by Michelle Kenway Pelvic Floor Physiotherapist
Keeping your pelvic floor in good shape during pregnancy and after childbirth is a positive step you can take towards preventing long term pelvic floor problems. This article helps you understand the effect of childbearing and pelvic floor changes during pregnancy.
Where is the Pelvic Floor?
The pelvic floor sits at the base or lower opening of the bony structure called the pelvis (shown right).
Located inside the body, the pelvic floor is invisible and can’t be seen from outside. The female sex organs (i.e. vulva, labia and entrance to the vagina) all sit below the pelvic floor. The pelvic organs (i.e. the bladder, uterus, rectum and anal canal) are all positioned above the pelvic floor.
What is the Pelvic Floor?
Sometimes the words ‘pelvic floor’ are used interchangeably with ‘pelvic floor muscles’ however in these structures aren’t exactly the same.
The pelvic floor is made up of a number of structures including the pelvic floor muscles along with nerves, blood vessels and connective tissues.
The pelvic floor muscles are part of the pelvic floor. They sit in layers and sling across the area where you sit like a mini trampoline. Pelvic floor muscles run from the pubic bone at the front, to the lower part of the tail bone at the back and from side to side between the sit bones. This position makes them vulnerable to strain and injury, especially during pregnancy and after childbirth.
What is the Role of the Pelvic Floor?
The pelvic floor helps your body in a number of ways during pregnancy acting to support, control and stabilise.
- Inner Support
Your pelvic floor supports or holds up the organs including your uterus and growing baby. Your pelvic floor resists and counteracts the pressure associated with the increasing load combined with your everyday activities.
- Bladder and Bowel Control
The pelvic floor assists in storing and emptying wastes from the bladder and bowel. Women commonly experience changes in bladder and bowel function during pregnancy caused by pregnancy hormones and the increasing load acting on the pelvic floor causing decreased control.
- Pelvic and Spinal Stability
The pelvic floor muscles work with other muscles and tissues in the body to hold together and stabilise the joints of the pelvis and spine. Pregnancy is a time when pelvic and spinal stability is challenged often leading to lower back and/or pelvic dysfunction and associated discomfort.
- Sexual Sensation and Response
The pelvic floor muscles play a role in sexual arousal and orgasm. Sexual sensation and orgasm can be heightened during pregnancy with increased pelvic blood flow, sensitivity and vaginal lubrication.
How your Pelvic Floor Changes with Pregnancy and Childbirth
During pregnancy and childbirth your pelvic floor undergoes many changes:
- Hormonal changes cause the tissues to soften and become more elastic to prepare for delivery and accommodate your growing baby
- As your uterus increases in weight, progressively more pressure is placed on your pelvic floor, bladder and bowel – sometimes causing pelvic floor problems such as stress incontinence or constipation
- During pregnancy the pelvic floor muscles and tissues become progressively more vulnerable to stretch and associated weakness
- During vaginal delivery the pelvic floor muscles and tissues stretch well beyond their normal limits causing pelvic floor weakness immediately after delivery
- Trauma and damage to the pelvic floor muscles, tissues and nerves can occur during vaginal delivery contributing to post natal pelvic floor dysfunction. Pelvic floor exercises can help in the recovery and prevention of long-term pelvic floor problems of the pelvic floor after pregnancy and delivery.
All women are at risk of pelvic floor problems after childbirth regardless of whether they have a vaginal delivery or a caesarean section.
Pelvic Floor Exercises after Childbirth
Pelvic floor exercises are important for pelvic floor recovery following pregnancy and childbirth. Pelvic floor exercises help restore pelvic floor strength and support which can prevent and overcome pelvic floor problems.