What Is the Pelvic Floor and Why Is It Important in Pregnancy?

Pelvic Floor Pregnancy

Throughout pregnancy your body changes in many obvious but also in some not-so-obvious ways. While it’s easy to see some changes, such as your baby bump expanding, other changes, such as the stretching of your pelvic floor muscles, are not as visible but very important in preparing your body for childbirth.

The pelvic floor muscles play a special role in your baby’s delivery, helping to guide the baby through the birth canal, but to do that they must first stretch and soften.

The pelvic floor is composed of layers of muscles, along with ligaments and connective tissues, that stretch from the pubic bone to the tailbone. These muscles help support the bladder, bowel, uterus and vagina, as well as stabilize the joints of the pelvis and spine. During pregnancy these muscles also help support the weight of the growing baby and assist in the birthing process.

As part of planning for that process your body releases a hormone called relaxin that softens and relaxes the ligaments and muscles of the pelvic region, so that the baby’s head can push through during birth. By the time you reach the third trimester the weight of the growing baby places more pressure on the pelvic floor, stretching the pelvic muscles. That pressure is why women often feel an urgent need to urinate in the third trimester and most pregnant women experience some stress incontinence.

The softening and stretching makes childbirth easier but can also traumatize the muscles to such a degree that it causes pelvic floor problems after delivery.  Whether or not a woman has a vaginal delivery or a cesarean, after childbirth she might find that she continues to suffer from stress incontinence, that is she might leak a little urine while laughing, coughing, or sneezing for a few weeks after delivery or even longer. Some women also suffer from lower back pain or pelvic discomfort because the weakened pelvic floor muscles no longer effectively stabilize spine and pelvic joints. Weak pelvic floor muscles can also reduce vaginal sensation during sex.

Fortunately, pelvic floor exercises, also known as Kegel exercises or Kegels, can help prevent long-term pelvic floor problems by strengthening these muscles. These exercises can be done during pregnancy and after childbirth.

Here’s how to do pelvic strengthening exercises:

* First, you have to find the pelvic floor muscles. The easiest way to find your pelvic muscles, is to try to stop urinating in midstream. If you are successful, you have the right muscles.

  • Contract the muscles and hold that contraction for five to ten seconds, then release. Do this exercise ten times and repeat each set three to five times a day.
  • Although the first time you try this exercise you may want to lie down, the beauty of this exercise is that you can do it anywhere and at any time. No one will notice you are doing them.

Follow this regimen and you can usually expect results within a few weeks or months.

If you have any problems with the exercises or are not getting the desired results, don’t be embarrassed. Talk to your doctor.

Sometimes trying kegels on your own does not work. You may think you are doing them correctly but need some help. If you experience stress incontinence that does not respond to pelvic floor exercises,  your doctor may recommend some therapy or refer you to a continence professional.

If the pelvic floor muscles become too loose a woman may develop long-term problems, which include a pelvic floor prolapse, in which the muscles can no longer support the pelvic organs so that they drop or press into or out of the vagina. Age and obesity may play a part in developing pelvic floor prolapse, which often requires surgery. Let your doctor know if you suffer any of the following symptoms after childbirth:

  • persistent incontinence that does not respond to pelvic floor exercises
  • a sensation of pressure or pain in the pelvic area
  • painful sex

While problems caused by a weakened pelvic floor are treatable, it’s a smart idea to proactively start doing kegel exercises during pregnancy and minimize your chances of developing such problems.

Joan MacDonald
Joan Vos MacDonald has written about health and fitness for newspapers, magazines and websites. She is a member of the National Association of Science Writers and the author of two books on health-related topics, "Tobacco and Nicotine Dangers," for young adults, and "High Fit Home," a design book about fitness and architecture. She lives in upstate New York near her children and grandchildren.

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