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How pregnancy changes your pelvic floor

Pelvic floor physio

Pregnancy is an exciting time of your life, where you’ll be undergoing many changes to your body, hormones and life.

For many women, this may include changes to your pelvic floor. And while this group of muscles may not be something you think about often, they are important for leading a healthy, active and happy lifestyle during and after pregnancy. So, this pregnancy month, learn more about your pelvic floor and how to keep it strong and healthy.


What are pelvic floor muscles?


Pelvic floor muscles are the muscles that allow you to control the release of urine, faeces and gas. A strong pelvic floor can delay going to the bathroom until you wish to.

When you contract your pelvic floor muscles, the openings of the vagina, anus and urethra tighten. When you relax them, the openings loosen, allowing you to go to the bathroom. They’re also important for sexual function and, in women, to provide support for a baby during pregnancy.

These muscles are part of the core cylinder, along with the respiratory diaphragm, transverse abdominus muscles (your abs) and the multifidus muscles (deep back muscles). This group of muscles are extremely important for your overall physical health, strength and wellbeing, so looking after them is vital.


What happens to core muscles during pregnancy?


During pregnancy, factors such as hormonal changes and the physical changes that come with growing a baby inside your uterus can affect the integrity of your core muscles, including your pelvic floor. Pregnancy can weaken the abdominal muscles, affect how deeply you’re able to breathe and place increased pressure and strain on your spine.

In one study, following pregnancy and childbirth, all women participating showed both superficial and deep changes in the pelvis, including muscle thickness and the size, shape and distance between various muscles and parts of the vagina (Céline et al., 2017).


Signs of a weak pelvic floor


How do you know if your pelvic floor has been weakened? Some signs and symptoms may include:

  • Stress incontinence. This is leakage of urine when you do things that impact your core muscles, for instance, when you cough, sneeze, laugh or exercise.

  • Urge or urinary incontinence. This is when you have urine leakage when you feel the need to go to the toilet.

  • Perineal heaviness. Usually experienced in the later part of the day, this is a feeling of heaviness, pressure, or discomfort in your perineum (the skin between vagina and anus).


Although they’re common to experience, these symptoms can all cause stress, anxiety and embarrassment. The good news is, you don’t have to just live with it – you can take action to mitigate the effects of a weakened pelvic floor.


How to strengthen your pelvic floor during pregnancy


Pelvic floor exercises, which involve learning to isolate pelvic floor muscles and train them, are recommended during pregnancy. Studies suggest that women who performed pelvic floor muscle training during pregnancy likely have less leakage in late pregnancy and up to six months after birth (Woodley et al., 2020).

Not sure where to start? A woman’s health physiotherapist can not only guide you through learning pelvic floor exercises, they can also assess your muscle function and help you put together a plan on how to optimise your lifestyle for better pelvic floor stability. This plan might include strategies to avoid constipation, which can put stress on pelvic floor muscles, and exercises to perform throughout your pregnancy. It’s a good idea to see a physiotherapist early in your pregnancy journey, because knowing your baseline function prior to delivery and learning how to strengthen these deep muscles is recommended to reduce symptoms.


Other treatment options to consider


There are other ways your women’s health physiotherapist can help keep you fit and healthy during pregnancy and right through to childbirth and postpartum.

For example, they can assess your personal pelvic and hip biomechanics and help guide you through birthing positions to help you have the best experience. They can also teach perineal massage as part of your birth preparations, which is an important step in adapting the vaginal tissues for childbirth.

Studies show that most recovery of pelvic floor muscles comes in the first 6 months post-pregnancy (Stær-Jensen et al., 2015). So, whether you’re currently pregnant or planning to start a family soon, there’s no better time than now to start working with a women’s health physiotherapist to help ensure the best pregnancy and birthing experience possible. Click here to find out more or to book an appointment with our women’s health physiotherapist, Eleanor Lee-Bognar.

 

Sources:

  • Stær-Jensen J, Siafarikas F, Hilde G, Benth JŠ, Bø K, Engh ME, Postpartum recovery of levator hiatus and bladder neck mobility in relation to pregnancy, Obstet Gynecol, 2015

  • Céline D. Alt MD, Franziska Hampel, Jan Philipp Radtke MD, Peter Hallscheidt MD, Bettina Schlehe MD, Christof Sohn MD, Kerstin A. Brocker MD, MSc, Early postpartum pelvic floor changes in primiparous women after vaginal delivery using 3T MRI, Neurourology and Urodynamics November, 2017

  • Woodley SJ, Lawrenson P, Boyle R, Cody JD, Mørkved S, Kernohan A, Hay-Smith EJC, Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women, Cochrane Database of Systematic Reviews, 2020

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