direct you to find some easy on-line and affordable maternity bands that don’t need a prescription. There are also some options for prescription level maternity bands and pelvic support contraptions we can help you navigate, but in my experience many times these have taken weeks to get and then ultimately ended up being more cumbersome for wearing and not well-loved, and unfortunately in the end, sometimes not covered by insurance. The simple, non-prescription versions seem to stand the tests of helpfulness for more people.
There is also a growing trend now for the use of KINISIOLOGY TAPING (KT) for some abdominal and back support during pregnancy, particularly in the third trimester. Some of our clients have been sensitive to the adhesive, but actually most who have tried it have found it helpful for the days they were able to wear the tape. Sometimes a physical therapist or a chiropractor will apply the taping, but honestly there are so many YouTube videos on how to DIY (or with some help from a partner).
OTHER OPTIONS: There are many other things that could be helpful managing the RELAXIN hormone changes while pregnant. Too many to list in full, but we are often asked about extra pillows for sleeping, working with a personal trainer, cranial sacral therapies, flotation therapy and float spas, and more. A big YES to all these in their safety to try during pregnancy.
After birthing, RELAXIN hormone remains in the body at the higher levels for a full 12 weeks post-partum, as it takes the liver at least that long to metabolize and rid the majority of circulating RELAXIN. There is some evidence that for those who breastfeed, it might stay at higher levels longer than 12 weeks. Restoring muscles strength and being able to control the laxity in joints is very important in the post-partum period. Starting slowing, gently, and pulling back from any exercise that causes pain is important. I always suggest setting the expectation of giving oneself at least a full year to find the feeling of a new normalcy after giving birth. Some of this recommendation is due to the recovery aspects from the vast major physical and emotional transformations that happen through birthing another human, the obvious weight gain and rebalancing, sleep deprivation issues, navigating calories and the demands of milk production, the evolution of new daily/nightly schedules, and so much more. All of these things are influenced to some degree by the rebalancing of RELAXIN hormone. Give the moments you can to be kind to yourself and to be mindful of the process.
Susan Moore Daniels, CNM, MSN
Through her hands, Susan has greeted, or has welcomed, or caught, or helped-in-the-coming-forth-to-safe-passage-of many human babies. Thousands of babies. She has been at Dar a Luz since 2014. The clinical influences of music on our health, the emotional and psychological transformations that happen through birthing and parenthood, and the vast importance of simple things such as stargazing or the crafting of culinary salad pleasures are things of interest she brings forth to share with those who might be curious.