Pelvic Floor in Pregnancy
We hear a lot about how we should strengthen our pelvic floor AFTER having a baby, but what about during pregnancy? Research suggests that pelvic floor strengthening during pregnancy can help with reduction in both incidence + symptoms of Stress Urinary Incontinence in both pregnancy and early motherhood. We often hear that strengthening the pelvic floor in pregnancy can make it “too strong’ or “too tight” for childbirth, but we are yet to have any research emerge that supports this. Learning correct pelvic floor activation, breath coordination and relaxation in pregnancy is going to stand you in great stead for the early motherhood days!
Where is my pelvic floor?
The key to Pelvic Floor strengthening lies in understanding your anatomy, and in timing and coordination with the breath, as well as avoiding excessive load, beyond which you can control your pelvic floor and core. The pelvic floor is a sling or hammock like collection of muscles + connective tissue which supports your organs, pelvis, and assists in controlling toileting, childbirth, and sexual function. To help you visualize where the pelvic floor sits, sit upright on a chair, and placing your hands on your hips, start to rock your pelvis all the way forward, to feel the pubic bone and the front, and then roll all the way back onto your tailbone at the back, or coccyx. Then sit back upright again, and shift your weight side to side, to feel your 2 sitting bones. The pelvic floor runs from front to back, and side to side, between these bony points.
How do I strengthen my pelvic floor?
Start on an inhale breath, releasing the pelvic floor, and on an exhale draw up the muscles from your coccyx to pubis, and then add an additional lift. Think zipping up from front to back, and then up internally towards your spine. You can think of it like the muscles you would use to prevent passing wind, then urine, and then adding an additional lift. Release these muscles on an inhale breath and repeat. Start with 3 sets of 5-8 reps per day.
Once you have easily mastered this, you can build up to holding the PF contraction over several breaths (i.e. not releasing on the inhale, but holding for 2,3,4,8 breaths, and then releasing. Once you have mastered the basics, start to incorporate into daily movements, such as exhaling to contract your pelvic floor when you make a movement such as coming up from the floor from a squat, kneel, or lunge, when you go from sitting to standing, to prepare for lifting your older children or a heavy object.
It’s important to note, that overactive pelvic floor is just as common as underactive, or weak – and so we also need to work on “down training” the pelvic floor. For this we usually recommend some stretching for the glutes, pelvic floor, inner thighs, as well as specific breathing exercises and focusing on”letting go” of your pelvic floor. So you start with an inhale (nothing) exhale, lift your pelvic floor, and then let the pelvic floor release on an exhale, on the inhale continue to release / let go, and on the exhale, try to continue to release and let go. I find it helpful to sit with a rolled up towel under my perinuem (straddling the rolled up towel, kneeling if possible) so you have a sense of the position of your pelvic floor and some where for it to “descend” to. For further information and instruction, check out our guide to pelvic floor health.