How to Strengthen Your Pelvic Floor for Pregnancy, Birth and Postpartum
Did you know that around 75% of women and about 15% of men will suffer from pelvic floor dysfunction (PFD) during their lifetime?
As we prepare for pregnancy and postpartum, chances are that we come across terms such as pelvic floor health and Kegel exercises. What is the pelvic floor? Why does it play an important role throughout pregnancy, the fourth trimester and beyond? And how can we strengthen the pelvic floor effectively?
In today’s blog article, I’m going to take a look at one of the most underestimated regions in our body: the pelvic floor.
Disclaimer: This article is intended for general guidance about pelvic floor health only. While postpartum doulas have basic knowledge about the pelvic floor, we are not certified to evaluate your pelvic floor health. To evaluate and optimize your personal pelvic floor health, please consult your local pelvic floor physiotherapist.
What is the pelvic floor?
The pelvic floor is a group of muscles located at the bottom of your pelvis region.
Pelvic floor muscles span across the bottom of the pelvis in a hammock shape. They support the pelvic organs, including the uterus and the vagina (for women), the prostate (for men), the bowel, the bladder and the rectum.
Pelvic Floor Muscle-Source-Atlas of Human Anatomy, Frank H. Netter, 2010 (Source)
Why is the pelvic floor important?
Good pelvic floor health is important for several reasons - not just in pregnancy or postpartum. In fact, the pelvic floor is multifunctional and does incredible work around the clock.
The pelvic floor supports and controls your bladder, colon, rectum and sexual organs. It helps your rectum and bladder contract to hold back and release to pass bowel movements or urine. The pelvic floor controls muscle contraction during sex and therefore contributes to sexual sensation and orgasms.
The Pelvic Floor. ASK Physiothérapie. (Source)
Along with the diaphragm, the pelvic floor muscles also interact with the deeper abdominal and back muscles to control the pressure inside the abdomen and support the spine area.
According to the Stanford Health Care Pelvic Health Center, pelvic floor dysfunction can occur when pelvic muscles are too tight or too loose:
Tight pelvic muscles can cause burning sensations during urination, weak urinary streams, painful bowel movements, constipation, painful intercourse or back/ hip pain.
Loose or weak pelvic muscles can lead to accidental bowel leakage, the inability to delay urination or even pelvic organ prolapse.
What affects pelvic floor health?
In fact, a variety of factors can impact pelvic floor health both for men and women, including:
Stress: The more stress we are subject to, the more our pelvic floor muscles will tighten and bear down on our pelvic floor.
Chronic constipation: People who suffer from constipation over extended periods of time can experience a change in their pelvic floor muscles, increased abdominal pressure as they pass a bowel movement and slow transit times.
Extreme physical effort: Physical activity including high-impact movements or heavy lifting can put pressure on the pelvic floor and lead to urinary incontinence.
Pregnancy and childbirth: The pelvic floor plays a major role in supporting the woman’s changing body as she grows and birthes her baby (see below).
Genetics: If family members have experienced pelvic floor issues, we are more likely to suffer from pelvic dysfunction ourselves.
The pelvic floor during pregnancy and childbirth
When we enter pregnancy, our bodies go through an incredible transformation. Our uterus expands to many times its original size, our body accommodates and nourishes our growing baby and our organs work together in beautiful harmony to support us.
As you can imagine, the pelvic floor needs to withstand quite a bit of extra pressure during pregnancy and childbirth. Regardless of whether we experience vaginal or caesarean birth, prolonged labor, delivery with instruments (such as special tools to assist the baby out of the birth canal) or episiotomies (surgical procedures to increase the vaginal opening) - our pelvic floor muscles work extra shifts.
It is very common for pregnant women and new mothers to experience frequent urinary leakage or incontinence, pelvic pain or even painful intercourse during pregnancy and in postpartum. Unfortunately, most women still suffer in silence – unaware there are many things that can be done to help.
How to strengthen your pelvic floor during pregnancy and postpartum
Speaking from personal experience, I would recommend two complimentary strategies to strengthen your pelvic floor during pregnancy and postpartum: gentle yoga and pelvic floor physiotherapy.
Prenatal/ postnatal yoga
As part of prenatal yoga, you will learn how to become aware of your pelvic floor region and associated muscles through gentle postures and breathing exercises. Even prior to giving birth, you can tune in to your body, learn about where your pelvic floor muscles are located and move them gentle with your breath.
Tip: Here’s one of my favourite breathing exercises for activating the pelvic floor:
Relaxing the pelvic floor: First, you breathe in and feel your lungs expand with the inhaled air. As you inhale, you will notice that your pelvic floor muscles lower and relax. Feel your pelvic floor descend and focus on the sensation of relaxation.
Contracting the pelvic floor: Second, you will breathe out and feel the air leaving your body. As you exhale, you will notice that your pelvic floor muscles rise automatically. Now, it’s time to contract your pelvic floor muscles and keep lifting them.
Repeat this exercise daily to increase your awareness and start working in tandem with your pelvic floor.
2. Pelvic floor physiotherapy
In pelvic floor physiotherapy, your pelvic floor health will be assessed by a qualified clinician.
Following your initial consultation (including a verbal evaluation and a physical exam), you will receive a personalized treatment plan to train your pelvic floor muscles and improve your overall pelvic floor health. This can include education and counseling, a customized exercise schedule, take-home aids and manual therapy.
“Treatment aims to restore the patient’s control of the pelvic floor muscles (contraction and relaxation) and to reintegrate them into the surrounding muscular, neural and connective tissue network in order to properly support the urinary, anorectal and sexual function.” (Source: ASK Physiothérapie)
Clinicians require post graduate training in order to practice. Fortunately in Canada, most insurance providers cover the expenses related to pelvic floor physiotherapy.
My personal pelvic floor health journey
I personally consulted a pelvic floor physiotherapist because I experienced frequent urination and painful intercourse several months after giving birth.
Thanks to my regular yoga practice during pregnancy and postpartum, I noticed rather quickly that my pelvic floor was no longer in optimal shape after giving birth. My long labour and slight vaginal tearing certainly contributed to that.
Of course, I had heard about the importance of doing my Kegel exercises regularly, ideally during each breastfeed according to my family doctor, but truth be told – I didn’t really get around to it.
In less than five sessions of working with a pelvic floor therapist, I was able to improve my pelvic floor health tremendously. During each session, we did different exercises to work on skills such as endurance, speed, accuracy and strength. I was given a set of exercises to do at home between the sessions, and I could really feel that my pelvic floor slowly regained strength.
Tip: Any Montreal mamas reading here? I highly recommend ASK Physiothérapie in Westmount. Amadea’s team has helped me tremendously to rebuild my pelvic floor after giving birth to my daughter.