6 Reasons to Start Prenatal Pelvic Floor Physical Therapy

The nine months before baby arrives are usually filled with long lists of doctor’s appointments to keep, nursery equipment to buy, and baby showers to attend. While it may seem overwhelming to add another item to your baby prep checklist, prenatal pelvic floor physical therapy (PFPT) is one you don’t want to leave out. More than just the occasional kegel, PFPT is even more helpful when started during pregnancy.

What is Pelvic Floor Physical Therapy (PFPT)?

Layers of muscles and connective tissue form your pelvic floor, like a woven hammock. Like the base of a bowl, this sling spans from your pubic bone back to your tail bone and holds up your pelvic organs. The pelvic floor muscles help with the alignment of your spine and pelvis.

Pelvic floor physical therapy is a specialized kind of physical therapy that can help treat chronic pain, incontinence (leaking urine or stool), and painful sex. Just like all of your muscles, regular exercise also strengthens pelvic floor muscles. Pelvic Floor Physical Therapists receive special training in exercises and techniques to help you feel better during pregnancy, labor, and postpartum. PFPT during pregnancy can: 

Prepare and strengthen your pelvic floor and vaginal tissues for labor

Through biofeedback and other therapies, your PT can help teach you about your amazing pelvic floor muscles, the nerves that make them work, and how to put them to work for you during your labor and delivery. Did you know that the muscles of your pelvic floor actually help your baby’s head rotate to fit through your pelvis? A strong pelvic floor can help the baby’s head get in the correct position for a quick and easy delivery.

Reduce your chances of injury and pain during pregnancy

Diastasis rectus, lower back pain, and sciatica can all be related to your pelvic floor. A physiotherapist can help teach you correct posture, how to effectively strengthen your core and pelvic floor muscles, and continue to exercise during pregnancy safely.

Help you recover more quickly and easily postpartum

Every postpartum mom would love to have one less worry. If you have already found a pelvic floor physical therapist you trust, like working with, and have figured out insurance coverage, you are already a step ahead. It will be more likely that you will continue with physical therapy postpartum when you might need it most. Having a physiotherapist who already knows your body and what it was like pre-baby can help them better coach you to relearn muscle coordination. Because your muscles have already done the exercises before, muscle memory will help them recover more quickly.

Reduce your chances of leaking urine or stool (incontinence) before and after delivery

Leaking urine during pregnancy is common because of the pressure and size of your growing uterus on the bladder and pelvic floor, hormonal changes, and sometimes urinary tract infections. Your pelvic floor physical therapist can help teach you strategies for managing your fluid intake, preparing for the gush that might happen when you sneeze and give you strengthening exercises to reduce leakage during pregnancy. Preparing your pelvic floor ahead of delivery means that you start in a better place postpartum to retrain your bladder and pelvic floor muscles. Postpartum, especially after a very long labor or difficult labor, women may experience urinary and bowel problems.

Help with constipation

Pushing and straining when trying to have a bowel movement is one of the most harmful things to do for your pelvic floor. Unfortunately, because of hormones and the growing uterus, constipation is a common pregnancy complaint. Pelvic floor physical therapy exercises can help teach you how to relax your pelvic floor muscles to allow the stool to pass more easily. Your friendly PT can also help you learn and practice safer and more effective ways to push during labor.

Help you enjoy sex again

Many women worry about sex after childbirth, but with some prenatal planning with your PT, you can look forward to being intimate again with your partner. Your pelvic floor muscles’ rhythmic contraction creates powerful orgasms. The stronger your pelvic floor muscles, the more intense your orgasm.

Pregnancy and childbirth put your pelvic floor to the test. You are essentially asking your pelvic floor to run a marathon. You would train for a marathon, right? So, it makes sense to train your pelvic floor with PFPT prenatally. Talk to your doctor or midwife about referring you for pelvic floor physical therapy to increase the likelihood of insurance covering your visits. Make sure to see a specially-trained pelvic floor physical therapist who has experience working with pregnant and postpartum moms. Your body will thank you!

Amy Harris
Amy Harris is a certified nurse-midwife with a Master's Degree in Maternal and Child Health from Harvard Chan School of Public Health. Her passions are health literacy and women's reproductive health. A recent two-year sabbatical with her family in Spain was the impetus for becoming a freelance women's health writer. An exercise nut, she is happiest outdoors and on adventures abroad.

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