Preparing Your Pelvic Floor For Birth: What you Need to Know
Pregnancy is an amazing journey, but it can also bring about challenges, especially when it comes to the health and well-being of your pelvic floor. The pelvic floor plays a crucial role in supporting your baby during pregnancy and delivering your baby during birth. The pelvic floor is also vital in allowing you to do day-day activities with ease, without leaking of your bladder or bowels, or heaviness associated with pelvic organ prolapse. Walking, running, jumping, pilates, sport, going to the gym, coughing, sneezing, and even lifting your new baby all require pelvic floor strength and coordination.
If you want to be able to keep doing these things after pregnancy and birth with ease, preparing your pelvic floor for labor & birth is essential to minimise the risk of injury and symptoms. Every day in the clinic I see women after birth who say ‘I just wish I knew… before birth’’ in relation to their pelvic floor.
This blog post can be your first step towards better pelvic floor health, as we explore the importance of pelvic floor preparation and share evidence-based tips on how to safeguard this vital area.
Understanding the Pelvic Floor
The pelvic floor is a group of muscles, ligaments, and tissues that form a hammock-like structure at the base of your pelvis. It provides support to your pelvic organs - the uterus, bladder, and rectum and is essential for controlling bladder and bowel movements. During pregnancy and childbirth, the pelvic floor undergoes significant changes, making it essential to maintain its strength and flexibility. The perineum is the term used to describe the space between your vagina and anus, including the skin, pelvic floor muscles, anal sphincter muscles and nerves. During labor & birth, it needs to stretch and move to let your baby pass through the birth canal and into your arms, and can be injured during this process.
Preventing Injury and Trauma
Birth should not be filled with unknowns, and you’ve likely heard about pelvic floor injuries and issues after birth from family and friends, so you may be worried or fearful this will happen to you, and not understand what you can do to help.
Pelvic floor injuries during childbirth are relatively common with 2/3rds of women describing distressing pelvic floor symptoms right after birth, but they are not inevitable, and can often resolve quickly with the right management. Teaching women how to reduce the risk of pelvic floor issues after birth is our passion at The Lady Physio. Preparing your pelvic floor can significantly reduce the risk of injury and trauma.
Here's how to get started:
Pelvic Floor Exercises: Pelvic floor muscle training, sometimes called Kegel’s, has been shown to be effective in strengthening pelvic floor muscles and should be included in every pregnancy. Did you know one study showed only 11% of pregnant women were regularly completing pelvic floor exercises, despite their amazing benefits! A study published in 2014 found that regular Kegel exercises can improve muscle tone and reduce the risk of urinary incontinence during pregnancy and postpartum. A review of all studies from 2020 found that they also shorten labor, reduce pain and enhance healing after birth. Even starting from 36 weeks has been shown to be beneficial, so it’s never too late to start. However the earlier you start the better, as this will form a lifelong habit for after birth and make recovery easier. Look for the button below, to download my free guide to Pelvic Floor Exercises During Pregnancy for more info.
Get Active: Regular, moderate exercise during pregnancy is essential for maintaining the strength and flexibility of your pelvic floor, and can reduce the length of your labor. Despite this, only ~15% of women are meeting the activity guidelines. A study in 2017 found that prenatal exercise programs can positively impact pelvic floor muscle function. Prenatal Yoga and Pilates is also beneficial, with a systematic review of studies in 2020 suggesting that prenatal yoga and Pilates can improve pelvic floor muscle strength and flexibility.
Perineal Massage: Perineal massage can be an amazing way to learn how to relax your pelvic floor, and allow it to stretch out of the way during birth. It has been shown to reduce the risk of severe perineal injuries, episiotomy and perineal pain after birth in a large review of studies. It can be tricky to master, but with the right advice from The Lady Physio, you will be able to do perineal massage with confidence.
Birthing Positions: Birthing positions can influence the risk of pelvic floor trauma. Studies show that upright or lateral positions during labor were associated with a lower incidence of severe perineal tears, with squatting and birth stools increasing the risk. The impact of positions in birth has been well studied, but we think trusting your body and getting into the position that is best for you is important. We cover this in much more detail in our course.
Pelvic Floor Physiotherapy: A study in 2016 showed that pelvic floor physiotherapy can improve pelvic floor muscle function and help women prepare for childbirth. However, we know that not all women have access to pelvic floor physiotherapy prior to birth, and this is why at The Lady Physio we created Pelvic Floor Prep for Birth - to teach you these all important techniques prior to birth so you know exactly what to do during pregnancy to prepare.
Education: A study in 2022 showed that childbirth education focused on creating a birth plan makes women feel more supported and in control in labor, and reduces psychological symptoms of depression and post traumatic stress disorder after birth. Consider taking education courses, practicing relaxation techniques, and discussing your birthing preferences with your healthcare provider. We create a birth map template and learn how to discuss with your team in our course!
Remember
Preparing your pelvic floor for birth is a proactive step toward preventing injury and trauma, backed by scientific research. With the right exercises, techniques, and guidance, you can increase the resilience of your pelvic floor and enhance your overall birthing experience.
Remember that every pregnancy is unique, so consult with your healthcare provider and seek personalised advice for your specific situation. Physiotherapy advice is also included in our group support or 1:1 Birth Preparation appointments that you can include in my online course Pelvic Floor Prep for Birth. See the Courses tab for more info.
Your pelvic floor is your biggest asset!
learn how to protect it today.
References:
Aasheim, V., Nilsen, A. B. V., Reinar, L. M., & Lukasse, M. (2017). Perineal techniques during the second stage of labour for reducing perineal trauma. The Cochrane database of systematic reviews, 6(6), CD006672. https://doi.org/10.1002/14651858.CD006672.pub3
Ahmadpour P. Moosavi S. Mohammad-Alizadeh-Charandabi S. Jahanfar S. & Mirghafourvand M. (2022). Effect of implementing a birth plan on maternal and neonatal outcomes: a randomized controlled trial. Bmc Pregnancy and Childbirth. https://doi.org/10.1186/s12884-022-05199-5
Bernard, S., Boucher, K., & Therrien, R. (2016). The effect of pelvic floor rehabilitation on pelvic floor muscle function during pregnancy. Canadian Journal of Human Sexuality, 25(2), 142-151.
de Azevedo, G. D., & Martins, G. B. (2015). Maternal position during the first stage of labor: A randomized controlled trial. American Journal of Obstetrics & Gynecology, 212(6), 1-7.
Gjestland, K., Bø, K., Owe, K. M., & Eberhard-Gran, M. (2017). Do pregnant women follow exercise guidelines? Prevalence data among 3482 women, and prediction of low-back pain, pelvic girdle pain and depression. Journal of Pregnancy, 2017, 8248-963.
Parker, L. M., & Wang-Price, S. (2020). The effects of prenatal yoga and Pilates on postpartum pelvic floor muscle strength: A systematic review. Journal of Yoga & Physical Therapy, 10(1), 1-6.
Smith, J. A., & Wood, A. M. (2014). Effect of pelvic floor muscle training on lower urinary tract function during pregnancy and postpartum: A randomized controlled trial. International Urogynecology Journal, 25(10), 1367-1375.
Sobhgol, S. S., Smith, C. A., & Dahlen, H. G. (2020). The effect of antenatal pelvic floor muscle exercises on labour and birth outcomes: a systematic review and meta-analysis. International urogynecology journal, 31(11), 2189–2203. https://doi.org/10.1007/s00192-020-04298-1
