Looking After Your Pelvic Floor by Midwife Karen Harrison

It’s probably an occupational hazard (and privilege) that once someone knows that I’m a midwife I get to hear their birth experiences and am asked questions about a whole host of issues. Pelvic floor exercises has been one of these, not just because I’m a midwife, but probably in response to seeing photos of me bouncing on my sons trampoline and being utterly in awe that I haven’t had an accident or am not wearing incontinence pants! ☺

So what is this pelvic floor that we hear about that can be the source of embarrassment? Pelvic floor muscles support and surround you bowel, bladder and uterus and are used if you ever try to stop the flow of urine when weeing. Although it is not advisable to try this every time you wee (it increases the chance of getting a urine infection) it is this action that is needed every time you do the exercise.

There seems to be the assumption that having a weak pelvic floor and incontinence during and following pregnancy and childbirth is inevitable or at least likely when coughing, sneezing, laughing, or even trampolining. There is some truth in this as during pregnancy the hormonal changes that happen in your body loosen up pelvic floor muscles. And with the increasing size and movement of your baby on your bladder, it may cause you to leak a small amount of urine. This is applicable to all women despite how they give birth.

A small number of women may be higher risk of developing injury and complications to their pelvic floor depending on their birth experience and may need further clinical management.

However for the majority of women there is something that we can try to do to strengthen our pelvic floor muscles during and after pregnancy. This is lifting and tightening our pelvic floor muscles. You might hear that you need to do it for X amount of seconds X amounts of the day but really there is no hard and fast rule. Try holding your pelvic floor in for about 5 seconds, building up to 10 and try and do 5 sets 3 times a day We know that we don’t do them enough, so any amount is better than none, building them into a routine will be more effective.

Going to a structured pre-natal and postnatal exercise class can really help as we know that weight increase puts extra strain on the pelvic floor, so if you maintain a healthy weight pre and post natal through exercising regularly this will reduce the risk. The instructor will advise you how  to hold in your pelvic floor before you engage in any exercise whether this is a pelvic tilt, stretch, jog or lifting a weight.

In addition to your pelvic muscles supporting the organs in the pelvis, a good strong pelvic floor can also help stabilise your core, and help reduce the chance of backache. Your instructor will ensure that you have good technique to help this further. This is a really good practice to get used to so that you engage your pelvic floor before doing any sort of day to day exercise such as lifting shopping/ baby seats, pushing prams etc.

And remember, if you get into the practice of lifting and tightening your pelvic floor during pregnancy, you will know exactly where to push when welcoming baby into the world.