Why Pelvic Floor Physiotherapy During Pregnancy?
When people think of pelvic floor physiotherapy, they typically think of postpartum moms, incontinence, and Kegels! So often we see patients seeking physiotherapy reactively, addressing issues after they appear. I believe strongly that physiotherapy should be preventative in nature, and that every pregnant mom should be given a referral to pelvic floor physiotherapy PRIOR to delivery, regardless of if their delivery will be caesarean or vaginal. I love working with women before or during their pregnancies to avoid common postpartum concerns and to empower and educate them on all aspects of delivery.
A testimonial from a patient that comes to mind was a patient who saw me in preparation for her first vaginal delivery.
Her labour progressed very quickly, and she ended up delivering in the car on the way to the hospital! She told me after the fact that one of the only things that
helped her during this time was what she learned during our sessions together. Most memorably how to properly push.
Each woman’s pelvic floor is different, and while one woman may need to strengthen their pelvic floor to continue to meet the increasing demands on the pelvis throughout pregnancy, another woman may need to work on down training and relaxing their pelvic floor. It’s only through a pelvic floor assessment that we can find out which of these are suited for you.
Some of the things I address during my time working with my pregnant patients include core recruitment and diastasis recti, pushing techniques, perineal massage, birthing positions, caesarean recovery postpartum exercises, and what to expect from recovery from both vaginal and caesarean deliveries.
Some common reasons to see a pelvic floor physiotherapist during pregnancy include:
- General check up! (Come find out how your pelvic floor is doing, and what YOU need to work on!)
- Pelvic or low back pain and what to do about it
- Diastasis Recti - what it is, strategies to use, and how to return to exercise
- Incontinence (bowel and bladder) prevention now and for later in life
- Heaviness/pressure through pelvic floor
- Painful intercourse
SO, what are some of my main tips for preparing for delivery?
Let’s assume you are preparing for a vaginal delivery.
- PERINEAL MASSAGE: this is a technique that we perform to significantly decrease the risk of higher severity perineal tearing.
- I spend a good chunk of time reviewing exactly HOW we do this technique during the assessment
- BELLY BREATHING: this type of breathing stimulates our parasympathetic nervous system and helps our abdominal and pelvic muscles relax!
- Lay on your back in a comfortable position
- Take a deep, slow breath in through your nose, on the count of 4
- Feel your belly rise and expand with this breath, keep your upper chest relaxed
- Exhale through your mouth
- CORE RECRUITMENT: practice recruiting your transverse abdominis, your inner core, throughout your pregnancy to maintain tension through your core! This helps with diastasis recti, lower back pain, and pelvic floor function!
- Sit or lay down in a supportive position
- Imagine doing up a zipper from your pubic bone to your belly button with your abdominal muscles. Your glutes should remain relaxed and your pelvis should stay still.
- Practice holding this tension for 10s, while you keep breathing!
- Once you have mastered this, you can start recruiting this muscle functionally throughout the day, as well as adding in more dynamic exercises such as heel slides, bird dog or dead bug, or supine marching!
I hope these tips are helpful for you in your pregnancy and if you would like more information please don’t hesitate to book in with a Pelvic Floor Physiotherapist who can help address your specific concerns.
Written by Meghan Murphy, PhysiotherapistPT, MSc.PT, BSc.
Meghan grew up in Calgary competing in dance, Kyokushin Karate, tennis, and rugby. As a result of her active upbringing, she had her own personal experiences with physical therapy, inspiring her to pursue physical therapy as a career. She completed her Bachelor of Science in Health and Exercise Physiology at the University of Calgary before earning her Masters of Science in Physical Therapy at the University of Alberta Meghan started her career in orthopaedics and her approach to physical therapy is grounded in strong manual therapy skills combined with education and individualized exercise prescription. Meghan continues to treat orthopaedic injuries, but has a passion for Pelvic Floor Physiotherapy. Her experience in treating orthopaedics is fundamental for any Pelvic Floor Physiotherapist in order to fully appreciate the pelvic floor's role and influence in many orthopaedic injuries and pain.
She has taken advanced training to specialize in Pelvic Floor Physiotherapy that allows her to treat conditions such as bowel and bladder incontinence, pregnancy and postpartum, and pelvic pain. She is passionate about educating and empowering women to take an active role in their health and recovery.