Case Study: Pregnancy Pain With An Unusual Factor

This case study covers the work done to treat a client who was experiencing pregnancy pain during her 16th week and who has a history of multiple fibroids on her uterus.

Client’s History

I recently had a client who was 16-weeks pregnant with her first baby. She came to see me because she was having severe pain in her lower abdominal area with a complaint of more pain being on the right side. She was having difficulty walking, sleeping, and sitting, and she was not finding anything to help her feel better.

My client’s pain started about a week before she came in to see me. In discussing her history, she shared that she had a history of fibroids on her uterus. She reported having 8 of them. 5 being small in size and 3 being larger than the rest. She was not aware of their location or the type of fibroids they are, but is having an ultrasound after seeing me to learn more.

In 2000, this client had an umbilical hernia repaired with mesh placement. She reported that her OB/GYN told her she might have trouble getting pregnant, but that was not the case with this pregnancy. She was able to get pregnant on the first try.

Assessment and Treatment

In assessing my client, the first thing I noticed was how tight her uterus looked and how forward it was positioned in her belly. When I went to find her fundus, it was at the level of her umbilicus, which was a bit larger than most at 16 weeks of pregnancy. Usually, the fundal height is at the level of the umbilicus by 20 weeks of pregnancy.

In evaluating her uterine mobility, all three ligaments were tight on her right side, and it felt like her lower abdominal fascia was restricted bilaterally. When I focused on releasing the left side’s lower abdominal fascia, the right side loosened as well. After releasing the uterine ligaments, her uterus softened, and I could feel the edges of a fibroid on the top right side of her fundus.

I found the uterus needed more than just ligamentous work. It felt like the hardness of the uterus was liking gentle compression anterior to posterior through the uterosacral ligaments and from the top of the fundus to the lower part of the uterus that I could palpate just above the pubic bone.

The side-lying technique I teach in the new Pregnancy Pain and Beyond course proved particularly helpful in softening the right side of her belly. I also found that her umbilical area was restricted from her hernia repair as the tissues had limited mobility to the right. Improving the restrictions in that helped the uterus to relax more.

Wrapping Up The Session

After all this release work, her uterus was more relaxed and softer. It wasn’t so anterior in her belly, and she had no more pain in her abdomen. She is getting an ultrasound of her uterus, and I asked her to note the locations and types of fibroids that we are dealing with in her body. We are planning on working together throughout her pregnancy to ensure she remains comfortable as her uterus expands and as we create space for the baby to get into a good position for birth.

Join me for the first live group cohort of the new Pregnancy Pain and Beyond course (starting May 19, 2025). I cover what to do with each position as well as how to help breech-positioned babies. You’ll have the skills to know exactly what to do to create space and balance in the body for the baby to choose a more midline and hopefully head down position to promote a smoother birth.

About the Author: Lynn Schulte is a Pelvic Health Therapist and the founder of the Institute for Birth Healing, a pelvic health continuing education organization that specializes in prenatal and postpartum care. For more information, go to https://instituteforbirthhealing.com