Pelvic Floor Exercises
Pelvic floor dysfunction is a relatively common condition that women may experience throughout their lifespan, especially during pregnancy and the postpartum period. It can manifest in various forms, such as urinary incontinence, difficulty urinating, pelvic organ prolapse, and even fecal incontinence. These issues are more likely to occur in the later stages of pregnancy as the body undergoes significant physical and hormonal changes.
Hormonal Changes
Pregnancy triggers a range of hormonal changes that affect the pelvic floor. One of the hormone the increases during pregnancy is relaxin. This hormone is responsible for increasing the flexibility and elasticity of connective tissues, such as ligaments, in preparation for labor. While this helps to facilitate childbirth, it can also decrease the ability of the pelvic floor muscles and supporting tissues to provide adequate support to the pelvic organs.
Morphological Changes
As pregnancy progresses, the pelvis undergoes structural changes to accommodate the growing fetus. The pelvis widens to create more space, and there is an increase in the intra-abdominal pressure, both of which contribute to the increased load on the pelvic floor muscles. This can impact the muscles' ability to generate the necessary force for support. Research has shown that as pregnancy progresses, pelvic floor muscle strength can diminish, which increases the risk of pelvic floor dysfunction during and after pregnancy. In addition to the pelvic changes, postural adjustments occur as the growing fetus alters the mother's center of gravity, leading to changes in posture that may affect the function of the pelvic floor muscles.
Pelvic Floor Exercises
Research consistently supports the benefits of strengthening pelvic floor muscles during pregnancy and the postpartum period. Pelvic floor exercises improve muscle strength, support pelvic organs, and help prevent or reduce symptoms of urinary incontinence and pelvic organ prolapse. The American College of Obstetricians and Gynecologists (ACOG) recommends that women incorporate pelvic floor exercises throughout pregnancy and in the postpartum period. Studies indicate that women who perform these exercises during pregnancy have a significantly lower risk of developing urinary incontinence postpartum. Additionally, pelvic floor rehabilitation after childbirth promotes faster recovery and reduces long-term complications such as prolapse and incontinence.
The following video made by NHS is a valid resource on how to exercise your pelvic floor muscles and it is highly recommended to follow:
References
Dehghan F, Haerian BS, Muniandy S, Yusof A, Dragoo JL, Salleh N. The effect of relaxin on the musculoskeletal system. Scand J Med Sci Sports. 2014;24(4):e220-e229. doi:10.1111/sms.12149
Bozkurt M, Yumru AE, Şahin L. Pelvic floor dysfunction, and effects of pregnancy and mode of delivery on pelvic floor. Taiwan J Obstet Gynecol. 2014;53(4):452-458. doi:10.1016/j.tjog.2014.08.001
Boyle R, Hay-Smith EJ, Cody JD, Mørkved S. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2012;10:CD007471. Published 2012 Oct 17. doi:10.1002/14651858.CD007471.pub2
