Your Go-to Guide To Pelvic Floor Preparation For Pregnancy And Birth

If you are pregnant, it’s likely that you’ve heard a lot about your pelvic floor and that it is important it is to look after…both during your pregnancy and in the lead up to birth. Here is your go-to guide on preparing your pelvic floor for pregnancy and birth! 

Why should you have your pelvic floor assessed during pregnancy?

Pelvic health condition management 

If you are experiencing any pelvic health condition - whether it’s something that starts during pregnancy, or is a condition that you have had prior to your pregnancy - it’s recommended to have this assessed, treated and managed by a pelvic health physiotherapist. Some common (but not normal) conditions include: 

• Urinary or faecal incontinence 

• Constipation 

• Pelvic pain conditions e.g. painful intercourse or endometriosis 

• Prolapse 

While these conditions are very common, they aren’t normal and there are so many things that can be done to help - even while you are pregnant! Having your condition assessed can help you understand more about how it may impact you for the rest of your pregnancy, birth and postpartum journey, as well as how to best prepare your body and pelvic floor for your journey.

Pelvic floor preparation for pregnancy and birth 

Just because you aren’t experiencing a pelvic health condition/symptoms, it doesn’t mean that you shouldn’t get your pelvic floor checked! Whether you are planning a vaginal or c-section delivery, your pelvic floor needs to be functional, and be able to support your little one and your body over the nine months of your pregnancy. The more you work on your pelvic floor function now, the better your function will be during pregnancy and postpartum. If you are considering a vaginal delivery, your pelvic not only needs to support your body throughout pregnancy, but it also needs to be able to relax and lengthen to allow the birth of your baby.

Part of your pelvic floor preparation might include working on:

• Your pelvic floor’s ability to squeeze and ‘lift’

• Relaxing, downregulating and lengthening of your pelvic floor 

• Overall pelvic floor strength, endurance and coordination

• Birth positions 

• Pain management strategies for labour 

• How to ‘push’ 

• Perineal massage from 34 weeks (insert reference here) 

• Working on any other contributing factors - as there are many other parts of your body that can play a role in how your pelvic floor works e.g. breathing, hip and back mobility 

So…how does a Pelvic Health Physiotherapist assess your pelvic floor? 

There are three main ways that your pelvic health health physio might assess your pelvic floor - an internal pelvic floor examination, an external visual examination, or an examination via ultrasound. A pelvic floor assessment helps to understand your current pelvic floor function, as well as how to optimise it for your pregnancy, birth and beyond.

An internal pelvic floor assessment is the most comprehensive and is considered to be the ‘gold standard’ of pelvic floor assessment. In this type of assessment, further is understood about:

• Pelvic floor strength and endurance 

• Pelvic floor coordination and quality of movement 

• Pelvic floor relaxation 

• Pelvic floor tone or tightness 

• Pelvic floor support

• Pelvic organs 

• Pelvic floor response to coughing, bearing down or pushing 

Visual/external examination can assess whether your pelvic floor can contract and relax. It can also help understand how much support your pelvic floor is giving you, as well as how it responds to coughing, pushing and bearing down.

Ultrasound can assess whether your pelvic floor can contract or relax, as well as how it responds to a cough, bearing down or pushing. If you are a visual learner, ultrasound gives you that visual feedback to help you understand what’s going on as well! 

It is completely up to you (as well as whether there are any other medical/health factors to consider) as to how you have your pelvic floor assessed, and your pelvic health physiotherapist will take you through all of these options when you see them. 

When should I have my pelvic floor assessed?

This is dependent on many different factors. If you are experiencing a pelvic health condition or symptoms, having an assessment as soon as you can is beneficial to start your treatment and rehab plan.

Otherwise, there are two time points that I generally recommend seeing a Pelvic Health Physiotherapist for an appointment. The first time is during your second trimester (somewhere between 16-20 weeks is ideal) to assess your pelvic floor function and address any conditions/issues. 

The second time is at 34 weeks for a specific birth preparation appointment to help prepare your pelvic floor for birth. In this appointment, topics such as perineal massage, birth positions, pain management strategies for labour, and further pelvic floor relaxation strategies may be commenced. 

If you’d like to have your pelvic floor assessed, book in for your consultation today.