Prenatal Care

Pregnancy asks a great deal of the body in a short span of time — roughly forty weeks to accommodate a growing baby, shifting hormones, a changing center of gravity, and a pelvic floor and core that are being progressively loaded in new ways. At SOMOM, our prenatal physiotherapy and massage therapy support people through this process, working alongside the care already being provided by an OB/GYN or midwife. We don’t replace obstetric care; we address the musculoskeletal and pelvic health side of pregnancy — pain, function, and preparation — that a prenatal appointment doesn’t always have time to cover in depth.

How the Body Changes, Trimester by Trimester

In the first trimester, changes are often more hormonal than mechanical: relaxin and progesterone begin softening ligaments throughout the body, including those supporting the pelvis and spine, well before there is a visible bump. By the second trimester, the growing uterus shifts the center of gravity forward, and the postural muscles of the back, hips, and pelvic floor start working harder to compensate. The abdominal wall also begins to lengthen and thin as the linea alba, the connective tissue running down the midline of the abdomen, stretches to accommodate the growing uterus — a normal, expected adaptation rather than a sign that anything has gone wrong. In the third trimester, increased weight, continued ligament laxity, and the approach of labour combine to bring pelvic girdle pain, rib and back discomfort, and pelvic floor heaviness into sharper focus for many people.

Concerns That Commonly Arise

• Pelvic girdle pain, including symphysis pubis discomfort and sacroiliac joint pain
• Low back and mid-back pain, often worse with prolonged standing or walking
• Leaking urine with coughing, sneezing, laughing, or exercise (stress urinary incontinence)
• A sense of heaviness or pressure in the pelvis, particularly later in pregnancy
• Rib flare or rib pain as the ribcage expands to make room for the growing uterus
• Questions about safe exercise, lifting, and staying active throughout pregnancy

These symptoms are common, but common does not mean they need to simply be tolerated. Many respond well to targeted physiotherapy.

How Physiotherapy and Massage Therapy Can Help

A prenatal physiotherapy assessment looks at posture, movement patterns, pelvic floor function, and how load is being managed through the pelvis and spine as the body changes shape. Treatment may include manual therapy for the back, hips, and ribcage; a supportive belt or taping for pelvic girdle pain; individualized exercise to build strength and control through the core and pelvic floor; and guidance on positions and movement strategies for daily activities, sleep, and labour itself. Pelvic floor assessment can be done largely through external observation and functional testing, with an internal exam offered only when appropriate and always by consent. Massage therapy can ease the muscular tension that builds up as posture shifts, particularly through the upper back, neck, hips, and low back, and many people find it a welcome complement to physiotherapy in the later months.

Preparing the Pelvic Floor for Birth

Later in pregnancy, some people choose to focus part of their physiotherapy sessions on preparing the pelvic floor for labour and delivery — learning to both engage and, just as importantly, fully relax and lengthen the pelvic floor muscles, along with perineal massage education and breathing strategies for pushing. This preparation does not guarantee a particular birth experience or outcome, and physiotherapy is not a substitute for the birth education, monitoring, and decision-making provided by your obstetric team. It is, however, a way to feel more familiar with, and connected to, your own body heading into labour.

What Prenatal Care Looks Like at SOMOM

Sessions are scheduled around your pregnancy and can begin at any point, from early in the first trimester through the final weeks before your due date. Care is collaborative and adjusts as your body and symptoms change from one trimester to the next. Our pelvic health physiotherapy service is central to this care, and many people continue with us into the postpartum period as recovery begins.

Working Alongside Your OB or Midwife

We stay in our lane as physiotherapists and massage therapists: we do not manage the medical side of pregnancy, order prenatal testing, or make decisions about your obstetric care. Please continue attending all recommended appointments with your OB/GYN or midwife throughout pregnancy, and let us know if anything we find raises a concern that should be discussed with them. If you’re dealing with pain, leaking, or simply want a body that feels prepared for what’s ahead, our High Park clinic is here to help. Book a prenatal assessment at any stage of pregnancy that feels right for you.