Pregnancy and the Pelvic Floor

Experiencing pregnancy is one of the most challenging and rewarding processes to go through as a woman. With all the changes that you experience both emotionally and physically, it's no surprise that your pelvic floor is not exempt! In fact, the pelvic floor muscles help to rotate your baby's head into the correct birthing position, whilst also supporting the weight of the growing uterus.


Contents

  1. Preparing for Pregnancy
  2. After Childbirth

What Happens to Your Pelvic Floor During Pregnancy?

Whilst the pelvic floor muscles do a great job in aiding pregnancy, they're also put under an extreme amount of pressure. Your pelvic floor muscles are vulnerable to weakness due to the extra weight from the baby. This weakness can become dangerous as early as 12 weeks into pregnancy. It's not uncommon to experience discomfort during this period, or even a pelvic floor disorder such as urinary incontinence starting to occur. You may continue to suffer during later stages of your pregnancy and unless dealt with it can continue after the birth.

It's also important to note that the risk of developing a pelvic floor disorder increases both with age, and each birth, due to the weakening of the pelvic floor. To learn more about preparing your pelvic floor for pregnancy, visit Preparing for Pregnancy.


What Happens to Your Pelvic Floor After Childbirth?

The risk of developing a pelvic floor disorder following a traumatic vaginal birth - where instruments such as forceps or vacuums are used, if your baby was large, or delivery was prolonged - is significantly higher than those who undergo a caesarean (C-section) delivery.

In terms of C-sections, don't assume that because you didn't have a vaginal delivery that you aren't susceptible to pelvic floor disorders. 43% of women that undergo a caesarean delivery still experience one or more pelvic floor disorders due to the changes that happened throughout the pregnancy.

Even the most uncomplicated vaginal deliveries have a negative effect on your pelvic floor, but it's important to remember that these damages can be reversible! To learn more about what happens to your pelvic floor after childbirth, visit our After Childbirth page.


What Can You Do to Help Your Pelvic Floor During and After Pregnancy?

It's important to work on improving and maintaining your pelvic floor strength both whilst you are expecting and after the birth. Whether you're a mum-to-be or a mum of three, you'll have probably heard about pelvic floor muscles. But you may not be aware of how important they are.

Before and during pregnancy, you should begin pelvic floor (Kegel) exercises regularly. These can often be a preventative measure towards pelvic floor disorders that can develop in later pregnancy and after birth. Kegel exercises are easy to do whilst you are resting during pregnancy; you can even do them whilst watching TV (multi-tasking at its finest).

It's important to know what muscles you should be using, as 50% of women do not, making weaknesses even worse. For more information on pelvic floor exercises, visit How to Find Your Pelvic Floor Muscles, and Safe Pelvic Floor Exercises During Pregnancy.


What Should You Do If Something Is Not Right With Your Pelvic Floor?

Pelvic floor disorders, such as incontinence and pelvic organ prolapses, can be distressing and unfortunately they are very common in mums to be. However, improving and maintaining the strength of your pelvic floor muscles can reduce your risk.

Most mild and moderate pelvic floor damage can be reversed through pelvic floor exercises alone. However, you should speak to your GP if:

  • You're having problems with your bladder or bowel.
  • You think you might have suffered a prolapse.
  • Sexual intercourse is painful.
  • You are having difficulty with pelvic floor muscle exercises.


Sources

Hay-Smith, E.J.,Dumoulin, C. (2006). Cochrane Database of Systematic Reviews. Pelvic floor muscle training versus no treatment, or inactive control treatments for urinary incontinence in women. [online]. 25(1). [viewed 01/08/2018]. Available from https://www.ncbi.nlm.nih.gov/pubmed/16437536

Morkved, S., Bo, K. (2000). International Journal of Obstetrics and Gynaecology. Effect of postpartum pelvic floor muscle training in prevention and treatment of urinary incontinence: a one-year follow-up.[online]. 107(8), pp. 1022-1028. [viewed 01/08/2018]. Available from https://www.ncbi.nlm.nih.gov/pubmed/10955436

Morkved, S., Bo, K. (2014). British Journal of Sports Medicine. Effect of pelvic floor muscle training during pregnancy and after childbirth on the prevention and treatment of urinary incontinence: a systematic review. [online] 48(4), pp. 299-310. [viewed 01/08/2018]. Available from https://www.ncbi.nlm.nih.gov/pubmed/23365417

Pelaez, M. et al. (2013). Neurology and Urodynamics. Pelvic Floor Muscle Training included in a pregnancy exercise programme is effective in the primary prevention of urinary incontinence: A randomized controlled trial. [online] 33(1), pp. 67-71. [viewed 01/08/2018]. Available from https://pdfs.semanticscholar.org/6681/fca29bf4f6347bb04ac3bb91efb5022b96a4.pdf

University Hospital Bristol (2017) Pregnancy and The Pelvic Floor [online] NHS [viewed 01/08/2018]. Available from http://foi.avon.nhs.uk/Download.aspx?r=1&did=15323&f=PregnancyAndThePelvicFloor-4.pdf .

Wijma, J. et al. (2001). British Journal of Obstetrics & Gynaecology.Anatomical and functional changes in the lower urinary tract during pregnancy. [online]. 108(7), pp. 726-732. [viewed 01/08/2018]. Available from https://www.ncbi.nlm.nih.gov/pubmed/11467699