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Written by Nicole Thorne, @pelvic_floor_secrets
Pelvic Floor Specialist, Certified Strength Training Coach, Master Trainer Core Confidence Education, Founder & Owner Pelvic Floor Secrets, Team STRONG Girls Coach

The human body’s ability to create and nurture new life is truly amazing, and its
way of adapting and recovering afterward is nothing short of miraculous. Although, for women, the stages of pregnancy, childbirth, and postpartum can be exciting and challenging at the same time as some women struggle with pelvic discomfort, pain, and leaking urine. 

With some knowledge and intentional prehabilitation you can minimize pelvic floor dysfunction throughout pregnancy and beyond the postpartum period. 

The body undergoes significant transformations to accommodate a growing baby and prepare for delivery, including hormonal fluctuations and physical changes such as loosening muscles and your organs shifting inside your body. This journey can be uncomfortable and difficult. However, there is a lot in your control before, during, and after pregnancy that does not have to result in any long-term pelvic floor dysfunction. Before we get into the concept of prehabilitation, let’s first understand what happens “down there” during pregnancy. 

Your pelvic floor is a vital group of muscles and connective tissue that acts like a hammock to support and protect.

Your Pelvic Floor and Pregnancy

The pelvic floor is a vital group of muscles and connective tissue that acts like a hammock to support and protect your organs such as your uterus, bladder, and rectum. It is essential for urinary continence, bowel control, and even sexual arousal.

During pregnancy, the pelvic floor is responsible for supporting your changing body and growing baby. Along with hormonal changes causing your muscles to soften and stretch, the uterus is also expanding, causing the pelvic floor to stretch and weaken under the added weight and pressure. In many cases, this is when women say their pelvic floor dysfunction started.

When the big delivery day comes, if it’s a vaginal delivery, your pelvic floor muscles need to stretch up to three times their normal length, separating to make way for the baby. Contrary to popular belief, the pelvic floor does not push the baby out (it’s your contracting uterus). In addition to the loosening and weakening of the pelvic floor during pregnancy, childbirth can also include other unintended perineal injuries such as tears or an episiotomy, which impact pelvic floor recovery.

C-section deliveries also affect the pelvic floor, but in a different way than a vaginal birth. C-sections involve cutting between your abdominal muscles which affects the core muscles. Since the core muscles and the pelvic floor are so connected in how they function together to manage your abdominal pressure, conditions such as uterine prolapse and incontinence can occur as a result of the surgery.

Postpartum Recovery

Many postpartum women are not prepared for the various issues they may encounter during the recovery period. These may include urinary incontinence (leaking pee), vaginal pressure or “heaviness,” or painful sex after the six-week mark. Pelvic floor symptoms tend to go unaddressed throughout the entire pregnancy and postpartum journey as there is an underlying assumption that the body will automatically “bounce back” after six weeks.

Pelvic floor symptoms tend to go unaddressed throughout the entire pregnancy and postpartum journey.

Prehab for Pregnancy

If you are like many athletic women, pregnancy is not going to stop you from being active. If anything, it may provide added motivation to be physically fit in order to better adapt to your changing body and be prepared for labor and childbirth. Understanding that looser ligaments, swollen body parts, fatigue, and changes in posture might require some modifications and adjustments to your exercise routine, be aware that there are some fundamental skills to develop before becoming pregnant, be maintained during pregnancy, and continued past the postpartum stage.

The concept of prehabilitation started in the surgical world as a way to improve a patient’s overall health status and functional capabilities to reduce risks related to postoperative inactivity or complications—in other words, get to a physically better place before a physically taxing event. In the world of pelvic floor dysfunction, the same applies. Regardless of where you are at in your childbearing journey, the approach is the same: assess and correct your posture, master the core breath, and strengthen the body to maintain proper alignment.

Common, Not Normal

Just because pelvic dysfunction is common does not mean it should be accepted as normal. Women deserve to live comfortably and confidently. Get to know the resources available to help you with your pelvic floor issues. Be an advocate for yourself and speak up about your symptoms—even if you’re being told everything “looks fine” or reassured that it’s “normal.” It is not. Ask for a referral to a pelvic floor physical therapist to start you on your healing journey. Most importantly, continue to maintain pelvic floor health by working with someone who specializes in helping women achieve pelvic floor functioning and maintain it over the long term through proper body alignment and strength training.

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