Many women report that when someone mentions ‘pelvic health’ in pregnancy, they often just tell you to “do your kegels” to help ensure you have a “smooth” labour and delivery.
But these statements often do not outline WHY these muscles are important for their upcoming delivery. They also don’t explain HOW to train your pelvic floor for a vaginal delivery, including when to start and what exactly to do.
Many women are left wondering what they can do to be proactive and how they can train their pelvic floor muscles to prepare for childbirth. There is surmountable evidence that pelvic floor muscle training can improve childbirth parameters and pelvic floor symptoms, however what that training looks like is often not clearly communicated.
In today’s blog post, we’re going to break down the importance of pelvic health in preparing for labour and delivery, and how your pelvic floor muscles play a role in childbirth.
We’ve organized the blog post by trimester, so you can work towards optimizing your pelvic floor through each stage.
Stepping into The First Trimester (Conception – 13 weeks)
During the first trimester, taking care of your mental and physical health is key. Many women in the first trimester experience nausea, fatigue and generally feel “off” due to rapidly changing pregnancy-related hormones.
One recommendation to help is to ensure you are feeding your body with nutrient dense foods that include key vitamins and minerals necessary to support your pregnancy. Working with a dietician or naturopath can be a helpful way to support your prenatal nutrition needs.
Another idea to support your pelvic health in the first trimester is by incorporating gentle movement into your day to day routine. This can assist with keeping energy levels up, provide mental clarity and for stress relief. Balancing this movement with proper rest and restorative practices (ie: a good night’s sleep) will also help support this phase in pregnancy.
Not only do our bodies need adequate rest regardless, but especially when we’re growing tiny humans!!!
Second Trimester Preparation (~14 weeks to 29 weeks)
As you enter the second trimester, increasing your awareness and connection to your pelvic floor is so important. One of the ways you can do this is by booking an appointment with a pelvic floor physiotherapist.
By seeing a pelvic floor physio, they can assess your pelvic floor muscles and give you specific exercises tailored to your individual needs, and give you the time to optimize their function prior to birth. Pelvic floor muscles take time to adapt and change, so working with a pelvic floor physio early on in your pregnancy is very helpful. Ideally, you should be able to both relax and contract your pelvic floor for the muscles to move through their full range of motion and function optimally.
In addition to seeing a pelvic floor physio, staying physically active is incredibly important to maintain global strength and keep your body feeling its best. This movement can be as little as 10 minutes per day, and should be an activity that feels GOOD in your body. Whether that is walking, prenatal yoga, or strength training, moving your body can help improve pregnancy-related symptoms and your overall sense of physical well-being.
Additional pelvic health considerations can include ensuring you are adopting healthy bladder habits such as drinking a minimum of ½ your body-weight in ounces of water per day, avoiding those “just in case” pees, and aiming to void every 2 hours. For bowel health, purchasing something like a Squatty Potty or putting your feet on your bathroom garbage can will help avoid straining to empty your bowels and stress to your rectal tissues!
The Early Trimester | Pelvic Floor Opening & Relaxation (~28 weeks onwards)
In the third trimester, you will want to shift your focus slightly and start training your pelvic floor muscles to specifically prepare for birth. Your pelvis makes up a bony ring, called the pelvic OUTLET and your pelvic floor muscles connect to the bones at the front of the pelvis and to either side. Within the pelvic floor muscles, you have 3 openings, including your rectum, urethra, and vagina. You will want to train the pelvic floor to relax, soften and lengthen, thereby increasing the vaginal opening for delivery.
One of the ways we teach clients how to lengthen their pelvic floor muscles, is by focusing on diaphragmatic breathing.
- By using your diaphragm and focusing your breath into your belly and rib-cage, your pelvic floor muscles should be opening and lengthening as you INHALE, and returning to their resting position on the EXHALE.
- We can couple diaphragmatic breaths with hip opening stretches that not only increase the flexibility of your hip muscles, but they also place your pelvic floor muscles in a lengthened position. You can start these lengthening exercises between 30 and 32 weeks and carry on until your due date.
Learning how to release the tension in your pelvic floor will be so helpful for birth as well as maintaining healthy bladder and bowel habits.
End of Third Trimester | Perineal Massage (~37 weeks onwards)
Towards the end of your third trimester, another technique you can add to your routine is perineal stretching. This is another thing that is commonly mentioned in pregnancy books or even in prenatal classes, but again is not commonly taught. Perineal stretching can be especially beneficial for first time birthers (Beckmann & Stock 2013).
Your perineum is located between your vaginal opening and your anus. When giving birth, this tissue needs to stretch in order to accomodate the baby if you are having a vaginal birth. Did you know, during delivery, your perineum can stretch up to 300% it’s resting length? When your perineum isn’t flexible or hasn’t been trained to stretch or lengthen, it can often be damaged and torn during childbirth.
Perineal massage is the practice of manually stretching this tissue during the last few weeks of pregnancy to increase flexibility and reduce the risks of physical birth trauma or the need for an instrumentation delivery.
At Bump Physio and Co, as part of our Prenatal Pelvic Floor Education, we often will see clients around 37 weeks where we will go over how to practice perineal stretching at home. By teaching perineal stretching to our clients, they are then able to confidently practice these it home leading up to their due date.