Thinking of Getting Pregnant? Why Pelvic Floor Strengthening Helps You Recover Faster

April 24, 2017

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We all know the benefits of regular exercise – weight control, reduced risk for many health concerns, and improved mood and sense of well being. During pregnancy, experts recommend 20 to 30 minutes of moderate-intensity exercise daily. Being in good physical condition can lessen the aches and pains of pregnancy, make labor easier, and speed postpartum recovery.

Exercises specifically focused on your pelvic floor muscles are an important addition to your daily fitness routine. Maintaining this part of your body during pregnancy may make labor easier – after all, these are the muscles you’ll be using to push your baby out. Strong pelvic floor muscles equal easier, more effective pushing during childbirth. When any muscle is in good shape, recovery from injury (or in this case birth) is easier and faster.

Pregnancy and childbirth, however, can put stress on this muscle group. Many healthcare providers, however, don’t mention pelvic floor exercises as part of your postpartum recovery. Getting your pelvic floor muscles back into shape after you’ve had a baby has many potential benefits, including:

  • Aids in episiotomy healing and improves perineal elasticity and comfort (a third or fourth degree laceration is deep enough to tear the pelvic floor muscles. And just like any other muscle tear, physical therapy is necessary for rehabilitation).
  • Lowers the incidence of urinary and fecal incontinence (in the immediate postpartum, as well as with aging).
  • May decrease lower back, pelvic or hip pain.
  • Prevents and aids in recovery from pelvic organ prolapse (where your uterus slips down into your vagina).
  • Lessens the effects of aging, such as vaginal atrophy (where the loss of estrogen causes thinning of the vaginal wall and a decrease in lubrication).
  • Boosts your sex drive and improves your orgasm frequency or strength.

What exactly is the pelvic floor?

Imagine a hammock of overlapping, crisscrossed layers of muscles attached one end at your pubic bone and the other at your tailbone. These are your pelvic floor muscles. They support all of your internal organs – and during pregnancy, the weight of your growing uterus and baby.

Several openings pass through this muscle group, including the vagina or birth canal. Strong pelvic floor muscles help the uterus to push the baby out during birth, but in the process of baby passing through, they are stretched, making recovery necessary. Particular exercises targeting these muscles will help your body return to pre-birth shape.

Pelvic floor exercises

You can begin pelvic floor exercises as soon as possible after birth. You may not feel them at first – it’s normal for the tissues of the perineum to be numb for the first few weeks after birth. These exercises can be a bit uncomfortable if you’ve had an episiotomy, but they shouldn’t be painful and they will aid in healing the surgical incision. Imagine the tissues of the pelvic floor like a soapy sponge, and the pelvic floor muscles like you hand squeezing that sponge underwater. What happens? The suds and dirt (or old blood) are squeezed out, and fresh water (or blood in the case of your muscles) is pulled in. This refreshes the tissues and encourages cell growth and recovery.

Next time you’re urinating, stop mid-stream. The muscles you use are your pelvic floor muscles. Alternatively, you can insert a clean finger into your vagina and squeeze. Your vaginal wall should hug your finger without your abdomen, thighs or buttocks tightening. If you’re struggling to identify the right muscles, ask your healthcare provider for help.

You may have heard pelvic floor exercises called Kegels – many childbirth educators will suggest them in prenatal classes. Several ways to do these exercises include:

  • Flicks: tighten and relax the pelvic floor muscles for 2 or 3 seconds at a time
  • Elevator exercises: Imagine that you’re pelvic floor is an elevator, slowly lift it to the fourth floor – pausing at each floor and moving up – then slowly releasing the muscle as if the elevator is returning to the lobby. Gaining control on the way back down is often the harder part.
  • Add them to foreplay – let your partner use his or her finger to check to see if you’re using the right muscles

Do a set of exercises every time you think of it – when you’re standing in line at the store, when you are talking on the phone, when you’re feeding your baby, when you’re driving to work. Start slowly and build up stamina. Aim for 3 sets of 20 Kegels per day.

If you’re having complications, such as urinary incontinence, and pelvic floor exercises don’t seem to be helping, you may want to visit a healthcare provider who specializes in pelvic floor function, such as a women’s health physiotherapist. This professional can develop a plan tailored to your specific complaints and needs, and may suggest other interventions along with exercises (such as the use of a special weighted vaginal insert to strengthen the muscles).

Interestingly, other countries are far ahead of the United States in postpartum pelvic rehabilitation. In France, for instance, specialized physical therapy programs have been developed specifically to strengthen the pelvic floor immediately after childbirth in order to prevent incontinence, prolapse and sexual dysfunction. Unfortunately, many obstetrician-gynecologists in the US discount women’s concerns and do not suggest the very simple interventions that could help improve her quality of life.

Pelvic floor exercises are a life skill. While doing them in the postpartum period can help with recovery from birth, you can practice the same exercises with the same benefits throughout your lifetime.


Resource:

American College of Obstetricians and Gynecologists. Exercise During Pregnancy. May 2016. http://www.acog.org.

American Physical Therapy Association. http://www.apta.org.

Finnbogadóttir H, Moghaddassi NM, Stenzelius K (2016) Pelvic Floor Muscle Exercise after Delivery with or without the Biofeedback Method: An Intervention Study. J Women’s Health Care 5: 311.

Flashenberg, Debra.The Importance of Kegels: Getting to Know Your Muscles "Down There." February 10, 2012. http://www.givingbirthwithconfidence.org

Gagnon, L. H., Boucher, J., & Robert, M. (2016). Impact of pelvic floor muscle training in the postpartum period. International urogynecology journal, 27(2), 255-260.

Hill, A. M., McPhail, S. M., Wilson, J. M., & Berlach, R. G. (2017). Pregnant women’s awareness, knowledge and beliefs about pelvic floor muscles: a cross-sectional survey. International Urogynecology Journal, 1-9.

Lamin, E., Parrillo, L. M., Newman, D. K., & Smith, A. L. (2016). Pelvic Floor Muscle Training: Underutilization in the USA. Current urology reports, 17(2), 10.

Neels, H., De Wachter, S., Wyndaele, J. J., Wyndaele, M., & Vermandel, A. (2017). Does pelvic floor muscle contraction early after delivery cause perineal pain in postpartum women?. European Journal of Obstetrics & Gynecology and Reproductive Biology, 208, 1-5.

O’Neill, A. T., Hockey, J., O’Brien, P., Williams, A., Morris, T. P., Khan, T., ... & Yoong, W. (2017). Knowledge of pelvic floor problems: a study of third trimester, primiparous women. International Urogynecology Journal, 28(1), 125-129.

Pelvic Health and Rehabilitation Center. Pelvic Floor Rehab: It’s time to treat new moms right. September 10, 2012. http://www.pelvicpainrehab.com.


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