I get this question ALL of the time from my pregnant friends! My answer? Take a deep breath. We have time! Ideally, we would take care of the pelvic floor before, during, and after pregnancy. But if you are already 9 months along and haven’t thought about it one bit, that is okay too!
Let's meet you where you are at. It is never too late to start taking care of your pelvic floor and core! So, I feel it is important to address common versus normal in pregnancy.
NORMAL DURING PREGNANCY
Stretch or separation of the rectus abdominus (6 pack)
Increased urgency/frequency of urination (girl, you’re gonna have to pee a lot)
Temporary aches and pains
Change in bowel habits
Pressure or gravity changes to pelvic floor
COMMON, BUT NOT NORMAL
Excessive separation of the rectus abdominus (6 pack)
Peeing your pants (see below)
Persistent pain to low back, SI joint, hips, pubic bone, etc.
Pelvic floor prolapse (feeling of pressure or bulge at bladder, rectum, or uterus
So how do I make sure to prevent these things during pregnancy?
TIPS FOR PREGNANCY
Water intake. Drinking water, at least 60-80 oz, helps to prevent bladder irritation and assists with healthy bowel movements
Consistent intake of healthy food with lots of greens (dietary consistency helps bowels move, if bowels are moving, there is less pressure to the pelvic floor or bladder, which can reduce instances of involuntary leakage)
Keep moving, sister! (See American Pregnancy Association guidelines for exercise)
Make sure your pelvic floor can CONTRACT (squeeze) and RELAX! This is important! This can be why kegels get a bad name during pregnancy.
Ask your provider about perineal massage. Research does not currently support it, but it definitely won't hurt to try!
Some people are told by their provider that they will not progress if their pelvic floor is "too tight". This can absolutely be true, but a strong pelvic floor does not mean that your muscles are too tight. A strong pelvic floor means you are able to contract (squeeze) and relax. For example, to strengthen your biceps, you would do reps of bicep curls, right? You would not take a 10 lb. weight and carry it around all day. Same goes for the pelvic floor, you would not squeeze it all day to prevent leakage and prolapse- because the muscles would get tired! We need a healthy balance.
As for peeing your pants during pregnancy, my personal story:
I feel that I have a strong pelvic floor. If anything, I need to work on relaxation. During pregnancy, Wyatt was sitting LOW. This meant that he was constantly on my bladder. When I would sneeze during fall allergy season, I would completely pee my pants. As a pelvic floor PT, this completely freaked me out. Now, I am not endorsing that this is normal. It is not normal to pee your pants. And despite what Billy Madison says, peeing your pants is not cool.
My encouragement: Postpartum I have not had ANY leakage or prolapse, but I have been continuing to strengthen my pelvic floor and core.. So if your baby is sitting low, you have a big baby, or you're just simply having trouble, don't fret! This could completely resolve postpartum. Now, if it resolves, that is still not a pass to avoid pelvic floor strengthening!! I encourage women to consider the pelvic floor as one of the muscle groups we need to continue to make apart of our daily habits in order to prevent problems in the future.
Congratulations, mama! This is a fun, exciting journey! As always, ask your provider about pelvic floor physical therapy if you feel that you are having trouble, or need extra guidance. A pelvic floor PT can also treat low back, SI, pubic symphysis, or any pelvic pain or trouble during pregnancy!
Need guidance on what to purchase postpartum? Check out my favorite products guide here!
This content is created in order for individuals to learn more about the pelvic floor. I am in no way giving medical advice or medically assessing the pelvic floor through this blog. If you ever have any health questions or concerns, please consult with your physician or midwife. If you are ever unsure if you are performing exercises correctly, it may be beneficial for you to get a referral from your physician to a pelvic floor therapist for further evaluation. My blog posts are for educational purposes only! I am not liable or responsible for any damages resulting from or related to your use of this information.