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The pelvic floor is something most people don’t talk about and many don’t even know about.
That’s despite it playing an enormous role in pregnancy, childbirth and continence.
You heard that right: if you don’t want to spend the rest of your life struggling to hold in wees and farts, read on.
What is your pelvic floor?
The pelvic floor is a group of muscles at the base of the pelvis that supports the pelvic organs and controls the bladder and bowel.
Lifting weights, high impact exercise, chronic constipation, obesity and ageing can weaken them.
But an instrumental vaginal birth, where the doctor uses forceps or handheld suction cup to pull the baby through the birth canal, is one of the biggest risk factors.
A caesarean section won’t get you out of trouble either. Hormonal changes and the extra weight of your baby can also strain the pelvic floor.
An overactive, tight pelvic floor can lead to difficulty going to the toilet and pelvic pain.
A weak or damaged pelvic floor may result in a leaky bladder or prolapse, which is when one or more of your pelvic organs drop into the vagina.
“For a pelvic floor to function well, the muscles need to be not too tight, not too loose, just right,” says Dr Marilla Druitt, an obstetrician and gynaecologist based in Geelong.
How do you strengthen your pelvic floor?
Everyone, no matter their age, should be doing regular pelvic floor exercises (also commonly referred to as Kegels).
Women’s health physiotherapist Lyz Evans says the first step is to learn to contract and relax the muscles, then to build up strength as you would any other muscle in the body.
Like any form of exercise, it’s a good idea to regularly set aside time to strengthen your pelvic floor and to follow a program.
“Where most people go wrong is they just do a few pelvic squeezes here and there but we need that muscle to fatigue like you would with weights in a gym,” she says.
How can you look after your pelvic floor during pregnancy?
The good news is there’s a lot you can do to prevent pelvic injuries.
Ms Evans recommends physically preparing the muscles for labour. After all giving birth is harder than running a marathon.
“In birth, we are actually asking our muscles to do something they have never ever done before and that no other muscle in the body could,” she says.
“We’re asking our pelvic floor to essentially open and lengthen to about three times its normal length.”
Dr Druitt recommends seeking the help of specialist pelvic physiotherapists.
She says they help strengthen your pelvic floor and can teach you how to massage perineal muscles to reduce the risk of a tear or episiotomy during delivery.
“You’re trying to stretch out a muscle so that it can stretch really well when a baby passes through,” says Dr Druitt.
According to research, one in three women contract their pelvic floor instead of relaxing it during labour.
“This is a mind-blowing number of women setting themselves up to fail,” says Ms Evans.
To avoid this, pelvic physios can teach you to push properly, which may reduce the time you spend in active labour and help lessen the need for an instrumental delivery which can damage your pelvic floor.
Ms Evans says understanding what happens to pelvic muscles during a vaginal delivery can help you make informed decisions if you are offered a caesarean or instrumental delivery.
What should you do after giving birth?
You’ve just birthed a tiny human – bravo!
Dr Druitt says women should have access to post-birth rehab programs with a physio or midwife.
“Because women have got fifty-thousand other things to be doing during that postnatal period, often that comes last,” she says.
You’ll know if your pelvic floor has been damaged if you pee when you sneeze or get a heavy, dragging feeling – like your insides might fall out.
Even without symptoms, Ms Evans encourages all women to have a six-week postnatal pelvic assessment to identify if you may develop conditions like prolapse in menopause.
And don’t expect to be putting your running shoes on anytime soon. Ms Evans says to start slowly with exercises like yoga, pilates, swimming and walking, and wait until 12 to 16 weeks after birth to step things up.
“Women can then gradually layer in some more intense exercise such as bike riding, weights and running, but ensuring they are listening to how the pelvic floor is feeling,” she says.
She says there are three other ways women can give their pelvic floors some post-birth love:
- Avoid constipation
- Factor in couch time to take the load off your pelvic floor
- Strengthen the rest of your body to take the weight of your baby, instead of your pelvic floor
Many women put up with leakage, prolapse, and pelvic pain thinking they’re normal and unavoidable.
But Ms Evans wants you to know there is treatment available and you shouldn’t suffer in silence.
“You do not need to accept that this is a normal part of becoming a mother.
“There is so much that you can do about it,” she says.
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Sources 2/ https://www.abc.net.au/news/2023-08-03/pelvic-injury-common-after-childbirth-how-you-can-look-after-it/102675488 The mention sources can contact us to remove/changing this article |
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