Pregnancy, Giving Birth and Pelvic Floor
Today we are discussing how fundamental it is to take care of your pelvic floor if you are planning to become a mum.
Index:
When you should do a pelvic floor evaluation?
What is important to check?
How giving birth can impact the pelvic area?
Is pelvic floor evaluation compulsory after childbirth?
Do you know how much blood you lose during your period?
Childbirth manoeuvres. Which one can severely impact the pelvic floor?
What if you gave birth ages ago and no pelvic floor evaluation has been made?
This is, sadly, the last chapter of our Pelvic Floor and Where to Find It series. If this is the first article you read on this topic, I recommend you look for the first ones where we give a much more in depth explanation on the pelvic floor.
Let’s start smashing some false myths on pregnancy and pelvic floor:
- Giving birth is the most traumatic experience for your pelvic muscles. That is not necessarily true; if you have a delivery without complications, no matter if natural or c-section, you should be more careful on taking care of your pelvic floor in the previous 9 months.
- Training your pelvic floor before and after giving birth is good for all. Absolutely not true. If you have a hypertonic pelvic floor before getting pregnant - that you do not know about because you have never done a pelvic exam - then training your pelvic floor will give you more issues than doing nothing. When we say “pelvic floor training or exercises” we usually mean contracting and relaxing the pelvic muscles in a series of exercises, which is supposed to tone up your pelvic muscles. But not all womxn’s pelvic floors need to be toned up! In most cases, especially before a pregnancy, it needs to relax.
- Having a c-section is less traumatic for your pelvic floor as the baby doesn’t have to go through your vagina. Totally wrong. A c-section is a proper quite invasive surgery, which involves not only a portion of the pelvic floor but several muscles around it. As we have learned, all muscles are connected within each other, and the scars might create painful adhesions even on the pelvic area. Plus, during a c-section muscles are very stretched and this might create micro traumas.
If you find yourself a bit confused at this point of our article, you are certainly not alone. The above are quite common thoughts on pregnancy! So let’s see together how you should take care of your pelvic floor when thinking of having a baby.
When you should do a pelvic floor evaluation?
If you have never done a pelvic floor evaluation (or even if you had but you are having twins) we suggest you do it even in the first trimester. Hormonal changes, the increased weight of our uterus plus the different posture we assume when carrying a baby have quite an impact on our pelvic floor.
Plus, as we have anticipated, if you already have some alterations in your pelvic tone, it is very important to have the time to restore a good tone and flexibility before giving birth.
What is important to check?
When taking care of your pelvic floor during pregnancy it is important to concentrate on how good your pelvic muscles’ movement is, how much control you have over it, if you are able to coordinate your breath with the pelvic movements. It’s also very important to be sure you have a good control over your sphincters as well as to massage and prepare your perineum.
How giving birth can impact the pelvic area?
As we said, c-section is not less impactful than a vaginal birth; however it always depends on the kind of delivery and birth you have. The more physiological it is, the more the mum is in control of the whole process, the less traumatic it is. Clearly, not every birth goes smooth and complications might happen.
If you give birth quite quickly (not because you are good, but because they speed up your rhythm), if there is the need to make any sort of manoeuvre (like an episiotomy - a cut on the vulva) that will have a higher impact on your pelvic area, therefore it is very important to take care of your pelvic floor after childbirth.
Is pelvic floor evaluation compulsory after childbirth?
Each country might have different rules, but a pelvic floor evaluation is mandatory in most countries. Usually a very first check is done right after the child is born. A quick note on this, by “quick check” we don’t mean just inserting a finger, ask the mum to squeeze it, and it’s done. At least a proper 15/30min check to analyze all muscles (especially around the anus, if you didn’t have a smooth childbirth) is very important.
Then, before sending the mum home, another check should be made. In case of any symptom, from pain to incontinence, it is extremely important to check the pelvic floor in the hospital or even if you are back home. Some protocols also see a compulsory check after more or less one month.
Childbirth manoeuvres. Which one can severely impact the pelvic floor?
This is a very important question as well as a very delicate topic, since we might end up talking about obstetric violence (abuse during childbirth). When the woman is not aware of all actions taken during the whole process and has not given explicit consent to them, this is abuse.
There might be life threatening situations (for the mum or the baby) where decisions have to be made quickly, nevertheless, consent should always be given. Remember that when you give birth people around you should be there to help and support you, but you are in charge.
Any action like active cervix dilatation, an episiotomia or a push on the mum’s belly to take the baby out are very delicate acts that might deeply damage your pelvic floor (so going through a rehabilitation is mandatory in those cases). We’d like to remind you that pushing on top of the mum’s belly is illegal in many countries, unless there is a life threatening situation.
What if you gave birth ages ago and no pelvic floor evaluation has been made?
You are not too late! The nice thing about muscles is that you can restore their tone at any age. So, in case there is something wrong, you are still in time to fix it before maybe it gives you any sort of discomfort or side effects (maybe when you’ll get through menopause).