There are several things that commonly happen to women during pregnancy, particularly if they’re newbies to the entire childbirth process.
First moms-to-be will research everything they're going through. Immense time is spent “on the Google”, at the library, or on Amazon curating a top notch reading list to help them learn everything they need to know about their changing pregnant body, and the growing babe who’s “Harvest” will be compared to everything from a peach to a watermelon over the next three seasons.
On top of this research comes a new appreciation for the body, along with careful measures surrounding what food is consumed, extra sleep, and appropriate levels of exercise throughout various stages of gestation.
Many pregnant women treat themselves with kid-gloves, eating more healthily, and taking better care of themselves than ever before, as they aren’t just taking care of themselves, they’re also trying to ensure a safe arrival for little bean!
Pregnancy makes women more aware of their body in unimaginable way. As internal organs shift to make room for the growing baby bump, we are suddenly acutely aware of them. I never even knew what a sciatic nerve was until my daughter lay across it for what felt like the final trimester of my pregnancy.
Most women haven’t given much thought to their pelvic floors, but here’s a little secret, it’s pretty important during pregnancy, really important for childbirth, and beyond. Here are 15 things moms should know about their pelvic floors and how to treat them right!
15 What Is A Pelvic Floor?
For those who don’t know, the pelvic floor is a series of muscles and other tissues that are located between the legs. These tissues and muscles run from the pubic bone at the front to the base of the spine or tailbone at the back. Their shape is similar to a sling capable of holding things, which makes sense as they are responsible for holding pelvic organs.
For women this muscle group holds the bowel, bladder, uterus and vagina in place and for men they support the bladder and bowel. Some people like to describe the pelvic floor as being like a trampoline since it stretches in response to weight, and bounces.
The urine tube and the back all pass through a person’s pelvic floor muscles. In addition to helping a person to control their bladder functions, the pelvic floor also helps with their intimate functions. For women these muscles are critical for their bowel functioning as well as their intimate functioning.
14 Why The Pelvic Floor Is So Important?
In addition to providing support to the bladder, bowel, uterus (and womb in the case of pregnant women) the pelvic floor gives a person control over when they empty their bladder or bowel. People with weak pelvic floors will find it harder to squeeze the muscles and sphincters at the bottom of the bladder allowing for urine to escape, whether you want it to or not!
People with weak pelvic floors might often accidentally pee a little bit unintentionally when they cough, sneeze, or even exercise. Urination during exercise is called stress incontinence. A weak pelvic floor may also cause a person to feel a heavy, dragged down sensation since their bladder, bowel and uterus aren’t being properly supported, or running to the washroom to make it on time.
A weak floor will impact vaginal muscles and can make sexual relations less satisfying, with less sensitivity in the vagina. Hormonal changes post menopause can sometimes increase the likelihood of pelvic floor issues.
13 What Is A Pelvic Floor Disorder?
It’s not something we talk about much, but it turns out the pelvic floor dysfunction affects millions of North American women, so maybe we should talk about it more often so people don’t feel so alone. Symptoms can be embarrassing so women may wait longer than they should to talk about it with their healthcare practitioner.
Unfortunately a lot of women are socialized to avoid having difficult conversations, and this can negatively impact our health. Many don’t even know what it is, and don’t find out what to do until symptoms get unbearable. Pelvic floor dysfunction relates to disorders within the pelvic floor including: bladder and bowel dysfunction, sexual dysfunction, pelvic pain, organ prolapse, and more.
People suffering from one form of dysfunction, unfortunately, are more likely to develop other forms of pelvic floor dysfunction. This is why it is paramount to identify issues and address symptoms early, and take action to prevent future complications.
12 How To Find The Pelvic Muscles
Since these are smaller internal muscles they are not as easily located as say the bicep is in the human body, but it is still possible to identify where they are with a little know how and concentrated effort. The best way to find your pelvic floor muscles is to correctly identify where they are.
It’s suggested that a person try to stop or slow their urine mid-pee the next time they empty their bladder to figure out exactly where the pelvic muscles are located. This “stop and start test” will help identify the location of the muscles which are around the front passage controlling the flow of a person’s urine.
The stop test however is not recommended as a pelvic floor strengthening exercise, merely a way to discover the specific area. More tips on the proper exercise techniques for pelvic floor strengthening will be explored later in this article.
Another way to figure out where the pelvic muscles are is to practice visualizing where they are located. By visualizing this group of muscles, women will get a better understanding of where they need to exercise and how these muscles are related to their bodily functions. The visualization can be completed laying down, sitting, or standing, with the legs positioned shoulder width apart.
Relax the muscles in the thighs, stomach and the gluteus (bum) and then squeeze the muscles around the front passage as if stopping the flow of urine, then squeeze and suck up the muscles around the vagina towards the inside the pelvis, and finally squeeze the muscles around the back passage (as if trying to hold in gas).
Take note of all of the muscles that contract when all of these things are done together, and then loosen them. Another tip for identification of the area is for women who use tampons imagining they were squeezing an inserted tampon higher up within the vagina.
10 The Pelvic Floor During Pregnancy
While working out during pregnancy isn’t going to give anyone washboard abs, it is certainly worthwhile. Fitness routines should be incorporated into a person’s pregnancy routine to help keep them active and well throughout pregnancy, and increase their ability for a speedy recovery after baby is born.
Exercise can help ease stress and tension in an expecting mom, and lower impact activities geared towards pregnant women, with appropriately trained instructors, can help keep someone limber for labor. Part of the key to this strength lies in the core muscles. It is said that strong abdominal muscles and pelvic floors can act as mommy’s secret weapon during labor.
A strong core means that mom will be able to push effectively and prevent urinary incontinence postpartum. The end goal during labor is to be able draw in your abdominals and then in turn relax the pelvic floor to allow for baby’s safe passage: essentially it will help you push effectively.
9 The TA Tag Team
By taking some time to exercise beyond performing the power-walk down the hallway to make several trips an hour to the bathroom, pregnant woman will be rewarded. A focus on the core muscles will help the body in pregnancy and beyond.
The tag team of muscles you want to focus on here are 1) the transverses abdominis (TA), which is located on the front and side of the abdominal wall, positioned below the oblique muscle and 2) the pelvic floor. This tag team will help a person’s pushing ability during labor. To work the TA muscles during pregnancy envision hugging baby inside the uterus with muscles instead of arms.
This “hug” is given by gently pulling in the abdominal muscles. Pregnant moms who want their bellies to shrink quickly will see a moment with a slightly smaller belly when completing this move. Some may even be able to see their bellies shrink as they practice engaging these muscles.
When working the TA, a way to know the exercise is being performed properly is that it should feel as if there is a tight belt around the midsection.
8 Exercises For The Pelvic Floor
The primary muscle of the pelvic floor is called pubococcygeus (PC for short) and is situated in a figure eight around the openings for the rectum, urethra, and vagina. The most popular way to strengthen these muscles is to practice Kegel exercises.
To complete Kegel exercises, consciously tighten or squeeze the levator muscles surrounding the vagina, like you would if you were stopping the flow of urine. Hold the squeeze for five to 10 seconds, while continuing a normal breathing pattern and then slowly release the tension. It’s suggested to complete 20 repetitions of this exercise, five times a day in order to prepare for childbirth.
Kegel exercises are easy to do, and are so discreet they can be completed at any time without anyone else knowing, so don’t worry, that person sitting beside you on the subway isn’t going notice your internal movements, there is nothing to be embarrassed about.
7 The Pelvic Area After Birth
Simply being pregnant can weaken a person’s pelvic floor; it doesn’t matter whether or not a they had a natural birth or had a C-Section. For those who experience labor in birth, the pelvic floor stretches in order to allow the baby’s head to pass out of the womb and vaginal passage.
As veteran moms know, this may have left bruises, swelling and soreness, it also stretched the pelvic muscles, along with the nerves connecting to the pelvic muscles. Birth can make the area between the perineum and vagina particularly tender, and make it difficult to engage the pelvic floor muscles.
This is more likely for those who pushed their baby out for a longer than usual amount of time, had a large baby, encountered a large tear, or had a birth using the assistance of forceps. A little bit of rest should help get mom ready for some pelvic floor exercise within a few days after birth.
6 Exercises After Birth
Exercise, particularly of the pelvic floor may be the last thing on the mind of a new mom, particularly for those needing a little TLC. New moms should avoid doing too much, and if the pelvic floor feels very heavy, or as if something is protruding between the legs, it’s time to rest up.
Spending time laying down, instead of sitting up, and keeping off of the feet will help take the pressure off of the anus, and allow for a speedier recovery of the affected area. For those who have had a catheter inserted into their bladder after giving birth, make sure to wait until this has been removed before attempting exercising the pelvic floor.
In the first little while post-birth it may seem as if nothing is happening during an attempt to engage the muscles. This is normal for stretched nerves and the attempts will be working, even if mom can’t feel it just yet.
5 Proper Exercise Technique
Go big or go home. There is not much point to practicing exercises to strengthen the pelvic floor if the technique is off, as this needs to be done correctly to be effective. When making the squeeze and contractions remember: nothing above the belly button should be tightened or tensed.
There will be some increased tension and flattening of the lower region of the abdominal wall, but again, nothing above the belly button. For those who can’t feel the muscles contracting while in a seated position, consider adjusting positioning or completing the exercise while lying down, or even standing.
Make sure to relax the muscles after each contraction and take a moment to recover before the next contraction. Remember this is an internal exercise, and if too many external muscles are tightening the exercise is not being performed correctly.
4 Abandoning Kegel Exercises
While the Kegel is the most popular technique for tightening the pelvic wall, there has been some recent criticism of the exercise. Some believe that Kegels may not really help to strengthen the pelvic floor for the long term. Some advocate squats as the solution to help lengthen the pelvic floor and ensure a smooth, quick labor.
Biomechanics expert Katy Bowman has said, ““I think squatting during delivery is awesome. It’s kind of like a DUH when you consider gravity and the fact that you want it out (out! out!). I also encourage people to remember that delivery is a huge physical performance.
Prepare for it, with lots of walking, working on pelvic alignment, and releasing the hips, sacrum and those pelvic floor muscles - which will make them stronger, as weird as that seems.” Squatting can be done any time, throughout pregnancy, or even when using a squatty potty, as long as the technique is correct.
3 The Big O
Maybe some new mom’s aren’t quite ready to “get back on the horse” in the bedroom and be intimate for a little while post pregnancy, and that’s very normal. However, take note, women with stronger pelvic floors have better, stronger, and more intense orgasms compared to those who don’t.
Some of the ways to strengthen the pelvic floor may have moms excited to practice the most fun workout ever! Many women like to complete their Kegel exercises while using a vibrator. This allows a person to contract their muscles against a resistance. Plus the hum of the toy will also add a little more fun to the task “at hand”.
This will allow for better pelvic floor control during sexual play or intercourse. Another item worth noting, when a person orgasms their pelvic floor muscles may contract up to 15 times. This will help strengthen the floor and increase sexual stamina.
2 Risk Factors
There are certain risk factors that can aggravate pelvic floor dysfunctions in addition to childbirth. People who are experiencing issues will want to visit their healthcare practitioner, but also take some of the following risks into consideration.
Contemplate making some lifestyle changes, and relay some notes on the factors that apply personally when seeking medical attention for pelvic floor dysfunction. Those who were bed wetters in childhood may be at higher risk, as are those with a family history of pelvic floor dysfunction.
People experiencing drastic body changes including increased weight or menopause may be more likely to suffer. Some medications, dehydration, smoking and diets that frequently contain bladder or bowel irritating foods may also exacerbate problems. Those suffering from severe urinary tract or yeast infections will also be at higher risk.
Proper diagnosis, with accurate personal notes will allow the best recovery and results from treatment.
1 Repeat Problems
Parents who have been through pregnancy, and post-pregnancy recovery know that each pregnancy is different than the last, and that keeps us on our toes. This can apply to issues surrounding morning sickness, sciatica, or even mandatory bed rest.
That being said, moms who experienced complications post birth surrounding their pelvic floor may have concerns about issues returning for baby two, three, or four. There are checklists online where people can determine if their pelvic walls have fully recovered from last time.
Note: There will be a slow pelvic wall muscle decline from one pregnancy to the next, but this can be very subtle and most people won’t even notice it. Regular exercise (both pelvic, strength training and cardio), along with a good solid diet with plenty of water (even though that may seem counterproductive at times) will help maintain pelvic wall health.
If there are concerns, speak up to your doctor, they’ll likely have suggestions that will help!