The Pelvic Floors Role in Birth
Most people think about pelvic floor PT as something most beneficial during the postpartum period. Don’t get me wrong, postpartum is a CRUCIAL time to see a pelvic floor PT and should be the standard of care. However, your pelvic floor has such an important role in the birth process and there is so much that you can do prenatally to set yourself up for the best possible birth experience. So how does your pelvic floor function during birth? Let’s talk about it!
First, let’s get oriented with the anatomy of the pelvic floor:
The pelvic floor is a group of muscles that sit in a bowl shape at the base of your pelvis. These muscles have attachments to your sacrum, tailbone, pubic bone and ischial bones. They also house your vaginal canal & opening.
During labor,
as your baby engages into your pelvis and approaches the level of your mid-pelvis (also known as 0 station), the fetal head comes in contact with the pelvic floor muscles (the levator ani and coccygeous muscles). Now, in order for the baby to continue their passage towards the pelvic outlet, they have to move through these pelvic floor muscles. If there is tension in your pelvic floor muscles, it can act as a block for baby during this process, which may slow down or stall labor. All of this leads to the 1st role of the pelvic floor muscles - they have to be relaxed! Pelvic floor muscle tension is something that can be evaluated and addressed starting prenatally. A pelvic floor PT can help reduce any muscle tension, and teach you strategies to stay relaxed, calm and connected to your body during labor.
During pushing,
your uterus is the large, contractile muscle that pushes your baby out. Contrary to popular belief, you don’t need a strong pelvic floor to birth because your pelvic floor is not what’s doing the pushing! During pushing, your pelvic floor muscles have to lengthen and “bulge” downwards as you get those strong uterine contractions. This brings us to the 2nd role of the pelvic floor muscles - they must be able to coordinate that bulge effectively. “Push prep” is something that can be practiced with a pelvic floor PT prenatally to teach you how to coordinate this action of your pelvic floor effectively AND with the appropriate breathing strategy. In my experience, many people don’t coordinate a push correctly. Oftentimes, I see that women will tighten their pelvic floors instead of lengthen them. This can lead to longer pushing times during labor!
During birth,
as your baby crowns and their head emerges from the vagina, the perineum must significantly stretch- the 3rd role of the pelvic floor muscles! In fact, it can stretch up to 250% of it’s resting length during birth. Our bodies are absolutely incredible! Even with the amazing capabilities of our bodies, perineal tearing can still happen. The perineum can be very rigid and the muscles can be tight, particularly if you've never delivered a baby vaginally before. By massaging and gently stretching the area prenatally, you can help reduce your chances of tearing. Perineal massage can be started prenatally starting around 34 weeks gestation. Your pelvic floor PT can assist you with this as well as teach you helpful birthing techniques & positioning that can minimize your risk of tearing.
In summary, your pelvic floor should be relaxed, coordinated and stretchy for an optimal birth. There is so much that can be learned & addressed in the prenatal period by working with a pelvic floor PT that is specialized in obstetrics.
We wish you an empowered birth experience!