Why All Women Need Pelvic Floor Physical Therapy During Pregnancy

Many women have never heard of pelvic floor physical therapy, let alone recognize the benefits of it before having a baby. In my experience, most assume pelvic floor physical therapy is for those with significant and ongoing symptoms.

While that is true, it is so much more than that!

There are so many benefits to preparation work before the big day: delivery. Over the years, most of my pregnant patients have started pelvic floor physical therapy due to a specific complaint such as back pain, pubic symphysis dysfunction, constipation, or urinary incontinence/urgency/frequency, for example.

However, I have started to see a shift in recent years, noticing women reaching out to “learn how to push and be prepared.”

Labor and delivery prep work is truly one of my favorite things to educate on because I believe an informed and prepared mom always creates a better delivery experience. As they say, knowledge is power. Very seldom we are told or taught what to expect and how to prepare. Many delivering providers don’t have the time, resources, or quite frankly, the knowledge.

I love being that person of support for my clients!

So, here’s what you will (or should) learn in pelvic floor physical therapy during pregnancy:

1. How to improve tissue and muscle health to prevent perineal tearing.

That’s the one everyone is afraid of. Perineal tears can be common and nothing can 100% guarantee that it will not happen. However, limiting the likelihood and severity is the goal! Internal pelvic floor work by your therapist and at home exercises such as perineal massaging are two important roles in preparing tissues for birth.

2. How to push effectively.

Pushing technique directly impacts the likelihood of tearing. Oftentimes we are told in the hospital setting to hold our breath and bear down as hard as possible. While at times that technique might be needed, the use of your breath helps to guide baby down as the uterus contracts.

Work smarter, not harder!

The role of the pelvic floor muscles during delivery is to lengthen and move out of the way. Therefore, muscle lengthening, range of motion exercises , and manual hands on techniques help accomplish this.

3. Positional strategies for labor and delivery.

There are many options for labor and delivery.

Even if you plan to get the epidural, know that you have options other than lying on your back! Movement is so great during labor, and I like to go over examples of what is best for baby to descend.

4. Deep core and glute strengthening.

Core and glute strength are essential for stability for women, especially as the pelvis changes during pregnancy. Focusing on these areas helps prevent or treat pain, diastasis or prolapse. Exercise in pregnancy also has been shown to lessen long, drawn-out labor and improve post-partum healing/recovery.

5) Spine and hip opening.

Several mobility or stretching exercises are great for pregnancy for the prevention or treatment of pain. I also like to get patients started on a specific stretching protocol in the 3rd trimester for what I call hip opening. Hip position (opening and closing) plays a helpful role during labor and pushing stages to facilitate proper baby positioning.