How does pelvic floor physical therapy help prepare me prepare for labor and delivery?

Pelvic floor physical therapy can help you maintain appropriate hip and pelvic mobility, teach appropriate pelvic floor movements, coordinate your breathing for pushing, and perform and teach you how to perform perineal massage to reduce tearing.

The pelvic floor is a set a muscles that we cannot see, so often we depend on just ‘feeling’ what they are doing. Pelvic floor physical therapists are able to do an internal vaginal assessment to specifically assess those muscles in order to help you train your pelvic floor for labor and delivery!

Contrary to popular belief, your pelvic floor does not push out your baby - your uterus actually does! Your pelvic floor has to get out of the way, and it does that by ‘relaxing’. We often think that our pelvic floors have to be squeezing and tightening, but especially during labor, the pelvic floor should be doing the opposite (should be ‘lengthening’).

At your first visit, we will discuss the anatomy of the pelvic floor and the relevant boney and ligamentous structures - there are a LOT of things involved in this area! An exam will follow - sometimes we will assess your hips/low back/ribs, posture, balance and movements as well!

Then, if appropriate, your pelvic floor physical therapist will perform an exam to determine your pelvic floor’s baseline:

• muscle tightness

• muscle coordination

• muscle strength

• ability of muscle to relax

• coordination with breathing

• core activation

An internal pelvic floor exam can be quite enlightening as you will be getting real-time feedback on what your pelvic floor is actually doing, as well as finding out what you actually need to be doing. We will be assessing for all the above, but also looking for issues such as prolapse, leaking, heaviness, hemorrhoids etc so that we can best help you to find positions and exercises that do not aggravate those.

Starting at about 34-35 weeks during your pregnancy, focusing on pelvic floor relaxations is key to start getting your body prepared for delivery. We will also demonstrate and review how to perform perineal massage to help decrease the risk of severe perineal tearing, as well review labor and delivery positions so that you can feel how your pelvic floor might feel in various positions.

More questions about labor and delivery and how pelvic floor physical therapy might help? Schedule a discovery call or an appointment!