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Things You Should Know About Your Pelvic Floor Before, During, & After Birth

Written by James Kicinski-McCoy

Photography by Photograph Courtesy Of Allison Oswald

Regardless of if you’re pregnant, trying to conceive, or well past the child-bearing years, staying knowledgable about your body’s make-up and the various physical stages it will go through—past, present, and future—is of the utmost importance. Perhaps one of the most mystifying body parts for women is the pelvic floor. If you, too, find the “PF” hard-to-find as well as hard-to-know, don’t fret. Below, women’s physical therapist specializing in pelvic health pre and post-natal, Allison Oswald, breaks down everything you need to know.

When a woman thinks of the pelvic floor, she most often thinks kegels. However, it’s time for all women to know that there is so much more to the pelvic floor than just that. The pelvic floor is a key component to the core system. Giving support to the contents of the abdominal cavity, maintaining sphincter control to the bodily systems, and providing sexual function and pleasure, it goes well beyond simple contracting.

Connecting to the pelvic floor is empowering, grounding, and strengthening, for a healthy pelvic floor functions all day, everyday, without too much recognition. And, most women are not in tune to how it works until a problem or dysfunction arises. But, if women can understand its function prior to that, they’ll be more prepared to mediate an issue, possibly preventing dysfunction, and be able to heal or recover more efficiently from an injury or childbirth.

To break it down, the pelvic floor is a sling of muscles at the base of the pelvis that connect from the tailbone to the pubic bone. They contract in anticipation of movement to stabilize the pelvis, as well as lengthen to accommodate any increased pressure, such as with a cough or a sneeze. These muscles work in conjunction with the diaphragm, our major breathing muscle, which is why breath is so crucial in connecting to the pelvic floor. These two components also work together with the deepest abdominal muscles and back muscles. Together these four parts make up the “core”, or “stabilizing system”. Keeping these parts aligned properly also contributes to proper function. Alignment is unique to each individual, but in general, it is advised to keep a neutral posture, meaning the pelvis is neither tipped forward nor backwards, and the rib cage/diaphragm is stacked directly on top of the pelvis. This way, the upper chest is neither puffed up or rounded down. With this alignment and diaphragmatic breathing, the core system is set up to work as efficiently as possible.

Thinking about becoming pregnant, experiencing pregnancy, and recovering from pregnancy are all phases of life where women become more attuned and aware of their bodies. This is especially so as it relates to the external appearance of the mother’s growing belly, changing posture, and overall weight gain. But, this is also a pivotal time for women to connect deeper to their pelvic floor, as it relates back to those physical and emotional changes.

That said, here are some important things women should know about their pelvic floor before, during, and after pregnancy:

Let It Go. Women hold a lot of tension in their bodies, specifically in the pelvic floor, without consciously thinking about it. In order to conceive, good circulation in the pelvis is crucial, which can be restricted with muscle tightness. One way to resolve this is to begin by making sure you are not standing or sitting with your butt tucked under you throughout the day. This position shortens the pelvic floor muscles and can cause unnecessary tightness.

Diaphragmatic Breathing. Begin a breathing practice to coordinate the diaphragm and pelvic floor system. Sit comfortably in good alignment, with a slight curve in the lower back. Inhale through your nose as the ribcage expands laterally, and feel the pelvic floor lengthen down and relax. Then, exhale through your mouth as the rib cage comes back in, and the pelvic floor recoils back up and in. Getting your body in tune with this connection and movement will allow you to carry it over into your everyday life, exercise, and movement practice, so that it becomes more natural.

Maintain Alignment As Best As Possible. As the physical changes occur during pregnancy, it can be easy to allow your body to fall into a less-supported position where you hang out in the front of your hips while standing, or slouch down while sitting. This will prevent your entire core system, including the pelvic floor, from functioning as best as it can. This, in turn, could lead to low back pain, hip pain, or incontinence.

Exhale With Any Exertion. Blowing out through your mouth as you lift anything heavy, or get up from a low position will automatically contract the pelvic floor to give you more support. Whereas holding your breath during these activities can lead to issues such as low back pain, incontinence, Diastasis Recti (abdominal wall separation), and hemorrhoids due to the pressure put down on the pelvic floor.

Deep Squat To Stretch the Pelvic Floor. Near the end of pregnancy, it is important to allow yourself to stretch the pelvic floor to prepare for labor and be able to breath in and out as these muscles stretch further. This is the only time you would exhale as you lengthen these muscles intentionally versus letting them naturally recoil up and in. Take a deep squat with support, and breath as you visualize the pelvic floor lengthening and opening up.

Leaking Is Not Normal. Just because you’ve had a baby—vaginal or c-section—does not make urinary incontinence okay. And, doing kegels is not typically the fix. Seek out a pelvic floor physical therapist to be properly evaluated, and set up with a treatment plan specific to your needs.

Sex Should Not Be Painful. Painful sex, or dyspareunia, is persistent genital or pelvic pain before, during, or after sex. And, it can be caused by a multitude of factors postpartum, some of which include pelvic tension, scar tissue, hormone levels, and more. Working with a pelvic floor physical therapist to determine the cause and set up a treatment plan is crucial.

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