This article was published on www.first1000days.ie and may differ slightly there due to editing
The pelvic floor, like the cervix, is one of those bits of anatomy that no one wants to chat about until you’re pregnant and then all of a sudden everyone is chatting about it!
As a pre and post natal yoga teacher I bang on about the pelvic floor ALL the time. Why? Because its not something you want to neglect really and here’s why.
Where is it and what is it for?
The pelvic floor is a group of muscles which behave like a hammock, hanging just under the pelvic bones. It’s basically the muscle you pull upwards when you’re trying to hold in a pee (teachers, nurses, mums...you know what I’m talking about!). Men have it too by the way. The hugely significant thing about the pelvic floor is that it supports all the organs within the pelvis so the bladder, the uterus in women and the intestines. It also gives major support to the lower back. So you can see that, in pregnancy, all this support is very very important.
In pregnancy, the pelvic floor provides a counter pressure upwards to counteract the weight of your growing baby and the pressure that puts on your pelvic organs. So you can see how giving it a bit of love and attention could lessen the impact on your bladder, digestive system and bowel.
During birth it has a hugely significant role in encouraging baby to rotate into the well, the kindest position to birth.
The pelvic floor also has a major role in preventing incontinence. Peeing on yourself when you laugh or sneeze isn’t really cool is it?
So ladies, (and gentlemen actually) sit up and listen.
How do I show it love then?
Yoga and/or Pilates
Your pelvic floor loves yoga and pilates. A good teacher trained to teach pregnant women will work a lot with the pelvic floor throughout the class. Lots of yoga and pilates poses and sequences make you automatically work the pelvic floor without even realising it. Taking a prenatal yoga class once a week in pregnancy can make a huge difference to the pelvic floor, apart from all the other amazingly helpful benefits of yoga in pregnancy.
Kegels/Pelvic floor exercises
I’m not a huge fan of these as frankly they’re boring and people forget to do them, but they can be effective. On the plus side you can do them sitting, standing, lying, sitting in traffic, sitting at your desk etc and no one will know!! They are good to do any time in life including while pregnant and post natally.
Firstly, you need to ‘find’ your pelvic floor. Do this by imagining you’re trying to stop a pee mid-flow. Pull up the muscles you use to do that, but try not to clench your buttocks. (Important: Don’t actually stop a pee i.e. don’t practice while you’re emptying your bladder. It can cause the bladder to retain urine and can lead to urinary tract/bladder infections).
Once you’ve found the pelvic floor you basically practice contracting it (pulling up) and relaxing it (letting it ‘fall down’ again). Its important to know how to both contract and relax the pelvic floor in pregnancy as when baby is eventually passing though, the more relaxed it is, the better.
Here’s some exercises to practice:
pull up the pelvic floor and hold for 3 breaths (increase to 5 breaths with time) and then release gently.
Imagine the pelvic floor is an elevator or lift within you. Contracting as much as you can is bringing the lift to the second floor, then try to bring it to the first floor and then the ground floor so you are learning to control it.
Doing these for 10 minutes or so daily will make your pelvic floor very happy!
Squats are a far more beneficial exercise and less boring then kegels, in my humble opinion. They’re harder - but - they tone your legs and bum too - how bad? Also, if you practice squatting a lot you may shorten the length of your labour! Positive Birth guru Ina May Gaskin famously said “Squat 300 times a day and you’re going to give birth faster!” 300 might be a little excessive mind you.
There are a couple of medical reasons not to squat. If squatting causes pain in any way don’t do it and consult your caregiver. If you have a history of, or are potentially at risk of giving birth prematurely then please consult with your caregiver before squatting. If you are over 30 weeks pregnant and your baby is in a breech position please don’t squat as it will push your baby down further in the breech position - wait until baby moves into a better position for birth and then squat!
In prenatal yoga we practice 2 types of squats.
The full squat or Malasana
Stand with your feet slightly wider that your hips. Inhale. As you exhale, bend your knees and lower yourself so that your buttocks are only an inch or two from the ground. Keep your knees wide and your heels on the ground. If your heels don’t reach the ground stick a rolled up towel or blanket underneath the heels to lean them on or a yoga block. Bring your hands together in a prayer position, resting your elbows on the inside of your knees to keep the apart. Lean forward slightly for balance, if necessary. Hold this pose for a few minutes - breathing deeply and calmly. This is also the best way to give birth - all that gravity, all that pressure!
The Half Squat or Utkatakonasana
This is a ‘half squat’ pose that is really intense on the legs but can help build strength and stamina for labour and birth, as well as stretching the groin and opening the hips. During labour, this is another pose that can help your baby settle down into the pelvis and and put pressure on the cervix to dilate.
Stand with your feet slightly wider that your hips and your toes pointed out. Inhale. As you exhale, bend your knees so that they are gliding over your second toes ( you should be able to see the big toes but not the second ones) and lower yourself so that your thighs are straight and parallel to the ground. Keep your heels on the ground. Bring the hands into prayer pose, or hold on to a chair or wall for support. Hold this pose for a few minutes. Breathe deeply and embrace the challenge - this is great practice for birth!
These exercises are all great to practice postnataly also - as soon as you’re feeling up to it. Always listen to your body and if they don’t feel right to practice, then don’t!
NOTE: Discuss any exercise with your caregiver before your start to rule out any special circumstances