Your pelvic floor plays a critical role in pregnancy and childbirth. As a pregnant woman, it’s important to understand how the pelvic floor works and how to take care of it. Here’s what you need to know:
What is the pelvic floor?
The pelvic floor is a group of muscles starting from the pubic bone at the front of the pelvis and going to the tailbone at the back. These muscles provide support to the pelvic organs, such as the bladder, uterus, and rectum. They help control your bowel and bladder function.
Why is the pelvic floor important during pregnancy?
During pregnancy, the weight of the growing uterus puts pressure on the pelvic floor muscles. This can weaken the muscles and cause problems such as urinary incontinence (leaking urine), fecal or flatal incontinence (leaking stool or wind), and pelvic organ prolapse (when one or more of the pelvic organs drop down into the vagina).
How can I take care of my pelvic floor during pregnancy?
You can take care of your pelvic floor by doing pelvic floor exercises, also known as Kegels. These exercises squeeze and release the pelvic floor muscles. A video of the pelvic floor contracting can be found here:
When should I start doing pelvic floor exercises?
It’s a good idea to start doing pelvic floor exercises as soon as you find out you’re pregnant. They can help prevent or reduce the likelihood of urinary incontinence and other pelvic floor issues. However, it’s never too late to start – you can do Kegels at any stage of pregnancy.
What if I’m already experiencing pelvic floor problems?
It is not uncommon to experience some leaking of urine in pregnancy. It is particularly common with sneezing or laughing. You are most probably drinking more water than usual, and your baby’s head is pushing on your bladder. If you are experiencing urinary leakage, talk to Dr Porter. While most leakage is related to your pelvic floor, it is important not to miss a urinary tract infection which can cause bladder irritation and mimic the symptoms.
If you’re experiencing fecal incontinence or pelvic organ prolapse, please alert Dr. Porter, as specific treatments may be available. Treatments may include pelvic floor physical therapy, medication, or surgery if necessary.
How do I do pelvic floor exercises?
A guide from “Pelvic floor health for expectant and new mums” www.continence.org.au:
Step 1: Find your pelvic floor muscles
- Sit up tall and relax your shoulders. Also, relax your thighs and bottom (buttocks) and soften your abdomen (tummy).
- Locate or feel the different parts of your pelvic floor by lifting the muscles around:
- Your urethra (front passage) as if trying to stop the flow of urine, then relax.
- Your vagina, drawing it upwards inside your pelvis, then relax.
- Your anus (back passage) as if trying to stop the passing of wind, then relax.
- Then lift all the pelvic floor muscles around your urethra, vagina, and anus simultaneously. Keep your legs and bottom relaxed.
- As you do this, there should be a feeling of lift each time the muscles are squeezed.
- Then let go and relax. There should be a distinct feeling of letting go.
- Lift and relax a couple more times to ensure you have found the right muscles.
Step 2: Exercise your pelvic floor muscles
- Lift and squeeze the pelvic floor muscles around your urethra, vagina, and anus simultaneously. Breathe while you hold your lift and squeeze.
- Aim to hold for 3 seconds, then relax them fully. Build up to hold for 5-8 seconds over time.
- Rest your pelvic floor muscles for the same time as you held the lift before repeating.
- Your shoulders, bottom, thighs, hands, and feet should remain relaxed.
- If you cannot feel your muscles contracting, change your position and try again. The exercises can be done while sitting, lying, or standing (lie on your side if you are over 16 weeks pregnant).
Step 3: Repeat!
- Repeat this process 3-5 times in one set, building up to 8-12 times in a set over time, as long as you can do it with the right technique.
- Try to do 3 sets each day in a variety of positions.
- 3-5 quick lifts of your pelvic floor can also be done, building up to 8-12 before or after your pelvic floor holds.
What if I can’t get the right muscles to hold/tighten/relax?
You may benefit from professional assistance if you have trouble with the above exercises. Dr. Porter can refer you to a local pelvic floor physiotherapist.
Can I overdo pelvic floor exercises?
It’s possible to overdo pelvic floor exercises, just like any other type of exercise. Doing too many Kegels or holding them for too long can cause muscle fatigue and lead to more problems. If the exercises cause pain or discomfort at any time, discontinue them. If you are at risk of overdoing your pelvic floor exercises, Dr. Porter may suggest you see a physiotherapist who can write you an individualised program.
What else can I do to take care of my pelvic floor?
In addition to doing pelvic floor exercises, there are other things you can do to take care of your pelvic floor during pregnancy. These include maintaining a healthy weight, avoiding coughing and constipation, eating high-fibre foods (fresh fruit and vegetables), and practicing good posture.
- Don’t ignore the urge to urinate. Go to the toilet right away.
- That being said, only go to the toilet when you need to. Don’t go frequently and ‘just in case’ as this can train your bladder to hold less volume.
- Rest your feet on a small stool. The ideal toileting position is when your knees are higher than your hips. You can relax in this position by leaning forward and resting your forearms on your thighs.