It happened four months into Jolynn Baca Jaekel's pregnancy. A slight stumble on an uneven sidewalk, and bam: She went down. "Out of panic, I twisted to avoid falling forward and hurting the baby, and landed on my back," Jaekel of Arlington, Va., says. "I was so shaken up, I started to cry."
Thankfully, Jaekel's story has a happy ending—mama only suffered a sprained ankle and gave birth to a healthy baby girl last January. Still, it's a scary-sounding scenario that happens to more moms-to-be than you might think. Almost a third of women fall during pregnancy, according to a study in the American Journal of Industrial Medicine.
"Most of my patients have experienced some sort of a misstep," says Sheryl Ross, M.D., an OB-GYN in Santa Monica, Calif. "Fortunately, falls that could send you to the emergency room are not common. Even if you land on your abdomen there's probably not enough force to hurt the baby." (Phew!)
So why are you wobbling? Even before your body starts visibly transforming your ovaries release relaxin, a hormone that softens the ligaments in your pelvis to create space for the growing fetus. Trouble is, relaxin circulates through your entire body, not just the pelvis—so ligaments in your hips, knees and ankles can get a little loosey-goosey, too, says Jean L. McCrory, Ph.D., assistant professor of exercise physiology at West Virginia University, who researches pregnancy and balance. Not to mention the changes to your center of gravity—front-heavy much?
But all this isn't a green light to spend your pregnancy parked on a La-Z-Boy. In fact, sitting on your bum all day might actually increase your likelihood of falling, according to a study of pregnant women McCrory published in the Journal of Biomechanics: All of the sedentary participants fell at some point during their nine months, while less than half of those who remained active—say, taking a walk three times a week or doing prenatal yoga once a week—shared the same fate.
"During exercise, you may be more aware of your changing body and size," McCrory says. "So when faced with balance issues, an active pregnant woman might be more equipped mentally and physically to control her body than one who doesn't work out."
You don't have to have a balloon of a belly to feel unstable.
"My balance started to go by 15 weeks," says Melissa Shevchenko of Jacksonville, Fla., mom to two girls, now 2 and 5. "I never had a full-on fall, but I tripped all the time."
Steadiness varies from woman to woman, so getting in and out of the bathtub might feel like a Cirque du Soleil routine for you, while a further-along preggo friend is balancing on one foot in yoga. Here's how things tend to get wonky, and what you should do at each phase if—worst-case scenario—you do happen to eat it.
Limb-loosening relaxin is always in your body, but it rises during ovulation. If you don't conceive, it drops back down until the next cycle. If you do, the hormone starts circulating through your body in earnest.
If you fall... There's little to nothing to worry about before 12 weeks since the uterus is well protected behind the pelvic bone.
Estimates vary, but one study found that relaxin peaks here, at the beginning of your second trimester.
If you fall... Call your doctor as a precaution. While miscarriage is rare at this stage—less than 2 percent—a severe fall such as wiping out on a steep stairway could be cause for concern.
Almost two-thirds of tumbles occur during the second trimester, notes a University of Cincinnati study. One possible reason? Your center of gravity is shifting forward, but your brain is still running on pre-bump muscle memory.
If you fall... However you land, call your doctor and ask if you should have an ultrasound to check of (highly unlikely) damage to the placenta—you'll rest easier knowing for sure.
You're getting bigger and feeling less mobile and more cautious—so you're less likely to tumble right now. (Surprise!)
If you fall... Your doc may ask you to stay at the hospital for 24 hours to make sure you don't go into early labor. But by the end of your third trimester your womb contains 1 to 2 liters of liquid cushioning—you're more likely to sprain a limb of your own than to harm your little one.
Relaxin is still dropping to pre-pregnancy levels, so your joints may still feel loose for a few months. Stop exercise right away if you feel dizzy. And avoid jumping or jarring moves for the first four months, says trainer Lisa Druxman.
If you fall... do normal pre-pregnancy injury checks: Are you bleeding? Did you hit your head? Turn your ankle? You know what to do.