During pregnancy, women’s bodies undergo massive changes to accommodate their growing baby. There’s a lot of focus on strengthening the pelvic floor muscles in preparation for pregnancy, but post-birth your body changes all over again.
Most women have never thought about this area downstairs, but during pregnancy it seems to be in every piece of information available.
How can you identify these muscles, and what exercises can you do to strengthen them before and after having a baby?
Lyz Evans is a women’s health physiotherapist at Women In Focus Physiotherapy, specialising in helping women pre and post birth. She’s also a mum, so she has first hand experience. Lyz explains how important it is for women to maintain the health of their pelvic floor muscles, before, during and after giving birth.
Listen to Lyz on Kinderling Conversation:
What do pelvic floor muscles do?
- Keep women continent, so when there is urine in the bladder, it stays there.
- When we’re active and exercising, they ensure we don’t leak.
- Support organs inside us, so our bladder, uterus and bowel are up where they should be, instead of dropping down out of place.
- Support the back and work with our deep tummy muscles in our core. Pregnant women have less back pain when pelvic floor muscles are strong.
- Help sexual function in women - including good sexual arousal and climax.
Women are often confused about this muscle because it’s one of the only voluntary muscles that are internal.
To strengthen these muscles, you need a daily, structured pelvic floor program - focusing like you would at the gym, until the muscle is fatigued. If the muscle is strong leading up to and during pregnancy, you can connect with your pelvic floor muscles a lot quicker post-birth.
How do you engage your pelvic floor?
1. Take a deep breath in and let everything relax.
2. Visualise the vagina area, thinking about the area between the anus and the pubic bone. Imagine there’s a tampon sitting in the vagina, and the tampon is sitting halfway in and halfway out. Consider the outside lips, the labia. Imagine gently pulling the labia in, so it gives the tampon a little hug.
3. Think about lifting the tampon gently towards them. So this should be a squeeze in and then a lift.
It’s very important to ensure you are exercising the muscle correctly and not detrimentally, by pushing down, instead of up. However, it’s never too late to correct this and like any other muscle, you have to use it to make it work well. You’ll be less likely to have leaking, pelvic organ prolapse, and even anal incontinence. If you don’t put any effort in, it’s going to be a weak muscle.
Alongside learning to strengthen these muscles, it’s important for women to learn how to consciously relax them too.
Women who have learnt to activate their pelvic floor in pregnancy can often learn how to relax better during labour, because it’s a muscle they’re now in tune with. The more you can connect with that muscle, the stronger the muscle memory is, and the stronger the neurological connection is.
A tool called the 'Epi-No’ helps women understand what this might feel like during pregnancy. It’s a small balloon that women insert into the vagina in the late stages of pregnancy, from around 35 weeks. It acts as a feedback tool on how to relax, how to bear down and push in the right way, for women who might want to feel prepared in this way.
What about after the birth?
Post-birth, your tissues will be trying to heal, so give them rest. That being said, you should try to get pelvic floor muscles activated as soon as possible post-birth, at a very gentle level - like trying to slow down urine flow. By engaging this area after having your baby, it promotes the healing of cells where stitches might be, helping to flush out the dead blood cells and swelling. So gently does it, and you'll be back to your old self in no time.
And remember, if you have any issues with incontinence or pelvic floor weakness after birth, visit your doctor for a referral to a post-birth physiotherapist. They are a wealth of information who can really make a difference. Don't suffer in silence!
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