Pelvic floor problems during pregnancy or after childbirth.
muscles of the pelvic floor
The effects of pregnancy and childbirth on the pelvic floor muscles:
Pregnancy and childbirth can have a lasting effect on your pelvic floor muscle fitness. It is therefore important to look after these muscles during this important time of your life.
When you’re pregnant the hormone ‘relaxin’ is released throughout your body. This softens the tissues in your body, allowing it to expand as your baby grows. It also allows your pelvic floor to stretch during birth.
The softening effect of relaxin and the increasing weight of your baby places pressure on your pelvic floor muscles. This can make it harder for the muscles to hold your pelvic floor organs in their correct position. The pelvic floor muscles and ligaments are also stretched at birth, which can sometimes lengthen the tissues permanently.
Some women are more at risk of pelvic floor problems during pregnancy and childbirth than others. These include women who have had:
multiple births
instrumental births (using forceps or ventouse)
long second stage of labour (over 1 hour)
severe perineal tearing
large babies (over 4Kg)
If you experience any of these, you need to give your pelvic floor recovery and rehabilitate these muscles. If you have pain, find it difficult to feel your pelvic floor muscles or have any problems with bladder or bowel control after the birth, treatment is available from a womens pelvic health physiotherapist.
Pelvic floor muscle exercises are an effective way to maintain your pelvic floor fitness during and after pregnancy.
Good pelvic floor muscle tone assists women to maintain bladder and bowel control throughout pregnancy. They also help reduce the risk of developing a prolapse during or after pregnancy and assist with recovery after birth.
The pelvic floor muscles.
The function of the pelvic floor muscles?
The pelvic floor muscles give you the ability to control the release of urine (wee), faeces (poo) and flatus (wind), and to delay emptying until it is convenient.
When you contract the pelvic floor muscles, they lift the internal organs of the pelvis and tighten the openings of the vagina, anus, and urethra. Relaxing the pelvic floor allows passage of urine and faeces. These muscles provide support for the baby during pregnancy and then they need to relax during the birth process.
This function is especially important if your urethral or anal sphincter muscles do not work normally, which may be the case after giving birth.
Pelvic floor muscles are also important for sexual function in both men and women. In women, voluntary contractions or squeezing of the pelvic floor contribute to sexual sensation and arousal.
The pelvic floor muscles form the base of the group of muscles commonly called the ‘core’. These muscles work with the deep abdominal (tummy) and back muscles and the diaphragm (breathing muscle) to support the spine and control the pressure inside the abdomen.
The floor of the pelvis is made up of layers of muscle and other tissue. These layers stretch like a hammock from the pubic bone at the front to the coccyx (tailbone) at the back, and from one ischeal tuberosity (sitting bone) to the other (side to side). The pelvic floor muscles are normally firm and
How to exercise the pelvic floor muscles:
Sit or lie down to focus on the sling of pelvic floor muscles at the base of your pelvis. Imagine trying to stop the flow of urine or passing wind and gently lift up around your anus and tighten these muscles.
Try to hold for 3-5 seconds without clenching your buttocks or holding your breath. Then relax for 5 seconds and repeat 5-10 times.
You can also do 5-10 quick squeeze lifts of these muscles, called the “knack” important for when the muscle has to work quickly and strongly such as when coughing, sneezing, lifting or sit to stand.
Over active Pelvic Floor muscles:
Some women have an overactive pelvic floor which means they have difficulty relaxing this muscle, which can result in pelvic pain and bladder issues.
These women need to focus on the relaxing of the muscles over the tightening and holding sensations.
Where to get help?
If you are experiencing any Pelvic floor issues during pregnancy or after childbirth:
leaking of urine after you cough, sneeze, laugh,
urgency to get to the toilet in time,
difficulty emptying your bowel or bladder,
pelvic pain,
pain during sexual intercourse,
a heavy sensation or bulging in your vagina,
PLEASE consult a womens’ health physiotherapist to have an assessment and get advice, education and treatment to improve your symptoms.