Body perception refers to the way we consciously perceive our own body and is considered a dynamic process that depends on continuous visual, tactile, and proprioceptive stimuli influenced by psychosocial factors, memories, and beliefs. Perceptual disturbances are observed in patients with chronic low back pain. They perceive their back as stretched, contracted, weakened, and fragile. Myofascial pain of the lower spine and pelvic girdle affects 50%-90% of pregnant women. These data are not alarming, as most women recover from childbirth. Only about 21% still report pain 2 to 3 years after childbirth, and 10% report worsening quality of life and decreased ability to work full time. Body image disturbances are more pronounced in women who experienced lumbosacral pain in late pregnancy and after delivery. Therefore, impaired body awareness during pregnancy may lead to pain in the lumbar-ilio-pelvic complex (1).
Although pregnancy is a very special time for women when weight gain is acceptable, many are unhappy with their appearance and physical condition during pregnancy, which can have a negative impact on both the mother and the baby. It is important to emphasize the importance of (pro)active body image assessment during pregnancy, even if women do not mention such disturbances themselves. It has been shown that people with body image disorders are afraid to talk about it because they fear that no one will believe them or because the “bizarre” nature of their experience suggests that they may have a mental disorder. Consequently, experiencing body image disturbances can increase stress, pain, and anxiety, leading to a vicious cycle that results in greater pain and disability (2). It should be emphasized that numerous scientific studies have shown an association between negative body image and variables such as depression, self-esteem, eating habits, and weight gain outside recommended limits (3). Therapies to improve body image and body awareness in pregnant women should be noninvasive and should not pose a risk to the course of the pregnancy or the child. Special care should be taken during the first trimester of pregnancy if we are going to use any form of massage or manual therapy. Acupuncture, light therapy and massage can reduce anxiety and prenatal depression (4) For postpartum women, the choice of therapeutic agents or methods is much greater and the implementation itself is safer, as there are no risks to the child resulting from the pregnancy itself. For both groups of women, the choice of therapy, i.e., the Feldenkreis method, biofeedback, the Lowen method, sensory integration, and other methods in which the therapist does not directly touch, is a safe solution.
Scientific research and increasing knowledge (training) in the subject of body image and related factors, which may benefit professionals working directly with groups of pregnant women (doctors, nurses, physiotherapists, nutritionists, psychologists), especially pregnant women themselves, to provide them with the healthcare they need as they deal with the changes in their body that are necessarily related to pregnancy. This will have a positive effect on the well-being and health of the mother and baby.
Grzegorz Jędrzejewski
References:
- Gutke A, Boissonnault J, Brook G, Stuge B. The Severity and Impact of Pelvic Girdle Pain and Low-Back Pain in Pregnancy: A Multinational Study. J Womens Health. kwiecień 2018;27(4):510–7.
- Goossens N, Geraerts I, Vandenplas L, Van Veldhoven Z, Asnong A, Janssens L. Body perception disturbances in women with pregnancy-related lumbopelvic pain and their role in the persistence of pain postpartum. BMC Pregnancy Childbirth. 18 marzec 2021;21(1):219.
- Meireles JFF, Neves CM, de Carvalho PHB, Ferreira MEC. Body dissatisfaction among pregnant women: an integrative review of the literature. Cienc Saude Coletiva. lipiec 2015;20(7):2091–103.
- Smith CA, Shewamene Z, Galbally M, Schmied V, Dahlen H. The effect of complementary medicines and therapies on maternal anxiety and depression in pregnancy: A systematic review and meta-analysis. J Affect Disord. 15 luty 2019;245:428–39.
