Recently I was at a mom and baby class to speak about pelvic health. I always start by asking the moms if they have had any experience with pelvic floor therapy. I am happy to report that after 6 years of doing this work, now the majority of the hands go up.
Most women generally recognize that bringing a new life into the world can be fairly traumatic to our pelvic floors. The increased risk for symptoms like urinary incontinence and painful sex is usually enough to get most of them through my door after their 6-week clearance appointment.
While I am thrilled that more women are self-advocating for their postnatal health, I still think many are missing a big part of the puzzle. Many studies are now showing that much of the strain to the pelvic floor actually happens as a result of pregnancy, not labour and delivery but too often pelvic floor is an afterthought in pregnancy.
This new information is critical for 2 reasons:
- If pelvic floor dysfunction potentially originates in pregnancy, then women who deliver via c-section are equally likely to experience postnatal symptoms.
- There are some basic practices we can employ in pregnancy to reduce stress to the pelvic floor and by association postnatal symptoms.
Unfortunately in our current climate, women are seeing their birthing professionals less frequently and often not in person which reduces the opportunity for pelvic exams and in depth conversation around lifestyle and healthy habits that could potentially improve birthing outcomes.
Here are three pelvic practices every woman should be aware of as part of her pregnancy:
STOP Doing Kegels Until You Know They Are Appropriate
There was a time not so very long ago that basic practice for pelvic health was to prescribe kegels. The problem with this as a comprehensive pelvic health plan is that for some women who already have more muscle tone, it can actually make symptoms of back pain, painful sex, painful internals and urge incontinence or frequency, worse. Moreover, the vast majority of women I see where kegels are appropriate, have never actually been taught how to do kegel properly and are recruiting other muscles or using compensatory strategies that are ineffective or create their own problems.
The tricky part here is that the only way to assess your muscle tone or know if you are recruiting your pelvic floor properly is through an internal exam. There is no DIYing this one. I might be biased but I firmly believe that a pelvic health physiotherapist should be part of your birthing team, largely because understanding the state of your pelvic floor can have a significant impact on the comfort of your pregnancy, as well as improving labour and recovery outcomes.
Start paying attention to your poop
We talk a lot about urination, both healthy and incontinent or frequent during pregnancy but we often leave out the poop discussion. Our poop is pretty much a health report card and provides important insight to how many of our internal systems are working. Specifically in relationship to the pelvic floor, it is important that we are emptying our bowels regularly and with ease.
Constipation, a regular challenge in pregnancy, can mean that your rectum takes up valuable real estate in the pelvic cavity and puts stress on the pelvic floor. Straining to have a bowel movement can also increase intra-abdominal pressure further straining the pelvic floor. If you are struggling with either of these, make sure you review your diet, hydration and positioning with your practitioner.
Make mindfulness a priority
It might not be the pregnancy health habit that comes first to mind, but a healthy nervous system can go a long way toward reducing muscle tone, regulating stress and managing pelvic symptoms. Most of the work we do with our pregnant clientele is to help them relax, make space and ready their bodies for a successful labour, all of which is hard to do if you are wound tight.
Not a meditator? Not a problem. Mindfulness comes in many forms and the research supports multiple approaches. Activities including yoga, Qi Gong, Tai Chi, forest bathing, chanting and deep breathing can all help to down regulate the effects of an activated neural system when applied with consistency.
In conclusion, a healthy pelvic floor can make pregnancy more comfortable, prepare you for a successful delivery, either vaginal or cesarean, and can improve your recovery outcomes. Motherhood comes with a learning curve and anything you can do to optimize your health through this transition will bring you one step closer to thriving on your own terms.
Interested in learning more about pelvic health through pregnancy to parenthood? Join us for a FREE Masterclass in November where we will focus on actionable ways to build a healthy pelvic floor throughout your pregnancy, tips to prepare you for labour and delivery and strategic considerations for optimizing your postnatal recovery.
There is no cost and everyone is welcome. Register here to save your spot.
Melanie Stevens Sutherland, Clinic Director & Senior Orthopaedic and Pelvic Floor Physiotherapist
Melanie is a graduate of McMaster University and brings 17 years of experience as a senior physiotherapist to Body Co. She has enjoyed a long tenure working with active populations at prestigious sport medicine clinics. Past clients include Provincial, National and Olympic level athletes as well as members of the National Football League, the Canadian Football League, the Ontario Hockey League, the American Hockey League, the National Lacrosse League and Major League Soccer.
Following the birth of her own children, Melanie developed a strong interest in women’s health. She has taken specialized courses in pelvic floor physiotherapy and women’s nutrition. She is passionate about helping women find strength and confidence in their post-natal bodies following pregnancy and delivery.
If you would like to work with me directly, you can book an appointment in my schedule online.