Why Pelvic Floor Strong Is So Important Before And After Childbirth

The pelvic floor is an essential group of muscles that stretch like a supportive hammock across the base of the pelvis. These muscles, intricately woven and layered, provide critical support to the organs located in the lower abdominal area, particularly the bladder, bowel, and for women, the uterus.

The muscles of the pelvic floor attach to the front, back, and sides of the pelvic bone and sacrum, acting like a dynamic floor that can move and adjust as needed. Their strength and flexibility are vital for several reasons. Firstly, they play a pivotal role in supporting the walls of the vagina, ensuring that these walls maintain their structure and position. This support is crucial not only for sexual health but also for overall pelvic stability.

Furthermore, the correct positioning of the bladder and the bowel is largely dependent on the integrity of the pelvic floor. These muscles provide a foundational support system that keeps these organs in their proper place, aiding in efficient and comfortable functioning. Beyond just support, the pelvic floor muscles are also responsible for controlling the release of urine, feces, and gas, contributing to continence and proper bowel and bladder function.

Moreover, the pelvic floor muscles are actively involved in various bodily functions such as aiding in childbirth by helping to guide the baby through the pelvic girdle, providing support for the growing fetus during pregnancy, and playing a role in sexual sensation and function.

Why is a strong pelvic floor important in pregnancy?

A strong pelvic floor is crucial during pregnancy for several reasons, and understanding its importance requires delving into the roles and functions of the pelvic floor muscles.

1. Support for Increasing Weight: As the fetus grows, the weight inside the womb increases. This added weight puts extra pressure on the pelvic floor muscles. A strong pelvic floor provides the necessary support to bear this additional weight without leading to discomfort or conditions like pelvic organ prolapse, where pelvic organs drop and press against the vagina.

2. Assistance in Childbirth: During childbirth, the pelvic floor muscles need to be flexible. A strong and well-toned pelvic floor can endure the stretching required during delivery. It’s not just about muscle strength but also about the ability to relax and contract these muscles effectively, which is crucial during the pushing phase of labor.

3. Prevention of Incontinence: Pregnancy and childbirth put a strain on the muscles that control the bladder and bowel. This can lead to incontinence (the involuntary leakage of urine or feces). A strong pelvic floor helps in maintaining control over these functions both during and after pregnancy.

4. Recovery Post Childbirth: Women with a stronger pelvic floor generally experience a quicker and smoother recovery after giving birth. This is because these muscles have been conditioned to manage the stress of childbirth and can repair and regain strength more efficiently.

5. Sexual Health: A strong pelvic floor can also contribute to sexual function and pleasure. Pregnancy and childbirth can affect sexual sensation and function, but a well-toned pelvic floor can help in maintaining sexual health.

6. Reduced Risk of Prolapse: Childbirth can lead to pelvic organ prolapse in some women, where the pelvic organs drop and create a bulge in the vagina. A strong pelvic floor before and during pregnancy can reduce the risk of this happening.

7. Overall Body Alignment and Stability: The pelvic floor is part of the body’s core, which includes the diaphragm, abdominal muscles, and the muscles of the lower back. A strong pelvic floor contributes to overall core strength, which is essential for maintaining good posture and reducing the strain on the back during pregnancy.

What causes a weak pelvic floor?

A weak pelvic floor can result from various factors, often involving increased strain or pressure on these muscles. Some of the primary causes include:

1. Pregnancy and Childbirth: These are among the most common causes of a weakened pelvic floor. The weight of the growing fetus during pregnancy puts significant pressure on the pelvic floor muscles. Vaginal childbirth can stretch these muscles considerably, and the strain can lead to weakening, especially after multiple births.
2. Aging: As with many other muscles in the body, the pelvic floor muscles can lose strength and tone as a person ages. This natural decline can lead to weakness in the pelvic floor.
3. Menopause: The hormonal changes during menopause can affect the strength and resilience of the pelvic floor muscles. Decreased estrogen levels can lead to weaker muscles and reduced elasticity, increasing the risk of incontinence and prolapse.
4. Constipation and Straining During Bowel Movements: Regular straining during bowel movements, often due to constipation, can put excessive pressure on the pelvic floor muscles, leading to weakening over time.
5. Chronic Coughing: Conditions that cause chronic coughing, such as asthma, smoking, or chronic bronchitis, can lead to repeated pressure on the pelvic floor muscles. This ongoing pressure can weaken these muscles.
6. Heavy Lifting and High-Impact Exercise: Regularly lifting heavy objects, either in a job or during exercise, can exert a lot of pressure on the pelvic floor. Similarly, high-impact exercises, like running or jumping, can also strain these muscles.
7. Obesity: Carrying excess weight increases the pressure on the pelvic floor muscles. This constant pressure can weaken the muscles over time.
8. Surgery or Injury: Surgical procedures, especially those involving the pelvic area, can sometimes lead to weakened pelvic floor muscles. Injury to this area, including nerve damage, can also contribute to weakness.
9. Genetics: In some cases, genetic factors might play a role in determining the strength and resilience of the pelvic floor muscles.

Recognizing these factors is important because it can guide efforts to prevent or treat pelvic floor weakness. Practices like regular pelvic floor exercises (Kegels), managing chronic coughs and constipation, maintaining a healthy weight, and using proper techniques for lifting can help maintain or improve the strength of the pelvic floor.

How can you keep your pelvic floor strong during pregnancy?

Maintaining and enhancing the strength of your pelvic floor during pregnancy is crucial for several reasons, including supporting the added weight of the growing fetus, assisting in childbirth, and aiding in postpartum recovery. Here are some strategies to keep your pelvic floor strong during this period:

1. Pelvic Floor Exercises (Kegels): These are the most recommended exercises for strengthening the pelvic floor. They involve contracting and relaxing the muscles of the pelvic floor. It’s important to learn the correct technique, which can be demonstrated by a healthcare provider, such as your doctor or a pelvic floor physiotherapist.
2. Prenatal Yoga or Pilates: Certain yoga and Pilates poses are beneficial for strengthening the pelvic floor muscles. These exercises also improve flexibility and overall strength, which can be particularly useful during pregnancy and childbirth.
3. Maintain a Healthy Weight: Gaining a healthy amount of weight during pregnancy can reduce the strain on your pelvic floor muscles. Consult with your healthcare provider to determine the appropriate weight gain for your pregnancy.
4. Proper Posture: Maintaining good posture can help alleviate unnecessary pressure on your pelvic floor. This includes sitting, standing, and moving with proper alignment.
5. Avoid Straining During Bowel Movements: Constipation can lead to straining, which weakens the pelvic floor. Maintaining a diet high in fiber, staying hydrated, and using proper positioning and relaxation techniques during bowel movements can help.
6. Breathing Techniques: Learning proper breathing techniques, especially diaphragmatic breathing, can be beneficial. This involves coordinating your breathing with pelvic floor movements, which can enhance strength and function.
7. Regular Physical Activity: Engaging in regular, pregnancy-appropriate exercise helps maintain overall muscle tone and strength, including the pelvic floor muscles. Activities such as walking or swimming can be particularly beneficial.
8. Avoid Heavy Lifting: Try to avoid lifting heavy objects, as this can put extra strain on your pelvic floor. If you need to lift something, use proper lifting techniques and engage your pelvic floor muscles.
9. Prenatal Education Classes: These classes often include information on pelvic floor health. They can provide valuable tips on how to strengthen and maintain these muscles during pregnancy.
10. Regular Check-ins with Healthcare Providers: Regular appointments with your healthcare provider can help monitor your pelvic floor health. They can provide guidance or referrals to specialists like pelvic floor therapists if needed.

Remember, every pregnancy is unique, so it’s important to consult with your healthcare provider before starting any new exercise regimen. They can provide personalized advice based on your health and pregnancy conditions.

When should you start doing pelvic floor exercises during pregnancy?

Starting pelvic floor exercises during pregnancy is an excellent proactive step for maintaining pelvic health. It’s advisable to begin these exercises as soon as you learn you are pregnant, if not before. Here’s why:

1. Early Prevention: Beginning pelvic floor exercises early in pregnancy can help prevent issues that might arise later, such as urinary incontinence and pelvic organ prolapse. It’s a case of ‘the earlier, the better’ in terms of building strength and endurance in these muscles.
2. Easier Adaptation: Starting these exercises early gives your body time to adapt to them as it undergoes the various changes of pregnancy. It also allows you to become comfortable with the exercises and integrate them into your daily routine.
3. Beneficial Throughout Pregnancy: Pelvic floor exercises are safe and beneficial throughout all stages of pregnancy. They help support the increasing weight of the baby and can ease some of the discomforts associated with pregnancy.
4. Preparation for Childbirth: Strong pelvic floor muscles can aid in the childbirth process. They can help you manage the pushing phase more effectively and might contribute to a smoother delivery.
5. Postpartum Recovery: If you start these exercises early and continue them throughout pregnancy, your pelvic floor muscles are likely to recover more quickly after birth. This can lead to a reduction in postpartum issues like incontinence or prolapse.
6. Helps with Body Awareness: Doing these exercises regularly helps you develop greater awareness of your pelvic region, which can be beneficial during labor and delivery.

Does the exercise plan change through the pregnancy?

The exercise plan during pregnancy, particularly for pelvic floor exercises, may indeed change as the pregnancy progresses. This is primarily because the body undergoes continuous changes throughout the pregnancy, and the needs of your pelvic floor can vary accordingly. Here are some points to consider:

1. Individualized Plan: Each woman’s body and pregnancy journey is unique, so the exercise plan should be tailored to individual needs. This is especially true for pelvic floor exercises, where factors like existing strength, any symptoms of weakness (like incontinence), and overall physical condition play a role.
2. Adjustments Over Trimesters: As the pregnancy progresses, the strain on the pelvic floor increases due to the growing weight of the baby. The exercises might need to be adjusted for comfort and effectiveness. For instance, the frequency or intensity of the exercises might be modified.
3. Consultation with a Specialist: A specialist physiotherapist, especially one trained in women’s health, can provide the best guidance. They can help adjust the exercise plan as your body changes and as you get closer to your due date.
4. Postpartum Considerations: After childbirth, the focus of pelvic floor exercises may shift slightly to aid in recovery. The timing to resume or intensify these exercises postpartum should be based on medical advice, considering factors like the type of delivery (vaginal or cesarean) and any complications during childbirth.

Regarding incorporating pelvic floor exercises into a daily routine, the challenge is often remembering to do them regularly. Here are some helpful tips:

• Use of Apps: The Squeezy App is specifically designed to remind and guide women through their pelvic floor exercises. It’s user-friendly and can be a great tool to keep you on track.
• Setting Alarms: Using an alarm clock or smartphone to set reminders three times a day can be effective. Choosing times that align with daily routines, like after meals or during a morning routine, can help make the exercises a habitual part of your day.
• Incorporate into Daily Activities: Associating pelvic floor exercises with regular activities like brushing teeth, watching TV, or during certain times like traffic stops while driving, can help in making them a part of your daily life.
• Visual Cues: Placing sticky notes in places you frequent (like the bathroom mirror or refrigerator) can serve as reminders.
• Building a Habit: It takes time to form a new habit. Being patient and consistent is key. Gradually, these exercises can become as routine as any other part of your daily life.

Should pelvic floor exercises be continued after pregnancy?

Absolutely, continuing pelvic floor exercises after pregnancy is highly recommended, and it can offer several benefits, especially if there are signs of pelvic floor weakness. Here’s why:

1. Postpartum Recovery: After childbirth, the pelvic floor muscles may be stretched and weakened. Continuing exercises can aid in the recovery process, helping these muscles regain their strength and tone.
2. Preventing Urinary Incontinence: Pelvic floor exercises are effective in preventing and managing urinary incontinence, a common issue for many women after pregnancy. Regular exercise can help control bladder function and reduce the risk of leakage.
3. Addressing Prolapse Risk: Pelvic organ prolapse, where pelvic organs shift or bulge into the vaginal canal, is a concern for some women after childbirth. Pelvic floor exercises can help reduce the risk of prolapse and alleviate symptoms if it occurs.
4. Supporting Overall Pelvic Health: A strong pelvic floor provides support to the bladder, bowel, and uterus. Maintaining this support is essential for optimal pelvic health.
5. Enhancing Sexual Function: Strong pelvic floor muscles can contribute to improved sexual sensation and function for both partners. This can be particularly relevant for women after childbirth.
6. Continuing Good Habits: If you’ve already established a routine of pelvic floor exercises during pregnancy, it’s a good idea to continue this habit. Consistency is key to maintaining strength and preventing issues.
7. Lifelong Benefits: Pelvic floor exercises aren’t just for the postpartum period; they are beneficial throughout a woman’s life. They become increasingly important as a woman ages because the pelvic floor naturally weakens with time.

It’s important to note that the type and intensity of pelvic floor exercises may need to be adjusted based on your postpartum recovery and any specific guidance from your healthcare provider. Additionally, if you experience any symptoms of pelvic floor dysfunction, such as incontinence or prolapse, it’s crucial to consult with a healthcare professional, such as a physiotherapist specializing in pelvic health. They can provide personalized advice and exercises tailored to your needs.