We recommend women have a pelvic floor assessment prior to giving birth. Find out why below….

For many women it is not until the child bearing years that they have even heard of the pelvic floor, let alone given it much attention.

 

Historically the focus for the pelvic floor has always been based around strengthening, however  just like any other muscle in the body the pelvic floor has the potential to a to also become excessively tight (hypertonic) and this can be incredibly problematic for some women. Clinically, we are now seeing an increase in the number of women presenting with hypertonic pelvic floors and the reasons for this seem to be multifactorial in nature mainly based around lifestyle and behavior choices. Factors such as high level participation in exercise can encourage over activation of the pelvic floor, and constipation from poor dietary choices can lead to chronic straining and a pelvic floor that is always in spasm. The impact of today’s fast paced lifestyle has also lead to a pelvic floor that is constantly ‘switched on’ as a result of a lack of relaxation, diaphragmatic breathing and high anxiety and stress levels.

 

To understand why it is so important to have it checked prior to birth, first we need to understand what it is and what it actually does…..

 

The pelvic floor is an intricate web of muscles, fascia and ligaments sitting deep within the pelvis spanning the base from the tailbone to the pubic bone. It is made up of 8-9 individual muscles that join together with the fascia to close off the pelvic outlet, hence creating the ‘floor’ of the pelvis. Although a relatively small muscle that is hidden from view, its importance should not be underestimated as it has some of the most critical functions in the entire body including:
• Keeping closure around the bladder to prevent urinary leaking
• Keeping closure around the rectum to prevent bowel leakage
• Providing a support system to the uterus, bladder and bowel to prevent downward descent (Pelvic Organ Prolapse)
• Provide sensation and tone required for enjoyable pain free sexual intercourse
• Provide the muscle activation to facilitate an orgasm
• Work with the deep abdominals and ‘core’ to assist with stability of the spine, hips, pelvis and rib cage
• Works with our diaphragm to ensure optimal breathing patterns
• Being able to open and fully relax at times when exiting from the pelvis is required such as when urinating, opening the bowels and of course birthing a baby!

 

During birth the requirement of the pelvic floor is incredible as it needs to stretch beyond 3 times its normal length! I can’t imagine another muscle doing that, can you?! The pelvic floor is truly a remarkable piece of anatomical engineering, however, in order for this impressive stretch to occur the muscle needs to have good flexibility and be able to completely relax during the crowning phase in birth. If a woman has a hypertonic pelvic floor that cannot fully relax or stretch, then you can imagine how this has the potential to impact or prevent achieving a normal vaginal delivery. 

 

One of the main reasons we encourage women to have their pelvic floor checked in pregnancy, is so that we can help determine what type of pelvic floor they have, and therefore how we can best help them. If a woman has a weak pelvic floor then a specific strengthening program will be given so that the pelvic floor can continue to support the bladder, bowel and uterus throughout the pregnancy and in the post natal period. 

 

If a woman has a hypertonic pelvic floor, then we will work with her to restore optimal breathing patterns, work manually through the vagina and pelvis to help release overly tight muscles to ‘down training’ and help restore normal mobility and length required for birth. This can be incredibly empowering and life changing for a woman who has always held tension in her pelvic floor.

 

Regardless of what type of pelvic floor a woman has, once in the final stages of pregnancy a Women’s Health Physio can work with her to teach her how to achieve full relaxation of the pelvic floor to achieve opening of the pelvic outlet rather than closure, which is what is required during birth.

 

To book an Initial Women’s Health appointment for a pre-natal check please call 9968 3424 or book online here.