The pelvic floor needs to be strong in order to support the added weight of the uterus during pregnancy, but it also needs to be able to relax and yield to let baby through during labor and delivery.
The pelvic floor muscles have an essential role in continence and provide support to the pelvic organs. They also have an impact on labour. The pelvic floor muscles should distend to allow the passage of the foetus during labour. The rotation and flexion of the foetal head is due to the pelvic floor resistance.
Marian says, “A weak or damaged pelvic floor can lead to urinary and faecal incontinence, urgency and frequency, as well as pelvic organ prolapse (which happens when the pelvic organs bulge into the walls of the vagina). A weak pelvic floor can also contribute to pelvic girdle pain and lower back pain.”
There are many factors that contribute to your pelvic floor health, including your age, genetics and some surgeries. And yes, pregnancy and childbirth can absolutely put pressure on your pelvic floor and lead to dysfunction.
This prospective study showed that there is a negative association between the pelvic floor muscle strength and preterm labour. This is the first clinical study indicating that weak pelvic floor muscles may cause a preterm labour.
Pelvic floor dysfunction is the inability to correctly relax and coordinate your pelvic floor muscles to have a bowel movement. Symptoms include constipation, straining to defecate, having urine or stool leakage, and experiencing a frequent need to pee.
After 4 to 6 weeks, most people notice some improvement. It may take as long as 3 months to see a major change. After a couple of weeks, you can also try doing a single pelvic floor contraction at times when you are likely to leak (for example, while getting out of a chair).
To strengthen your pelvic floor muscles, sit comfortably and squeeze the muscles 10 to 15 times. Do not hold your breath or tighten your stomach, bottom or thigh muscles at the same time. When you get used to doing pelvic floor exercises, you can try holding each squeeze for a few seconds.
Regular gentle exercise, such as walking can also help to strengthen your pelvic floor muscles.
Deep squats help relax and lengthen the pelvic floor muscles and stretch the perineum. Stand with your legs wider than hip width. Slowly squat down as far as you can go with your hands pressed together in front of you. Your physical therapist can talk with you about how often and how many deep squats you should do.
During pregnancy and childbirth, the muscles of your pelvic floor come under a lot of strain. With weak pelvic floor muscles, there is a chance of pelvic organ prolapse − where organs in the pelvis bulge into the vagina, causing discomfort and pain.
We can do this by focusing on self-directed pushing with open glottis breathing, avoiding pushing directly on the back for prolonged periods, and laboring down instead of pushing once we are 10cm! Learn more about pushing and pelvic organ prolapse in our childbirth education courses and webinars.
Placing a warm cloth on the perineum during the second stage of labor might help. Perineal massage. During the second stage of labor, your health care provider might place two fingers of a lubricated gloved hand just inside your vagina and move them from side to side, exerting mild, downward pressure.
Contract your pelvic floor muscle by imagining that you are stopping the flow of urine. You should be able to feel a squeezing and lifting sensation around your finger. If, after performing these self-exams, you were able to see and feel your muscles contracting, congratulations!
Pelvic Floor Therapy in Pregnancy
Preparing your body for the birthing process should include a visit with a Pelvic Floor Physical Therapist (PFPT). At around 36 weeks of pregnancy a visit to Method Physical Therapy includes treatment and education to decrease the chances of perineal tears and the length of labor.
Did you know that as little as five minutes of pelvic floor exercises a day can significantly reduce incontinence – or even make it go away? Once you get the hang of it, you can do them anywhere, at any time and it's never too late to get started.
Neither! When you're squeezing to hold back the flow of urine, you're actually flexing your pelvic-floor muscles. But while you might be giving those a good workout, don't get into the habit of walking around with a full tank.
Lie down and insert a finger into your vagina. Try to squeeze around your finger with your vaginal muscles. You should be able to feel the sensation in your vagina, and you may also be able to feel the pressure on your finger. If you can feel this, you are using the right muscles.
1) How common are pelvic floor disorders? One in three women will experience a pelvic floor disorder (PFD) in her lifetime. PFDs occur when women have weakened pelvic muscles or tears in the connective tissue, which may cause pelvic organ prolapse, bladder control problems, or bowel control problems.
Sometimes the organs move back into the correct position on their own, or at least don't drop down further. Many women find that doing pelvic floor exercises and/or using a vaginal pessary is enough to improve the symptoms. But there's no guarantee that these treatments will make the symptoms go away.
Signs of a tight pelvic floor:
Difficulty with starting your stream with urination. Spraying urine while peeing or having a wildly unpredictable stream. Dribbling after you pee or feeling like you have to pee again right after you go. Constipation and/or very skinny poops.
Purple pushing, coached pushing, holding your breath, all mean basically the same thing. Mothers being instructed on pushing causes them to hold their breath and push down into their bottom. Another more normal and less exhausting option would be “breathing or bearing down” working with the contractions.
Birthing in the side-lying position has been shown to reduce perineal tearing by allowing the presenting part to descend more slowly (Shorten, Donsante, & Shorten, 2002).