Birth Preparation
Pregnancy, birth, and postpartum can feel like a mix of emotions, unknowns, and questions. It doesn’t help that we are bombarded with mixed messages and unsolicited advice from social media, parents, and friends which can leave you feeling like all of your choices may not be the best. The good news is, pelvic health therapists can be with you every step of the way helping you feel your most confident and provide support and one-on-one guidance to help you prepare for childbirth and reduce or prevent the musculoskeletal complications that typically follow!
Whether you are someone who is or who is not having symptoms such as urinary leakage, constipation, pelvic pain, dyspareunia, or diastasis recti during pregnancy you can be seen and benefit from pelvic health physical therapist! We offer a childbirth prep package that consists of 4 sessions to ensure you have all of your questions answered and feel supported as you go through this journey.
Changes in the Pelvic Floor During Pregnancy
During pregnancy there are a lot of changes that happen with the body. Let’s start with the pelvic floor. The pelvic floor is a basket of muscles that attach from the pubic bone to the tailbone and side to side at the SITs bones. These muscles have many actions such as stopping the flow of urine and gas, supporting organs (bladder, uterus, and rectum), playing a role in sexual activity, stabilizing the pelvic structure, and pumping blood flow.
During pregnancy, your uterus is growing which is an organ that sits on top of the pelvic floor muscles. With this growth, the pelvic floor muscles naturally lengthen which can cause weakness and decreased support at this area. This natural lengthening can also be seen in the abdominal wall which can cause diastasis recti and poor pressure management. The ligaments that stabilize our pelvic structure are relaxing due to changes in hormones and our hips widening throughout pregnancy. With this, the muscles need to work harder to provide stability during transitional movements, walking, stair climbing, and lifting activities. If this is not happening, you could have pelvic pain with daily activities.
Physical Therapy
If you are not having symptoms during pregnancy or if your symptoms are mild, you may just require the 4 sessions through the childbirth prep package (1 evaluation and 3 follow up sessions). If you are having symptoms, you can certainly start with this package, but you may require a couple more sessions to ensure you are getting the necessary treatment.
In physical therapy, we will discuss your pelvic floor history prior to pregnancy and what has changed (if anything) during your pregnancy. We will go over your birth history, gynecological history, bladder, bowel, and sexual health history. If you are in your second or third trimester we may perform an internal pelvic floor muscle assessment as appropriate and with consent. With this, we will determine your pelvic floor muscle function, resting tone, and pelvic floor tenderness. In addition, externally we will also assess your abdominal, hip, and low back muscle strength, endurance, and coordination. We do not perform an internal assessment in the first trimester.
With our findings, we will educate and instruct you on good pressure management to reduce or prevent chances of DRA, prolapse, stress urinary incontinence, and hemorrhoids. We will improve movement patterns for lifting/carrying, getting in and out of bed and exercise routines to keep you moving through your whole pregnancy. Lastly, we will teach you how to perform a kegel and how to relax/lengthen your pelvic floor muscles to ensure your pelvic floor is working optimally during pregnancy, labor, and delivery.
As you are nearing the end of your pregnancy, we will go over specific labor and delivery techniques geared towards your goals whether that is having an at-home birth, birthing at an alternative birthing center, or birthing in a hospital setting. We will educate and instruct you on how to prep your pelvic floor for the delivery process and how to properly bear down in a variety of positions! We will also go over considerations to take for your pelvic floor in the immediate postpartum period (1-6 weeks). We recommend seeing a pelvic physical therapist after your 6 week check up to ensure things are heading in the right direction.