Training For Natural Birth? Don’t Forget Your Psoas

We hear a lot about natural birth these days. Learn how to get in touch with your psoas to improve your chances of natural delivery, with some tips from psoas expert Liz Koch.

“Training for birth is just like training for a marathon.” This is a helpful analogy that I’ve heard frequently and even used myself. It expresses the need for physical conditioning and discipline throughout the nine months of pregnancy. But like any analogy, it has some limitations, especially for women who want to birth naturally:

“Training for birth is just like training for a marathon.” This is a helpful analogy that I’ve heard frequently and even used myself. It expresses the need for physical conditioning and discipline throughout the nine months of pregnancy. But like any analogy, it has some limitations, especially for women who want to birth naturally:

  1. You don’t know the race date. Your due date could be days or weeks off.
  2. You don’t know the mileage. Labor could take a few hours or a few days.
  3. Giving birth is not a specialized skill that you can practice regularly.

Today I want to talk about #3. To train for a race, you run. You might do some other things, but mostly you run. Preparing your body for birth is different. There is no one type of exercise or movement that you should do to prepare for labor – not Kegels, not squats, not tailor sitting. The prenatal period presents a unique opportunity to delve even deeper and go beyond ‘prenatal fitness.’ Specifically, pregnancy provides an opportunity to get to know that ambiguous and rapidly expanding area of your body known as ‘the core.’ To do that, I suggest pregnant women spend more time looking like this woman to the right, and less time looking like Momzilla, especially if they want to birth naturally.

This is where Liz Koch comes in. Although her website is called “Core Awareness,” Liz has devoted her life’s work to the psoas muscle. Not sure what the psoas is? I will leave it to her to describe it, as no one else can:

Located behind those flab or fab abs is a little known but oh so powerful muscle called your PSOAS (pronounced so-as). The only muscle to connect your spine to your leg, the psoas influences everything from low back pain and anxiety, to full body orgasms and pure pleasure. It is a supple, juicy dynamic muscle.

Needless to say, Liz likes the psoas. I came across her work last year while reading an article at Spinning Babies on the role of the psoas in breech presentation. I am intrigued with the topic of fetal positioning, not only because I work with pregnant women, but also because I have had two breech babies myself. I was fascinated to learn that this inconspicuous muscle may actually play a significant role, not only in fetal positioning, but in prenatal health in general. In fact, even if you’re not pregnant, a regular psoas release practice is beneficial. (For example, Liz recently interviewed powerlifter Deric Stockton.) So what can we do to strengthen the psoas muscle?

liz koch, psoas

Liz Koch’s answer to the question may seem counterintuitive. In fact, she calls the psoas “the one muscle that doesn’t need strengthening.” Liz explains that the goal of working with the psoas is not simply to strengthen an isolated muscle, in the same way that a curl strengthens the bicep, but rather to release and vitalize it. This process involves the lost art of relaxation, which is so important throughout pregnancy and, of course, in the delivery room. As Liz notes:

There are many practical advantages to understanding the psoas such as releasing back tension, improving blood circulation, and enhancing overall digestion. Equally important is its ability to offer a deep sense of safety and relaxation.

Relieving stress in every phase of pregnancy and birth by releasing extraneous tension from the psoas tissue brings great benefits to both mom and baby. The psoas is best understood as not a muscle but a messenger from the very core of our being. Therefore the psoas does not need to be strengthened because it is not weak. What a person may believe to be weakened is actually an exhausted psoas.

The goal then, is not simply to strengthen the muscle but to awaken and release it. If you’re like most normal people, you probably don’t think about your psoas a lot. You might not even know where it is. Getting in touch with your psoas during pregnancy will help alleviate many common pregnancy symptoms, such as pain in the groin and lower back, and will also improve your ability to relax. As awareness about natural birth increases, women who desire to birth vaginally need to not only stay active during their pregnancy, but also foster this connection. Liz notes the important roles of the psoas in a successful natural delivery:

In the Taoist healing tradition, this supple tissue is referred to as the muscle of the soul. For the baby born vaginally, it is the mother’s psoas that provides a guide to spiraling through the birth canal. Thus, the quality and health of a mother’s psoas influences the overall experience and outcome of birth for both mother and baby. For the baby, the mother’s psoas become the tracks it follows down into the birth canal.

A vital psoas muscle encourage a smooth transition from womb to world, as well as optimal fetal positioning. These effects have to do with the relation of the psoas to the pelvis, as Liz explains:

When the iliopsoas is compromised, tension in the muscle inhibits skeletal alignment, organ functioning and visceral vitality. Moving directly over the ball and socket joint, a tight iliopsoas can close the socket limiting movement and rotation. Tilting the pelvis forward and down its tension limits both blood flow through the legs and feet and often results in pressure on the sciatic nerve. Pulling the pelvis forward, a constricted iliopsoas limits diaphragmatic breathing and curtails digestive processes. By reducing internal space, the womb, rather than cradled in the pelvic bowl, gets pushed up and forward. This stresses the abdominal wall and thrusts the baby outside of the realm of containment.

So how can pregnant women get in touch with their psoas? Through a very simple exercise that Liz calls the constructive rest position. The basic idea behind this position is that it uses gravity to release the psoas muscles. Here’s how you can use the constructive rest position during pregnancy (or any time!) to encourage proper fetal positioning and relieve stress and anxiety as well:

  1. Lie on your back and use pillows to create a diagonal support from your sit bones to your head (if you’re not pregnant, you can just lie on your back).
  2. Bend your knees, with your heels about 12 – 16 inches away from the buttocks. Keep your feet about a hip width apart and paralle with each other.
  3. Place your hands on your belly or at the sides of your body and simply rest in this position for 10 – 20 minutes.

Sounds easy, right? The key to this position is to allow your spine to be neutral – which does NOT mean flat. We often hear advice to tuck the pelvis or get rid of the slight arch in the lower back. In this position, focus on maintaining the natural curves in the spine to release the psoas and the pelvis. I know the first time I tried to rest in this position I had to talk myself out of tucking my pelvis several times.

Combine this practice with the 10 yoga poses Liz recommends, and you will be on your way to awakening “the juicy psoas.” Your baby and your body will thank you.