Pelvic Floor during Pregnancy, Birth and Beyond

Your pelvic floor muscles are tasked with some pretty important roles - they support your pelvic organs, control your pelvic openings and stabilise your spine. During pregnancy and in the post-natal period, they are often stretched (quite literally) to their limit. As a pelvic health physio, one of the most common things I hear is “I wish I had known this sooner.”

So, let’s change that….

What is the pelvic floor?

The pelvic floor is a group of muscles, ligaments and connective tissue that forms the base of your pelvis. Think of it like a trampoline, sitting beneath your bladder, uterus and bowel. It controls your bladder and bowel function, supports your pelvic organs, ensures you have good sexual function and works together with your back and abdominal muscles to stabilise your spine.

When the pelvic floor is working well, you don’t really notice it as it just does its thing. When it is not working well, you’ll often know about it! You might start to leak urine with a sneeze or cough, experience pelvic heaviness or sex may start to hurt. These are all signs that your pelvic floor needs attention.

During Pregnancy

Your pelvic floor will adapt throughout your pregnancy, responding to changes in your hormones that gradually encourage your connective tissue to loosen ready for the delivery of your baby. Things you can do to optimise your pelvic floor function during pregnancy include:

See a Pelvic Health Physio Proactively

An assessment of your pelvic floor during pregnancy in the second (or third) trimester can identify any early pelvic floor dysfunction and set you up for success, ensuring you have a pelvic floor program that is tailored to your individual lifestyle and needs.

Avoid Straining

Constipation is common in pregnancy so making sure you drink the right amount of fluid, eat a fibre-rich diet and use a footstool on the toilet to avoid bearing down excessively is really important (click on the link and get yourself one right now!).

Get a Pelvic Floor Plan

Your pelvic floor physio will develop a plan that is right for you. It may be a strength program, or a relaxation regime or a combination of both depending on your pelvic floor (this is why an assessment is really important).

Exercise Right

If you are leaking or experiencing heaviness or pain with your workout, it may need to be modified but different bodies are different so again, an assessment and an individualised plan can be really helpful. Physio led pregnancy classes will always have a focus on the abdominals and pelvic floor so this can be a great place to start if you are not sure. Here is a link to one I highly recommend.

During Labour and Birth

Birth is one of the most significant events you and your pelvic floor will experience. Perineal tears, an episiotomy, prolonged pushing time (over 2 hours) and instrumental deliveries (forceps or ventouse) can all affect pelvic floor muscles and nerves.

Research supports performing perineal massage from around 34 weeks to reduce the likelihood of severe tearing - your pelvic health physio can guide you on your technique. During pushing, working with your contractions and avoiding prolonged holding of your breath can reduce strain on your pelvic floor.

The Postnatal Period

During the weeks and months after giving birth, your tissues will usually make a very impressive recovery. You still may require a pelvic health physio to help you navigate the pelvic floor rehabilitation whether you have had a vaginal delivery or a caesarean section (the muscles are still carrying the weight of the baby as it grows).

Some Top Tips for Pelvic Floor Recovery

Start some gentle pelvic floor squeezes in the days and weeks post birth – this helps connect your brain to the muscles and can act like a muscle pump to help reduce any swelling you may have in the perineum.

Book in to see your pelvic floor physio around 6 weeks after your birth for an assessment of your pelvic floor. They can assess your pelvic floor function, scar tissue and give you a personalised plan for rehab/return to exercise.

Walking is the ideal exercise for the first 6 weeks as doing too much high impact exercise too soon can put increased strain through your pelvic floor and lead to dysfunction (such as leaking or heaviness). If you are keen to return to running, wait until 3 months post birth and get a pelvic floor assessment before you start.

The Bottom Line

Your pelvic floor deserves care and attention during and after your pregnancy to ensure it can serve you well throughout your life. The good news is that with the appropriate treatment, most pelvic floor dysfunction is treatable. Don’t wait until your symptoms are your new normal, early intervention can make all the difference.

If you would like a personalised pelvic floor assessment, call the rooms at Rose Green Physio on

8239 2811.