Perhaps you’ve already heard of the importance of the pelvic floor. It acts like a hammock for our internal organs. It holds up our uterus, bladder, intestines, (basically all your abdominal organs) in place. Throughout pregnancy with your uterus and baby growing and becoming heavier extra strain is placed on the pelvic floor.
A weak pelvic floor can lead to:
• stress/urgency incontinence
• affect your sex life and ability to orgasm(!)
• bad posture
• lower back pain
• your baby not being able to turn in an optimum position during first stage of labour
• vaginal prolapse (extreme cases)
Stress incontinence – when you sneeze or laugh too hard some urine comes out.
Urgency incontinence – when you urgently “need to go” and run to the toilet but don’t make it in time.
Vaginal prolapse – the vaginal wall muscles weaken, come down and sometimes out of the vaginal opening.
You can see how important these muscles are!
Both strength and length is important for your pelvic floor
It is widely known that a strong pelvic floor is good for you. As well as supporting your posture, and preventing incontinence, it is helpful to ensure baby is in a good position ready for birth.
A strong pelvic floor acts as resistance to the baby’s head. This allows the head to flex (chin tucked into chest) and turn to enable descent further into the pelvis. A weak pelvic floor will mean the head won’t be tucked in (ie de-flexed). Baby will then be less “aerodynamic” and not efficiently positioned to navigate the pelvis – meaning the labour may be longer and more painful.
However, what some people don’t realise is that as well as strengthening them, these muscles need to be lengthened and relaxed. Too much strength and rigidity in the muscles is also bad. Why? Because your baby needs to be able to pass through the pelvic floor during the second stage of labour.
Anecdotally, the women who have the strongest pelvic floor (cyclists, horse-back riders, even yogis) tend to have the longest labours. Why? Because their strong pelvic floor doesn’t allow baby to pass through easily.
The pushing stage
Your pelvic floor is important during both your first and second stage of labour.
Some people call the second stage of labour the pushing stage, which it is. However this term can be confusing. When you think of pushing, you think of contracting and squeezing your muscles very tightly. The trick is that you are squeezing your abdominal muscles and the top of your uterus (to push your baby down the birth canal) but you are relaxing your pelvic floor muscles to enable your baby to pass through. Your body needs to do slightly contradictory actions. But don’t worry, if you don’t have interventions, your body instinctively knows what to do when you get to the “involuntary pushing” stage, which happens if you let your body do its natural thing.
When I was in labour, I knew I was approaching the second stage. Because I felt an intense sensation as if I needed to go to the toilet. This heaviness sensation in my back passage felt very strong. My body was already pushing without me giving it much thought. You literally can’t help but push. At this point in my labour, I just went with the flow and relaxed my pelvic floor muscles as much as possible.
Many women have told me how they encountered this strong urge to push that they couldn’t stop even if they wanted to. This is also known as the fetal ejection reflex – check out this brilliant post why some babies are born in cars!
Most women, if left undisturbed, will not need anyone “coaching” (read, shouting at) them to push. In fact, I wrote that on my birth plan because I really dislike that whole “cheerleading shouting” which is not conducive to a calm environment. I wanted to be in the zone, concentrating on relaxing the pelvic floor muscles and anyone shouting at me would very much distract me!
The only time you would need guidance with when to push is if you have an epidural. Then your senses are numb, and it is difficult to sense when you are contracting. Your midwives will then guide you when and how to push.
I hope I have shown you the importance your pelvic floor.
To download a specialised info sheet on various tried and tested pelvic floor exercises designed by midwives and yoga teachers – CLICK HERE. And let me know how you get on with them!