Midwifery Care for Pregnant Women in the Third Trimester with the Obstetric Complaint of Low Back Pain
DOI:
https://doi.org/10.53713/htechj.v3i3.365Keywords:
low back pain, third trimester, physical activity, pregnancy gymnasticsAbstract
Low back pain is a common musculoskeletal disorder experienced during pregnancy, with a prevalence ranging from 30% to 78% in regions such as the United States, Europe, and Africa. Approximately one-third of affected individuals experience low back pain that leads to decreased productivity and reduced quality of life. An increased body weight of 11–12 kg, along with hormonal and biomechanical changes during pregnancy, contributes to a higher risk of pain in the back, pelvis, and other musculoskeletal areas. Given the potential impact of such complications during pregnancy, health policymakers should place greater emphasis on addressing this issue. In addition, public education on the importance of maternal health, coupled with timely diagnosis and intervention efforts, plays a crucial role in reducing pregnancy complications. This study aims to provide midwifery care to a third-trimester pregnant woman with complaints of low back pain through a case study of Mrs. N.A. (G3P2002, 28 weeks gestation). Data were collected through interviews, observation, physical examination, and documentation review. Diagnoses were made based on subjective and objective findings, and interventions were implemented through health education and pregnancy gymnastics as a promotive and preventive approach to improving maternal well-being. The evaluation results showed a significant improvement in the client's lower back pain after the intervention. The client reported decreased pain intensity to the point where it no longer interfered with daily activities, indicating that the intervention was effective and aligned with the previously planned objectives and success indicators. It is essential to provide follow-up education and regular evaluations in midwifery practice to ensure that similar complaints do not recur or develop into more serious issues.
References
Alestari, R., Devitasari, I., Evy Kasanova, & Lidia Widia. (2025). Comprehensive Care for Patients with Low Back Pain in The Third Trimester of Pregnancy. Health and Technology Journal (HTechJ), 3(2), 170–179. https://doi.org/10.53713/htechj.v3i2.337
Babiloni-Lopez, C., Fritz, N., Ramirez-Campillo, R., & Colado, J. C. (2024). Water-Based Exercise in Patients With Nonspecific Chronic Low-Back Pain: A Systematic Review With Meta-Analysis. Journal of strength and conditioning research, 38(1), 206–219. https://doi.org/10.1519/JSC.0000000000004635
Bernard-Giglio, M., French, S. D., Myburgh, C., & de Luca, K. (2023). Drivers, barriers, and response to care of Australian pregnant women seeking chiropractic care for low back and pelvic girdle pain: a qualitative case study. Chiropractic & manual therapies, 31(1), 43. https://doi.org/10.1186/s12998-023-00516-x
Blomgren, J. (2025). Midwize: a midwife-led intervention to improve the quality of care during labour and childbirth in Uganda (Doctoral dissertation, Karolinska Institutet). https://doi.org/10.69622/28193309.v1
Buin, L., Vitale Torkomian Joaquim, R. H., Strong, J., & Robinson, K. (2024). The Experience of Pregnancy-Related Lumbopelvic Pain: A Qualitative Evidence Synthesis. Canadian Journal of Occupational Therapy. https://doi.org/10.1177/00084174231172037
Chen, D., Zhou, J., Lin, C., Li, J., Zhu, Z., Rao, X., Wang, J., Li, J., Chen, H., Wang, F., Li, X., Gao, M., Zhou, Z., Xi, Y., & Li, S. (2024). A causal examination of the correlation between hormonal and reproductive factors and low back pain. Frontiers in Endocrinology, 15, 1326761. https://doi.org/10.3389/fendo.2024.1326761
Daneau, C., Abboud, J., Marchand, A. A., Houle, M., Pasquier, M., Ruchat, S. M., & Descarreaux, M. (2021). Mechanisms underlying lumbopelvic pain during pregnancy: a proposed model. Frontiers in Pain Research, 2, 773988. https://doi.org/10.3389/fpain.2021.773988
Daneau, C., Nougarou, F., Abboud, J., Ruchat, M., & Descarreaux, M. (2025). Changes in pregnancy-related hormones, neuromechanical adaptations and clinical pain status throughout pregnancy: A prospective cohort study. PLOS ONE, 20(2), e0314158. https://doi.org/10.1371/journal.pone.0314158
Ferdinandov, D., Yankov, D., & Trandzhiev, M. (2024). Common differential diagnosis of low back pain in contemporary medical practice: A narrative review. Frontiers in Medicine, 11, 1366514. https://doi.org/10.3389/fmed.2024.1366514
Gebhardt, A., Langius-Eklöf, A., Andermo, S., & Arman, M. (2021). Health and suffering are associated with social support: a cross-sectional study of women and mothers with exhaustion and pain. BMC Women's Health, 21(1), 259. https://doi.org/10.1186/s12905-021-01398-y
Kurniyawan, E. H., Balqis, M., Irfan Aditya Pratama, M., Putri Permata Hati, H., Ega Isfadillah, O., Tri Afandi, A., & Rosyidi Muhammad Nur, K. (2023). Farm Family Support in Increasing Health Awareness. Health and Technology Journal (HTechJ), 1(6), 616–627. https://doi.org/10.53713/htechj.v1i6.122
Lin, C., Lin, C., Chen, L., Wei, S., Sung, W., Lu, L., Chang, S., Lin, Y., Lee, C., & Chiang, S. (2022). Chronic low back pain is associated with impaired bed turning ability: Evaluation by a mobility detection system. Clinical Biomechanics, 92, 105572. https://doi.org/10.1016/j.clinbiomech.2022.105572
Mamipour, H., Farazmehr, S., Negahban, H., Nazary-Moghadam, S., Dehghan-Manshadi, F., Navi Nezhad, M., Jafari, S., & Sharifzadeh, M. (2022). Effect of Core Stabilization Exercises on Pain, Functional Disability, and Quality of Life in Pregnant Women With Lumbar and Pelvic Girdle Pain: A Randomized Controlled Trial. Journal of Manipulative and Physiological Therapeutics, 46(1), 27-36. https://doi.org/10.1016/j.jmpt.2023.05.005
Molin, B., Zwedberg, S., Berger, A., Sand, A., & Georgsson, S. (2024). “The ignored pain” - experiences of encounters with healthcare from the perspective of women with pain persisting after childbirth - a qualitative study. Sexual & Reproductive Healthcare, 39, 100929. https://doi.org/10.1016/j.srhc.2023.100929
Muthike, M. (2021). Development of a Patient Education Program: Non-Pharmacological Interventions for Management of Chronic Low Back Pain. https://doi.org/10.5281/zenodo.4891954
Novelia, Shinta, Rukmaini, and Siti Anisah. (2021). The Effect of Warm Compress on Low Back Pain During Pregnancy. Nursing and Health Sciences Journal (NHSJ) 1 (3):254-57. https://doi.org/10.53713/nhs.v1i3.55.
Ozdilek, R., Yıldırım, M., Aksoy, S. D., & Gul, D. K. (2025). The Frequency of Back Pain, Lumbar Pain, And Pelvic Girdle Pain During Pregnancy. Pain Management Nursing. https://doi.org/10.1016/j.pmn.2025.01.005
Pang, H., Chen, S., Klyne, D. M., Harrich, D., Ding, W., Yang, S., & Han, F. Y. (2023). Low back pain and osteoarthritis pain: A perspective of estrogen. Bone Research, 11(1), 1-14. https://doi.org/10.1038/s41413-023-00280-x
Pereira, C. L., Grad, S., & Gonçalves, R. M. (2023). Biomarkers for intervertebral disc and associated back pain: From diagnosis to disease prognosis and personalized treatment. JOR Spine, 6(4), e1280. https://doi.org/10.1002/jsp2.1280
Shi, Y., & Wu, W. (2023). Multimodal non-invasive non-pharmacological therapies for chronic pain: mechanisms and progress. BMC medicine, 21(1), 372. https://doi.org/10.1186/s12916-023-03076-2
Sima, S., & Diwan, A. (2025). Contemporary clinical perspectives on chronic low back pain: The biology, mechanics, etc. underpinning clinical and radiological evaluation. JOR spine, 8(1), e70021. https://doi.org/10.1002/jsp2.70021
Szumilewicz, A., & Santos-Rocha, R. (2022). Exercise selection and adaptations during pregnancy. In Exercise and Physical Activity During Pregnancy and Postpartum: Evidence-Based Guidelines (pp. 275-361). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-031-06137-0_9
Tesio, L. (2023). Low back pain: a new comprehensive pathogenetic model supporting methods of medical rehabilitation. Bulletin of Rehabilitation Medicine, 22(5), 83-92. https://doi.org/10.38025/2078-1962-2023-22-5-83-92
Üzelpasaci, E., Özçakar, L., Özgül, S., Gürşen, C., & Akbayrak, T. (2024). Low back pain, ultrasonographic muscle thickness measurements and biopsychosocial factors at different trimesters of pregnancy. Journal of Orthopaedic Science, 29(4), 958-963. https://doi.org/10.1016/j.jos.2023.07.006
Vesting, S., Gutke, A., & de Baets, L. (2025). Educating women to prevent and treat low back and pelvic girdle pain during and after pregnancy: a systematized narrative review. Annals of Medicine, 57(1). https://doi.org/10.1080/07853890.2025.2476046
Wong, J. J., Tricco, A. C., Cote, P., Liang, C. Y., Lewis, J. A., Bouck, Z., & Rosella, L. C. (2022). Association between depressive symptoms or depression and health outcomes for low back pain: a systematic review and meta-analysis. Journal of general internal medicine, 37(5), 1233-1246. https://doi.org/10.1007/s11606-021-07079-8
