Pelvic Floor Physical Therapy During Pregnancy: Prepare Your Body for Birth and Recovery
Pelvic Health During Pregnancy
Pregnancy is an incredible journey of change, but with a growing belly comes new pressures—literally! The nine months of carrying a baby, along with the process of childbirth, place significant demands on your pelvic floor, a sling of muscles that supports your organs, bladder, uterus, and rectum. Understanding and caring for your pelvic health is crucial for a comfortable pregnancy, smoother delivery, and quicker postpartum recovery. A pelvic floor physical therapist is the specialist who can guide you through this process.
Understanding the Pelvic Floor in Pregnancy
The pelvic floor muscles act like a hammock at the base of your pelvis. During pregnancy, these muscles face two major challenges:
Increased Weight and Pressure: The expanding uterus and growing baby put constant downward pressure on the pelvic floor. This can lead to common issues like urinary leakage (incontinence), discoordination, and weakness. It can also exacerbate conditions like Diastasis Recti (abdominal separation) and Pelvic Girdle Pain (PGP), sometimes called Symphysis Pubis Dysfunction (SPD).
Hormonal Changes: Hormones like relaxin increase joint laxity and soften ligaments throughout your body, preparing the pelvis for childbirth. While helpful for delivery, this hormonal shift can temporarily reduce the structural support of the pelvis, making the muscles work harder and increasing your risk of injury.
Ignoring these muscles can lead to common (but treatable) issues like incontinence, pelvic pain, and, in severe cases, pelvic organ prolapse.
How Can You Prepare Your Body for These Changes?
Caring for your pelvic floor isn't just about kegel exercises; it's about movement awareness and body mechanics throughout your day. Seeing a Pelvic Floor PT is the best way to ensure you're doing safe pregnancy exercises that support your body.
Posture and Body Mechanics
As your center of gravity shifts, poor posture increases strain.
Avoid Arching: Be mindful of excessive lower back arching (swayback) when standing. Try to tuck your tailbone slightly under to keep a neutral spine.
Log Rolling: To get out of bed, avoid sitting straight up, which puts massive strain on your core and pelvic floor. Instead, "log roll", so roll onto your side first, then use your arms to push yourself up while keeping your body in one line.
Bowel and Bladder Health
The increased pressure on your bladder and rectum can be managed with proper habits:
Avoid Straining: Chronic straining during bowel movements (due to constipation) severely weakens the pelvic floor. Stay hydrated and eat plenty of fiber. Use a footstool (like a Squatty Potty) to put your knees above your hips, which straightens the rectum for easier passage. It is also important to avoid “power peeing” or pushing your pee out. This can also lead to pelvic floor dysfunction.
Don't "Hover": When urinating, sit fully on the toilet. Hovering prevents the pelvic floor from fully relaxing, making it harder to empty your bladder completely.
Preparation for Birth and Postpartum
As you near your due date, focus shifts to preparing the pelvic floor for labor and delivery.
Perineal Massage (Late Pregnancy): Beginning around 34–36 weeks, perineal massage can help increase the elasticity of the tissues around the vaginal opening, potentially reducing the risk of tearing. Discuss this technique with your pelvic floor specialist. One of our favorite tools is a pelvic wand from Intimate Rose. If you have questions on how to use one, reach out to Dr. Amy here at Pursuit Physical Therapy.
Stretching/Positioning: Understanding how your body is changing and shifting in preparation for delivery is important so that you can prepare. Learning labor positions that optimize pelvic opening can be highly beneficial.
See a Pelvic Floor PT: We recommend seeing a pelvic floor physical therapist at weeks 28, 36, and then at 6 weeks postpartum. Your PT will help guide you to adequately prepare your body for labor, teach you how to push effectively, and set you on the right path for optimal healing, managing issues like Diastasis Recti and postpartum pain.
Caring for your pelvic health is a gift to your body, setting you up for a healthier pregnancy and a smoother transition into motherhood. Understanding what is happening to your body is so important in learning how to prepare.
We are here to help you optimize your pregnancy and recovery! At Pursuit Physical Therapy, we’ve put together our pregnancy package to help you do all of the above. Reach out and schedule a Discovery Call to see if we’re a fit to help you with your pregnancy and postpartum needs.
References:
Pelvic Floor Disorders During Pregnancy
Pelvic Floor Dysfunction in Pregnancy
Pelvic Floor Muscle Training in Pregnant and Postpartum Women
