Pregnancy and childbirth can do a number on your back. That’s why you see so many women in the proverbial “hand on back pose” during the second and third trimester.

The good news is you can reduce these backaches and encourage your baby to move down the birth canal with a simple exercise known as pelvic rocking.

“Pelvic rocking is the name given to moving the pelvis the front to the back or from an anterior to a posterior pelvic tilt,” says orthopedic and pelvic floor physical therapist, Juan Michelle Martin, DPT.

You can do pelvic rocking in a variety of positions such as on your back, seated on a ball, or even on your hands and knees.

According to Kecia Gaither, MD, MPH, FACOG, double board certified in OB-GYN and maternal fetal medicine, and director of perinatal services at NYC Health + Hospitals/Lincoln, performing pelvic rocking during labor can assist with moving the baby down the birth canal.

Martin recommends pelvic rocking during labor because it can help you focus, and it’s an effective distraction from contractions. “It also helps to guide baby into the pelvis, especially when on hands and knees or an upright position,” she adds.

And this expert opinion is backed by research. One 2016 study found that practicing pelvic rocking exercise while sitting on a birth ball during childbirth can help:

  • reduce pain
  • improve the progress and shorten the first stage of labor
  • promote maternal comfort

During pregnancy, Gaither says the exercise is useful to ease backaches and to increase flexibility.

And Martin points out that pelvic rocking is a way to help maintain pelvic mobility, which is helpful during pregnancy. She also explains that pelvic rocking is a way to help ease back pain during these times by encouraging movement, especially in women who have become sedentary.

Another 2019 study found that performing pelvic rocking exercises on a birth ball is useful for correcting the fetal lie (position) as you near labor and delivery.

The researchers also discovered that pelvic rocking could reduce the structural burden many women experience during pregnancy and labor as well as reduce back pain and improve the abdominal posture and pelvis muscle.

One of Martin’s favorite positions for pelvic rocking is on your hands and knees. “This exercise is typically performed independently for isolated pelvic movements such as when there is low back or sacroiliac joint pain, or it can be integrated with the trunk in what is known as the cat/camel exercise.”

With that in mind, here are the steps to do pelvic rocking on your hands and knees:

  1. Get on your hands and knees and position your hands directly under your shoulders and knees under hips.
  2. Take a deep breath in and tuck your head downward and move your tailbone upwards toward the ceiling. This will feel and look like the cat phase of the Cat-Cow pose in yoga.
  3. Hold this position for a few seconds.
  4. Exhale, bring your head up, and straighten or flatten your back.
  5. Hold this position for a few seconds.
  6. Repeat by alternating between curling and straightening.

Allison Molinski, MSN, CNM and Shannon Kane, MSN, CNM — both midwives at Mission Hospital in Southern California — say you can also practice pelvic rocking in a standing position by leaning against a wall, bench, or chair. “Whether you are on your hands and knees, or in a standing position, this exercise helps you leverage gravity to help the baby get in position for birth,” they explain.

Here are the steps to perform pelvic rocking while standing:

  1. Stand with your back against a sturdy wall with your knees slightly bent. Maintain the natural curvature in your spine.
  2. Take a deep breath in and move your pelvis towards the wall. Your lower back will touch the wall.
  3. Exhale and return to neutral position. Then, gently rock the top of your hips forward. This will allow your back to arch.
  4. Return to the starting position and repeat the rocking motion 8 to 10 times.

Birthing balls are a great tool for pregnancy, labor, and postpartum. Kane and Molinski often recommend sitting on a birthing ball in lieu of a chair during pregnancy, especially in the third trimester.

When choosing a birthing ball, make sure your hips are slightly higher than your knees. The right-sized ball should also allow your upper body to have a slight tilt forward, which supports and opens the pelvis and encourages good posture.

If using the ball during labor, Kane and Molinski say you can lean over the ball while on your knees or sit on it. The choice will depend on your comfort level.

Follow these steps for sitting on the ball:

  1. Sit on the center of the ball with your feet flat on the floor. Make sure you’re sitting up straight, and your body is stable.
  2. Gently rock your pelvis forward and backward while keeping your upper body vertical.
  3. Repeat the rocking motion 10 to 15 times.

You can also perform pelvic rocking on the ball by moving side to side, in a circle or in figure-8 movements. “The gentle movement creates space in your pelvis and helps your baby move down the birth canal,” explain Kane and Molinski. In early labor, rocking back and forth during contractions can feel soothing.

Once you’re in active labor, the duo says you may find the ball most useful to lean against. To do this, position yourself on your knees and kneel over the ball, or you can place the ball on a bed or couch and stand leaning against it.

“Leaning against the ball, whether on your knees or in standing position, is an excellent position to labor in,” they explain.

As with any exercise in pregnancy, Gaither says it’s best to clear any regimen with your physician first. While most women can perform pelvic rocking during pregnancy and labor, Gaither says anyone with a spinal disorder should avoid this exercise.

To learn correct body positioning and form, consider working with a midwife or physical therapist. They can demonstrate the motion and observe while you perform pelvic rocking on the ball, on your hands and knees, or standing. If you experience any pain while doing the pelvic rocking, stop the exercise immediately.

Performing the pelvic rocking exercise during pregnancy can relieve back pain and improve flexibility. It can also get you ready for labor.

Using this technique while laboring and during delivery can distract from painful contractions, help baby move down the birth canal, and relieve minor back pain.

Sound like a win-win-win? Absolutely. But as with any exercise, always get approval from your doctor before trying pelvic rocking.