The impact of pregnancy on your Pelvic Floor is not always obvious compared to other changes in your physical appearance.
When discussing pregnancy and childbirth, some providers will say “your body is made for this, don’t worry.” This is only partly true. While your body adapts to pregnancy and is capable of childbirth in many ways, this narrative can minimize real difficulties during this time.
What is the impact of pregnancy on the pelvic floor?
During pregnancy, women gain weight in a very short period of time. They gain the weight of the baby, the placenta, an enlarged uterus, increased blood volume, and very often from increased fluid retention and fat. This extra weight especially strains the pelvic floor, which is part of your body’s core and plays a vital role in your body.
At the same time, the placenta secretes “relaxin,” a hormone that loosens the ligaments, muscles, and joints in the pelvis. This is important to allow the body to prepare for birth, but the increased flexibility it enables can cause instability. When we lack stability in areas like the SI and the pelvic girdle, we’re more likely to experience pain and muscular strains.
A key reason to see a pelvic floor physical therapist during pregnancy is to optimize your body mechanics with daily activities and guide your movement (for exercises and normal activities) to ensure you are supporting your pelvic floor and not further straining it. In the clinic we work on bending and lifting mechanics, transitions (getting out of bed or getting on and off the ground), and proper sitting and standing postures. Overall, the goal is to help you learn to move more mindfully so that you can continue doing the activities you love throughout pregnancy.
How does pelvic floor physical therapy help prepare me for childbirth?
During a pelvic floor physical therapy exam, we assess your pelvic floor and help support your tissues to maintain healthy tension, tone, and coordination. We work on specific stretching and breathing exercises that coordinate the diaphragm and pelvic floor muscles during pregnancy and delivery. We work on perineal massage and pushing practice in various positions. We also help support your body so you’re feeling strong and stable throughout your pregnancy.
How does childbirth affect my pelvic floor?
During vaginal delivery, the pelvic floor undergoes tremendous stress, especially during active pushing. Depending on how pushing is progressing, some women may need an episiotomy (a cut or incision), assistance from a vacuum or forceps, or manual assistance (leading to hands inside your body) which can cause more trauma to the pelvic floor. It’s also very common that women undergo some level of tearing to their perineum or labia. All of these things can lead to pelvic floor dysfunction
Statistically, the more vaginal deliveries a woman has, the more likely she is to experience pelvic floor dysfunction.
There are numerous ways your body can suffer trauma from childbirth, such as If you deliver a baby over 8.8 lbs, it’s your first baby, forceps are used, or have a prolonged (or even very fast) second stage of labor. These are all major risks for trauma to your pelvic floor and can lead to long lasting issues if not correctly addressed by a qualified specialist.
After vaginal delivery, it’s very common that women experience increased bladder mobility, pelvic organ prolapse, urinary or anal incontinence. With planned c-section deliveries, it’s less common to experience these symptoms; however, women likely experience almost 60% loss of abdominal strength afterward, which can cause more strain to the pelvic floor. Further, active labor before a c-section (aka an unplanned c-section) increases risk for pelvic floor disorders.
I’m pregnant. When should I start Pelvic Floor Physical Therapy?
We typically see women 6 weeks postpartum when they are cleared for internal exams. Even before this, many pregnant women suffer from back, hip, tailbone, neck, or shoulder pain both before and after birth as their bodies are recovering while adjusting to the new responsibilities of childcare and breastfeeding. You do not have to live in pain and discomfort— seeking out care from a pelvic floor pt can make this time much more enjoyable and manageable.
At Anewu Physical Therapy, we offer the “Birth Package,” which includes a visit during pregnancy and two visits postpartum. This is what we consider the minimum amount of monitoring and care for pregnancy and childbirth and during this time we can identify and treat any issues we see arise, or recommend further care from our team or one of our many connections in other practice areas.
I already had my baby. Should I still see a pelvic floor physical therapist?
Following up with a Pelvic Floor Physical Therapist 6 weeks postpartum is vital to ensure that your tissues are healing appropriately, your body is able to repair and maintain the connection between breathing and your pelvic floor, you’re able to contract your abdominals correctly to help heal abdominal separation, and safely return to activities, including sex.
So many women hurry back to running, hiking, weight-lifting, and other strenuous exercise after birth without guidance, ultimately causing Pelvic Floor Dysfunction. Even basic activities like lifting and holding your baby can contribute to Pelvic Floor Dysfunction when performed incorrectly.
Research has shown that correct training in pelvic floor coordination is essential— many women completing pelvic floor exercises under group direction are not doing their pelvic floor exercises correctly. Rather than create fear of activities and limit movement, come work with a pelvic floor pt so you feel confident that you are supporting your body appropriately during pregnancy and after delivery!
To learn more about how Anewu Physical Therapy can help you through your pregnancy and postpartum recovery, schedule an evaluation or discovery call. We would love to help!
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