THE PELVIC FLOOR IN PREGNANCY
PELVIC FLOOR EXERCISES AND HOW TO DO THEM
If you’re reading this and you’re pregnant – congratulations! One of the first things that you’ve probably (and regularly!) been asked is “are you doing your pelvic floor exercises?” It seems that we hit pregnancy and all of a sudden everyone is interested in them.
But for many of us this is the first time we’ve ever considered our pelvic floor muscles: What in fact are they? What happens to them in pregnancy? When should you start doing pelvic floor exercises? And the all important question… How do you actually do them??
Here we hope to break all this down for you.
FINDING YOUR PELVIC FLOOR
So firstly, what is your pelvic floor? The pelvic floor is a sling of muscles at the base of the pelvis. Kinda exactly what it says: the floor of the pelvis. It runs from the coccyx at the back to the front of the pelvis, with space for the rectum, vagina and urethra to pass through. There are many layers made up of both fast and slow-twitch muscle fibres.
The role of the pelvic floor is to:
- Keep us continent of urine, fecal and wind
- Contribute to sexual pleasure
- Support the spine as they make up part of the deep abdominal group of muscles.
HOW DOES PREGNANCY AFFECT YOUR PELVIC FLOOR?
During pregnancy, the pelvic floor stretches to make room for the growing baby. It works super hard as it needs to support the growing weight of the baby, placenta, amniotic fluid etc. It is also softened by the effects of pregnancy hormones, causing it to be stretched and lengthened.
Over time, the muscles become weak from being weighed down. Instead of bouncing back to provide support, the weakened muscles may not return to their optimal location. Whether you end up giving birth vaginally or by caesarean, the pelvic floor is impacted so it’s always worth seeing a pelvic floor specialist when your bubba has arrived.
WHEN SHOULD YOU START DOING YOUR PELVIC FLOOR EXERCISES?
The NHS recommends to start pelvic floor exercises as soon as you find out you’re pregnant. It helps to keep them strong from the outset and also gets you into a good habit of doing them regularly!
For the first 30 weeks you want to focus on the lift, whilst still remembering to release. However 30+ weeks you should focus on the release as we start to think about birth.
HOW DO YOU PERFORM YOUR PELVIC FLOOR EXERCISES?
A lot of the time we might be given a leaflet by our pregnancy caregiver, or advised to just squeeze, hold in a fart etc, which can all be effective… but how do we know if we’re doing them correctly?
As mentioned above the pelvic floor is made up of two types of muscles and these need to be trained in two separate ways.
Take a deep breath in
Think about holding in a fart as you breathe out. (you should feel a squeeze around your back passage and your vagina.
Take a full inhale and fully relax, try taking another deep inhale if this helps.
Repeat this x10
Try some where you hold for up to 10 seconds whilst you’re breathing in and out.
Don’t worry if you can’t hold for 10 seconds to begin with, you can gradually build up to this.
Repeat this x10
You want to try and do x10 of these, x3 a day during pregnancy. Try in a range of positions, lying down, seated, standing up and whilst moving.
HOW CAN I REMEMBER TO DO MY PELVIC FLOOR EXERCISES?
They can feel like a drag can’t they, and how do you remember to do them?
It can be useful to tag them on to an existing routine, such as brushing your teeth in the morning and evening. I’ve found it useful to put a post-it on the mirror as a prompt, and often recommend this tip to friends and clients.
You can do them whilst in the car, on the school run or waiting at the traffic lights. One really good resource is the squeezy app, recommended by the NHS.
Alternatively, invest in the fabulous pelvic floor trainer, Elvie. It’s a little bit pricey but from what I’ve heard it’s totally worth it. You can use it during pregnancy and postpartum too. It makes a game of the squeezes so it makes it slightly more fun too! Mine is on order, so I’ll be writing a review of it in a few weeks. I’m definitely excited to try it and will let you know what I think!
WHAT ELSE CAN YOU DO TO SUPPORT YOUR PELVIC FLOOR?
There are a few lifestyle things you can do to support your pelvic floor:
- Make sure you don’t hold your breath whilst you’re getting out of bed, out of the bath, out the car.
- Instead perform these movements on an exhalation
- Visualise the pelvic floor moving with the breath
- You can challenge the pelvic floor muscles by adding in movement, such as squats/lunges or by adding resistance.
I hope this has helped you. If you are in any doubt of how to do them please reach out to me or a women’s health physio to get an assessment. There are great, trustworthy resources such as the Royal College of Obstetricians and Gynaecologists and The NCT Charity too.