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Should You Be Concerned About Pregnancy-associated Osteoporosis (PAO)?

March 6, 2023

I’m willing to bet that one of the last things on your mind as a mama (or soon-to-be mama) is bone mineral density. Not the sexiest topic, I know. But pregnancy-associated osteoporosis (PAO) is a real concern, and for those if you due soon or currently breastfeeding, *please* consider speaking to your physical therapist or physician if you are experiencing severe back, hip or leg pain, as this can be a sign of vertebral fractures – especially if other possible causes have been ruled out and your body isn’t responding as we would expect to physical therapy or other manual techniques.

Risk factors for PAO include physical inactivity, limited calcium intake, family history of osteoporosis, inadequate nutrition, and a low body mass index. *Notice that age is not listed here – women younger than 25 have been known to get fractures related to pregnancy or lactation!*

Now, before you run off in a panic, it’s worth mentioning that PAO is relatively rare: they made up 2 out of 535 fractures that were studied, in a 2016 paper by Krishnakumar, Kumar, & Kuzhinattam. But rare doesn’t mean nonexistent, and the more you know about changes to your body during and after the pregnancy, the more empowered you can be in your own care.

And of course, the best medicine is preventive, so beefing up those bones before pregnancy is a great idea: Vitamin D (sunshine!) and calcium (leafy greens!) are key, as are strength training and appropriate protein intake. I’m happy to put you in touch with my preferred registered dietician (Rachel Meltzer Warren: if you need some guidance, and I will be starting a postpartum strength training class in the next few months – so keep an eye out for that!

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