Loss of Balance and Pregnancy: What to Expect Every Trimester

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—she only suffered a sprained ankle and gave birth to a healthy baby last January. Still, it's a scary-sounding scenario that happens to more parents-to-be than you might think. According to a study by the National Institute for Occupational Safety and Health (NIOSH), 26.6% of pregnant parents experience a fall before giving birth.

"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!)

What Causes Unsteady Balance During Pregnancy?

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.

The 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 all day might actually increase your likelihood of falling, according to a study 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."

Keeping Your Balance Every Trimester

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 person to person, so getting in and out of the bathtub might feel like a Cirque du Soleil routine for you while a further-along pregnant 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 happen to land on the floor.

Weeks 1-11 (ovulation)

Limb-loosening relaxin is always in your body, but it rises during ovulation. It drops down until the next cycle if you don't conceive. If you do, the hormone starts circulating through your body in earnest.

There's little to nothing to worry about if you fall before 12 weeks since the uterus is well protected behind the pelvic bone.

Weeks 12-16

Estimates vary, but it is generally accepted that relaxin peaks here at the beginning of your second trimester.

Call your doctor as a precaution if you experience a fall during this period. While miscarriage is rare at this stage—less than 2%—a severe fall such as wiping out on a steep stairway could be cause for concern.

Weeks 17-28

Are you feeling particularly wobbly during your second trimester? That might be because your center of gravity is shifting forward, but your brain is still running on pre-bump muscle memory. In other words, as your center of gravity changes, you become more likely to become unbalanced.

However you land after a fall during weeks 17-28, call your doctor and ask if you should have an ultrasound to check for (highly unlikely) damage to the placenta—you'll rest easier knowing for sure.

Weeks 29-birth

You're getting bigger and feeling less mobile and more cautious—so you're less likely to tumble right now. (Surprise!)

However, if you do fall, your doctor 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.

Birth and beyond

Relaxin is still dropping to pre-pregnancy levels, so your joints may still feel loose for a few months. Stop exercising 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 regular pre-pregnancy injury checks: Are you bleeding? Did you hit your head? Turn your ankle? You know what to do.

When To Call Your Doctor If Your Pregnant And Fall

No matter your trimester, a fall is enough to rattle anyone. And while some trimesters are safer than others regarding how cushioned your growing baby is, any fall after the second half of the second trimester or the in the third trimester should be evaluated by a doctor.

Seek medical help for any injuries, but for concerns about falling while pregnant, here are signs that you should seek immediate medical attention:

• You fall directly on your belly.
• You experience pain, including cramping or contractions.
• Any vaginal bleeding.
• Any signs of amniotic fluid leaking.
• If you notice that your baby isn't moving as much.
  

The Bottom Line

The pregnancy hormone relaxin can cause unintended consequences, such as loss of balance, leading to falls. To prevent falls, wear comfortable, supportive footwear, avoid slippery or uneven surfaces, and use railings when possible. Always talk to your doctor about any concerns you may have.