The Importance of the Pelvic Floor in Pregnancy
A Guest Article by Mary Bacon
In today’s blog, I want to demonstrate how to effectively strengthen your pelvic floor, and how to relax your pelvic floor muscles.
As a young mum no one educated me on the importance of pelvic strength during pregnancy and post-delivery. I had my first baby at twenty, and second at twenty-two. Two very different pregnancies, but both natural deliveries without any complications.
I found my passion in the fitness industry after my first daughter was born.
I joined a gym and started my journey in fitness, strength, and happiness.
Thirty years later, the passion is still strong.
Over the years as I personally trained women, it became evident that women are not being taught how to activate their pelvic floor muscles correctly. Some women presented with weak muscles, and small percentage with unusually tight muscles. To my surprise most of the women who had super tight pelvic floor muscles were the group fitness instructors or heavy weights lifters. We can understand why there are so many pelvic floor physios nowadays.
The Importance of the Pelvic Floor in Pregnancy
Your pelvic floor muscle is only one part of the core muscles. It covers a good area of the deep part of your pelvis supporting your bladder, baby, organs, and bowels.
During pregnancy this muscle has a lot of load to carry, especially as your baby grows. Knowing how to effectively strengthen it is key, not only to facilitating a smooth birth, but also to avoid future problems like prolapses and incontinence.
Towards the end of the pregnancy all mums need to do some exercises to relax the pelvic floor and prepare for the birth. Alison uses Optimal Maternal Positioning with all her clients to help with this preparation.
Strength and Relaxation
The hormones progesterone and relaxin are high in the first and the third trimester, their function being to help loosen muscles, joints, and ligaments, especially in the pelvic area, in preparation for the growth of your baby and for delivery. But it is also beneficial for the mum to know how to consciously relax her pelvic floor muscle, as this will help move things along during labour and delivery.
There are different methods of strengthening pelvic floor. My favourites are ultrasound machine or a blood pressure cuff as a bio-feedback tool. But of course, how many mums would have access to these? If you do go to a pelvic floor physio, look for one that has an ultrasound machine and can test your pelvic floor.
With an ultrasound machine you get to contract your pelvic floor and visually see on the screen if you are doing too much or too little. I have personally had this done and have been present during many of my pregnant ladies’ ultrasound sessions. They are blown away by how much concentration it takes to contract, control and yet not over activate.
The blood pressure cuff is used as a bio-feedback tool. This can be used at any stage of pregnancy or for lower back rehabilitation. Basically, the mum lays on her back with knees bent. The pressure cuff is pumped to a certain measurement and placed directly under her lower back. Breathing exercises, followed by pelvic floor contraction, are then done to generate a certain pressure reading on the cuff.
This is repeated a number of times, and progressively pelvic floor strength and stability is improved. It is very concentrated effort, and might seem slow and perhaps boring at times, but it’s for a short period of time.
According to Pelvicfirst.org.au, bladder and bowel control problems affect almost 4.8 million Australians, 80% of whom are women. That is the equivalent of the population of Sydney.
Exercise prescription for core work needs to be individually tailored, as some women have a flat back, some lordotic (eg: gymnast curve) and most women have a neutral normal curvature.
Strengthening the Pelvic Floor
Let’s assume everyone has a neutral curve in the lower back.
In this example I will help you do your pelvic floor exercise. Imagine you’re doing it with a blood pressure cuff under your back – except you will use your hand to perform this exercise.
- Lay on your back with both knees bent.
- Place one hand under the small of your back. Generally speaking it’s the area directly under your belly button area.
- Breathe in diaphragmatically. Your diaphragm sits between your ribcage and belly button. (Ensure that your lungs are not expanding, as it’s the diaphragm that should be expanding first).
- As you breathe out, slowly and gently lift your pelvic floor muscles in. Your pelvic floor muscles are like an internal hammock, which attach to the pelvis via ligaments, and extend from in front of your vagina to behind your anal passage, so ensure that you are contracting this area also. It should be a very gentle lift, and not a sharp pull or a strong contraction. This part is the internal lift of your pelvic floor.
- While maintaining the lift of your pelvic floor muscles, you will need to draw the lower portion of your abdomen inwards (or towards the spine). At the same time, gently press your lower back down on the hand under your back.
- This will create pressure in your abdominal wall. Hold that pressure while still breathing normally for 10 seconds and relax for 10 seconds.
- Repeat for 10 times or as many as you can. Movement should be slow and controlled. Build up on it.
There are many other pelvic floor exercises which incorporate other core muscles, but this is the foundation that you build with first as it isolates the muscles. You can then integrate with other muscles later.
Relaxing your Pelvic Floor
In your third trimester, you need to focus more on relaxing the pelvic floor muscle.
This will prepare you for natural birth and needs to be practiced now.
As this muscle is internal, and you can’t very well pick it up and stretch it, it has to come from the brain connecting with this muscle and doing a slow and gentle push. Fortunately, it’s quite easy.
- Find your comfortable position. You can lay on your back with your knees bent, or do a bridge like position on all 4’s. (hands and knees).
- Do your breathing as you would for the above exercise, including a small contraction. Don’t hold it – instead gently push out from the internal section of your vagina. It can help to visualise you are pushing the baby’s head out, or that you are about to poop. (TMI, but I actually pooped during the crowning of my baby’s head. I was very embarrassed, but the nurse made me feel so comfortable I was over it in a sec).
This is the time that you just let it all out and relax. Your mindset should be all around welcoming this baby in the easiest and most natural way possible. The more tension you hold the longer it takes to birth the baby. So, being visual and relaxed will help you manage pain and a give you a better birthing experience.
Mary Bacon is a pregnancy fitness expert, personal trainer and a published author of Pregnant Fit and Fabulous. Her work is endorsed by doctors and PhD’s and is sought after by Olympic medallists such as Jana Pittman, who represented her country at three Olympic Games. Mary also helps mums and couples get fit and healthy before they fall pregnant. Her passion is to help women feel confident, nourish their body and baby, and have a happy and healthy pregnancy. Mary’s reputation in getting mums back in shape after delivery is like no other. She takes a total holistic approach, focusing on recovery, nutritional balance and individual exercise programs.
As a certified life coach, Mary also covers the mental and emotional aspect of pregnancy and postpartum or fourth trimester.
You can follow Mary on FB or Instagram @pregnantfitandfabulous
If you would like more information on how to strengthen your pelvic floor, or you have questions about any other aspect of your changing body, l would love to chat. Give me a call on 0422 258 771 or contact me: