The pelvic floor muscle is truly the floor of our pelvis and during pregnancy it has to work way harder than it did before. It is made up of muscles and connective tissues that have 3 really important roles:
1. Support: the pelvic floor muscle supports the core and pelvic organs
2. Sphincter: it wraps around the urethra and anus so that we don’t leak pee or poop
3. Sexual: it relaxes during penetration and contracts strongly and quickly to create pleasure during an orgasm
During pregnancy these roles can be stressed by the physical and hormonal changes that occur. Let’s take a look at how and what you can do to reduce the stress on your pelvic floor.
Hormonal Changes
One of the most significant changes that occur is the influx of hormones including relaxin. One of the main purposes of relaxin is to soften the joints to make room for the baby’s growth and birth. With the decrease in connective tissue support surrounding the joints, the muscles take over more of that role. When there is an imbalance in muscle strength, an increase in tension may occur.
This is particularly noticeable in the pelvic floor because it works with surrounding muscles to provide support to the hips, pelvis and spine, and relies on these other muscles to find balance. In particular, the abdominals, adductors (inner thighs) and glutes. If these other muscles aren’t pulling their weight, the pelvic floor muscle does more work, and this creates more muscle tension.
What you can do about it!
There is nothing you can do about the hormone changes, however there is a lot you can do to address the muscular imbalances that may occur. Performing exercises that target the glutes, abdominals and adductors can help you manage your joint stability and reduce the stress on your pelvic floor. During pregnancy, exercise including strength training, as long as you are having an uncomplicated pregnancy, is recommended!! Taking time to lengthen the pelvic floor muscle by spending a few minutes deep breathing and hanging out in a child’s pose can tremendously helpful.
Pressure Changes
As baby grows and moves upward, eventually taking up the majority of the abdominal cavity, your diaphragm muscle is impacted and it makes it much harder for it to work effectively. This can lead you to breathe in a shallow pattern, which changes the intraabdominal pressure.
This is a significant change on the pelvic floor since increased downward pressure can lead to incontinence and pelvic organ prolapse.
What you can do about it!
Working on your breathing and maintaining downward movement of the diaphragm with an inhale, and upward movement of the diaphragm with an exhale, can reduce the impact of pressures changes in pregnancy. This includes doing thoracic mobility exercises to reduce stiffness in the ribs and mid back strengthening exercises. Performing breathing centered exercises in multiple positions will also help you clue into patterns that aren’t serving you, like ballooning the belly out on exhale or sucking in on inhale.
Posture Changes
During pregnancy your center of gravity changes and so will your posture. The most common posture change results in increased curvature in your low back (sometimes called sway back) and your ribs push forward. Unfortunately, this can strain your joints, especially if your muscles can’t provide the support necessary.
This posture puts a lot of pressure downward onto the pelvic floor which can increase pubic symphysis pain, bladder control issues, and pelvic pressure. We also notice that this posture can sometimes cause pelvic floor tension in the back that contributes to constipation.
What you can do about it!
Building strength in postural muscles like your glutes, abdominals, hamstrings, adductors and upper-mid back, while maintaining proper pelvic and rib alignment can help during pregnancy and in the postpartum period. For most women, we are advocating they stay as active as possible with their chosen form of exercise during pregnancy. Weight lifting, yoga, pilates, walking or running have all been shown to be beneficial for the pregnant mom and baby, especially when the woman listens to her body. We would love to guide you along this journey.
To help your changing body we love SRC Health Pregnancy tights and leggings. They provide amazing support to your abdominals, low back, pelvis and are fantastic if you have developed vulvar varicosities. We are excited to have these products in our clinic so you can touch and feel and try them on for yourself!!
There you have it, 3 major changes that occur in pregnancy and how they impact the pelvic floor. These changes start well before your birth, which is why you may have pelvic floor problems even if you had a cesarean birth or uneventful vaginal birth. The good news is you can influence these changes by being mindful and proactive.
If you want to learn more about Pregnancy and its impact on the pelvic floor muscle, ways to prepare for lactation / feeding, and the mental health changes that occur in pregnancy, sign up for our 3 Part Virtual Series. It is $110 for three virtual hours over three weeks (or receive the recordings if you are unable to attend). Sign up by clicking on the Book Now button below.
Virtual 3 Part Series: Holy $@%^& I'm Pregnant, What do I need to know? (8-9 pm)
Thur Mar 23, 2023 Kristen Parise (Pelvic Health Physiotherapist) Pelvic Health Changes in pregnancy / Exercise / Birth preparation
Thur Mar 30th, 2023 Alexandra Evans (Breastfeeding Consultant / Osteopath) Preparing for Lactation / Feedubg
Thur Apr 6th, 2023 Andrew Gumbinger (Psychotherapist Qualifying) Mental preparation and changes in pregnancy