Pelvic Floor Health During Pregnancy and Postpartum

So, what is this "pelvic floor" everyone is talking about?

The pelvic floor is, essentially, a system of muscles, connective tissues, blood vessels, and nerves that extend from the back of the pelvis, connecting to the front of the pelvis, forming a hammock-like structure. These muscle structures play a significant role in supporting pelvic organs like the uterus, urinary bladder, and rectum, assisting in controlling the sphincters and maintaining proper positioning.

What happens to this pelvic floor system during pregnancy and childbirth?

Several factors during pregnancy and childbirth can lead to the weakening of these muscles:

• The growing fetus places substantial pressure on the pelvic floor muscles.
• Hormonal changes during pregnancy can cause these tissues to become more relaxed and lengthened, up to three times their original length.
• During childbirth, strong stretching forces, and in some cases, tearing, can weaken these muscles even further.

If you haven't been actively working on strengthening these muscles, they may have weakened. It's essential to know that the weakening of the pelvic floor muscles can lead to issues such as urinary incontinence, sexual dysfunction, back pain, and even the prolapse of internal pelvic organs, such as the uterus and/or bladder.

So, what can be done?

• During the first trimester of your pregnancy, you should start seeking guidance on pelvic floor muscle strengthening from a qualified physical therapist, specially trained in this area. This service is covered by your health plan and is a part of your healthcare services.
• It's important to begin daily exercises to target these muscles, preventing the undesirable effects mentioned earlier.

Here's a simple exercise that can be performed anywhere:

1. Contract your pelvic floor muscles as if you were trying to prevent bowel movements.
2. At the same time, imagine pulling your vagina upward, as if you're stopping urine flow midstream. Additionally, imagine closing your urethra (the urinary opening) as if you're trying to hold back urine.
3. Initially, perform this exercise quickly, contracting and releasing.
4. With practice, slow down and aim to sustain the contraction for as long as possible. Try to reach a count of 10 before relaxing.
5. Perform three sets of eight such contractions daily.
6. As you progress, try to contract your pelvic floor muscles during coughing or sneezing, helping prevent urine leakage.
7. Continue these exercises even after giving birth.

*To ensure you're engaging the correct muscles, you can try stopping your urine flow while in the bathroom. However, it's not recommended to do this frequently, as it can harm your urinary bladder and lead to urinary tract infections.

Remember, your health and quality of life are just as important as your baby's well-being. Congratulations on your pregnancy!

Leumit’s physical therapy services are available at medical centers and clinics.
You will need a referral from your treating physician to access these services.