Is there anything I should be doing in pregnancy to support pelvic health?
This blog post is part of our monthly knowledge drop! Each month for our newsletter, the Lady Blurb, we'll share answers to some questions you've submitted. The questions below were taken directly from you! To submit a question for next month, comment below or email us at contact@ladybirdpt.com.
Submitted question: Is there anything I should be doing in pregnancy to support my pelvic health?
Heck yes. Despite most people not thinking about their pelvic health until after their baby arrives, taking care of your pelvic floor before and during pregnancy is one excellent way to set yourself up for postpartum recovery.
Here are 4 ways to care for your pelvic health during pregnancy:
Address underlying pelvic floor dysfunction
While pelvic floor symptoms increase in prevalence during pregnancy and following childbirth, it’s common to experience leakage, pain with sex, constipation, pelvic pain and other pelvic floor conditions during adolescence and adulthood. There are so many people entering into pregnancy with underlying pelvic floor symptoms and conditions. These underlying pelvic floor conditions have the potential to impact your health during pregnancy, your birth experience and your postpartum recovery.
How can they impact your health, you ask? Fantastic question.
The symptoms I mentioned above are often caused by pelvic floor dysfunction. This can mean tight pelvic floor muscles, weak pelvic floor muscles, or poorly controlled pelvic floor muscles. In order for your pelvic floor to support your body through pregnancy, these muscles need to be strong enough to hold up the progressively increasing weight of your uterus, placenta and baby. During a vaginal birth, these muscles need to be able to relax, stretch and release to allow your baby to pass through the birth canal. Once your baby is born, they need to wake back up, turn back on, and kick in to to support your healing internal organs and core as they recover from the months of pregnancy. This remains true for folks following a cesarean as well.
Addressing the weakness, tension and control deficits that have developed prior to pregnancy will support these muscles in their ability to support a healthy pregnancy, birth and postpartum recovery. It’s also common for these symptoms to arise during pregnancy. As with any health condition, the sooner you address your symptoms, the sooner they improve. Symptoms during pregnancy are an indicator for symptoms following pregnancy but treatment during pregnancy can reduce the risk of symptoms continuing postpartum.
Manage underlying constipation
Constipation places a huge stress on your pelvic floor in a couple of ways:
When we have stool stuck in the rectum, that’s extra weight for your pelvic floor to support.
When we push and strain to have a bowel movement, that’s added stretch and stress to your pelvic floor.
As a result, chronic constipation leads to chronic stress on the pelvic floor. Managing underlying constipation, reducing the need for pushing and straining, and reducing the stress to your pelvic floor can help keep your pelvic floor healthy during pregnancy as well as postpartum.
Learn more about constipation management here.
Prioritize movement
Moving your body, whether it’s a 30 minute gym workout 3x/wk or a daily 30 minute walk, helps to maintain cardiovascular endurance, balance, lower body strength. All of these factors are important for pelvic health. Prioritizing movement can mean walking your older kids to the park, walking your dog, a 20 minute yoga flow, swimming a few days a week or 10 minutes of daily strength training. The options are endless and should be modified to fit your needs.
Check out the American College of Gynecology’s recommendations for exercise during pregnancy.
Have a pelvic floor physical therapy evaluation
Everyone has unique needs during pregnancy. While some folks need to prioritize strengthening, others benefit more from prioritizing flexibility. This is part of what makes online information about prenatal care so difficult to navigate. People’s needs are highly variable.
While some need coaching on which forms of exercise may be appropriate to incorporate during various stages of pregnancy, others may need help understanding how to reduce intensity in their training regimen. Pelvic floor physical therapists can offer you a baseline assessment to better understand your strengths and weaknesses in order to create a personalized program for the remainder of your pregnancy and postpartum recovery.
Sign up for our newsletter to keep learning with us or send us a message to schedule a virtual or in-person physical therapy appointment if you’d like to learn more about prenatal pelvic health care.
This post was written by Dr. Rebecca Maidansky, PT, DPT, owner and founder of Lady Bird Physical Therapy. Rebecca is a pelvic floor physical therapist in Austin, TX and founded Lady Bird Physical Therapy in 2019. She is the creator of Birth Preparation and Postpartum Planning, Baby Steps Fitness and the head writer and editor of The Pelvic Press.
Rebecca is a passionate writer and vocal advocate for pelvic health and the importance of improving access to perinatal care. She believes strongly that many common pregnancy pains and postpartum symptoms can be eased or even prevented with basic education and care.
She created this blog to help all birthing people manage common pregnancy pains, prepare for birth and recover postpartum.