Pelvic floor and pregnancy: Why everyone talks about it & what to do
As a personal trainer for pre and postpartum women, the pelvic floor comes up alot. During pregnancy and birth the pelvic floor comes under lots of strain. Not only is the pelvic floor supporting your growing baby, it’s also a muscle group that will help you push your baby out.
In this article, I’ll focus on the pelvic floor and pregnancy, sharing tips and tricks to train it, and why it’s important to be able to engage and relax it.
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What is the pelvic floor?
The pelvic floor is a group of muscles that sit like a hammock or sling, from your pubic bone to your tailbone and from side to side. The pelvic floor supports your bladder, bowel, and uterus. During pregnancy, the pelvic floor also supports the baby. This added weight can be a strain on the pelvic floor, particularly as you get further along in your pregnancy.
The role of the pelvic floor during pregnancy
Pelvic floor and pregnancy naturally fall into the same conversation. The pelvic floor is important for supporting your growing baby and for birth. If you have a vaginal birth, your baby needs to move through the pelvic to come out.
No doubt you’ll have heard people talking about the perils of a weak pelvic floor in pregnancy, and how important it is to keep it strong. Your pelvic floor needs to hold the weight of pregnancy to reduce pelvic pain and incontinence.
However, that’s not the only reason to care about your pelvic floor in pregnancy. After birth, you’ll want the pelvic floor to be strong enough to hold the bladder, uterus, and bowel. If the pelvic floor is weak, you can experience incontinence, organ prolapse, and pelvic pain.
While you need to work on strengthening the pelvic floor, you also need to understand how to relax it when you are pregnant. During birth the baby needs to move through the pelvis, and this is much easier if you can understand how to relax the pelvic floor.
Not being able to relax the pelvic floor (also known as pelvic floor tightness or hypertonic pelvic floor) is not only an issue during natural birth. It can also cause painful urination, constipation, and pain during sex.
Even if you have a c-section scheduled, it is important to train the pelvic floor during pregnancy. While the muscle group may not become stretched during birth, you are still carrying all the weight of the baby during pregnancy, putting pressure on the pelvic floor. This pressure weakens your pelvic floor which could then lead to pelvic floor issues postpartum.
So, in short, if you’re pregnant, you must train your pelvic floor.
How to find your pelvic floor during pregnancy
I’ve got a few different ways on how you can identify where your pelvic floor is. Some might make more sense to you. Here they are:
Option 1: Don’t pass the gas!
Imagine you’re in a crowded room and feel like you need to pass gas. Squeeze your anus muscle so as to not pass the gas and if you add a squeeze in your vagina as well, it’s your pelvic floor muscle you’re activating.
Option 2: Stop the pee
Imagine you’re trying to stop the flow of pee. Squeeze. Now, also squeeze your anus like you are trying to stop stool coming out. This is your pelvic floor muscle activating. Though, word of caution, don’t practice this while you are emptying your bladder because that can cause problems with completely emptying your bladder. Just imagine it as you’re sitting on the sofa, or doing the dishes.
Option 3: Finger test
In the finger test you insert one finger into your vagina. Try to squeeze around your finger with your vagina muscles. If you feel pressure around your finger, you are using the pelvic floor muscles.
Option 4: Coffee bean visualisaion
Imagine having a coffee bean at the entrance of your vagina. Take a deep breath, on the exhale try to bring that coffee bean up into your vagina. Hold the coffee bean up for a few seconds. And then inhale and relax your pelvic floor and let the coffee bean go or even fall out.
When to start with pelvic floor exercises during pregnancy
Week 18-32
You can start with pelvic floor exercises in your early pregnancy. If you haven’t started yet, starting at around 18 weeks is a good idea as it’s when your baby is getting heavier. Focus on pelvic floor strengthening exercises until around 32 weeks pregnant.
Week 32-Birth
When you get to 32 weeks, you should start to do pelvic floor relaxation exercises to help loosen and open the pelvic floor ahead of birth. Try to do relaxation exercises about 2x per week. When you get to week 38, start doing them daily.
After Birth
Once you’ve had the baby, you can start connecting to your pelvic floor and do pelvic floor strengthening exercises again. Strengthening your pelvic floor after pregnancy and labor will help you avoid incontinence and prolapse. However - if you notice signs of a tight pelvic floor (difficulty emptying your bladder completely or pain during sex, you might suffer from pelvic floor tightness. In this case, you still want to focus on pelvic floor relaxation.
Weak pelvic floor during pregnancy
These are the signs that you might have a weak pelvic floor during pregnancy
Urinary Incontinence when you walk, exercise, cough, sneeze, or laugh
Overactive bladder (needing to use the toilet but nothing coming)
Accidental bowel leakage
Reduced sensation during sex
Pelvic organ prolapse (descent of one or more organs into the vagina)
Dysuria (pain with urination)
Downward pressure or heaviness in the vagina
Constipation
Muscle spasms in the pelvis, hip, and legs
Discover how strong or weak your pelvic floor really is with my free Pelvic Floor Quiz.
Pelvic floor exercises during pregnancy
When you do pelvic floor exercises during pregnancy, you need to use a proper breathing technique as breathing is directly linked to your pelvic floor.
As you inhale, your diaphragm lowers and presses on your organs, increasing the pressure on your pelvic floor. At this point, your pelvic floor naturally relaxes. As you exhale, your diaphragm moves up and so does your pelvic floor. This means, when you exhale you need to activate your pelvic floor.
To properly engage the pelvic floor, you need to exhale and activate the pelvic floor on the exertion part of the exercise. For a squat, we inhale and relax as we lower, and exhale and engage as we lift back to standing.
WEEK 18 - 32
Do these exercises from pregnancy week 18-32 to strengthen your pelvic floor during pregnancy.
WEEK 32 - BIRTH
Do these exercises from week 32 until birth to prepare and stretch your pelvic floor for birth.
How to relax pelvic floor muscles
Learning how to relax your pelvic floor during pregnancy is key for an easier natural birth. Your pelvic muscles need to be able to relax to allow for the baby to exit, and to ensure good blood flow for nutrients and oxygen.
Try the following to relax the pelvic floor
Deep breathing exercises
Lie or sit comfortably
Place one hand on your lower stomach, and another on your chest
Breathe through the nose and fill your stomach with air so your hand rises
Then exhale, breathe all the air out and relax your pelvic floor imagining letting go of urine
Pelvic floor and pregnancy
My pregnancy fitness program BUMP gives you a clear workout plan and follow-along. BUMP workouts to strengthen your pelvic floor in the second trimester.
If you are in your third trimester, the BUMP program helps you to prepare your pelvic floor for an easier and faster natural birth. All workouts are targeted to your exact pregnancy week so you feel confident and strong during pregnancy and have an empowering birth!
