Tips for pregnant women

The pelvic floor

During pregnancy the pelvic floor is placed under great hormonal and static pressure. Under the influence of the hormone relaxine, the pelvic floor muscles relax to make the coming birth easier. The increased weight of the mother during pregnancy also puts extra pressure on the pelvic floor.

The best course of action is to train the pelvic floor even before the start of the pregnancy in order to reduce the risk of bladder dysfunction such as urinary incontinence. The pelvic floor has an important function during childbirth. The tissue has to be as relaxed and elastic as possible so that the baby can glide smoothly out of the birth canal. It is therefore important to become aware of the pelvic floor muscles during pregnancy and to learn how to activate and relax these muscles. This is why pelvic floor exercises are recommended for pregnant women. In the final trimester the emphasis is placed on awareness and relaxation of the pelvic floor.

These exercises are useful not only during but also after the birth. The pelvis and the pelvic floor should be allowed to rest for the first few days, but after that it is important to begin with the exercises as soon as possible.

Good pelvic floor control not only makes childbirth easier but can also reduce possible consequences such as (stress) urinary incontinence and the prolapse of the bladder, womb or intestines.

Pelvic floor exercises during pregnancy

Exercise: Awareness exercises using imagination (figure 1)

• Imagine that you need to break wind. Try to hold this back.

• Imagine that you have a tampon in your vagina and that you are pulling on the cord. Try to hold the tampon in your vagina.

Exercise: Pelvic floor control (figure 2)

• Sit on a chair with your fingers under your buttocks so that you can feel both seat bones. Tighten your pelvic floor muscles so that you can feel the movement with your fingertips.

 

Figure 1 Becoming aware of your pelvic floor



Figure 2 Perception, feeling pelvic floor activity with your hands

The aim of these two exercises is to discover which muscles you are trying to activate. What you can feel are your pelvic floor muscles. Now try to tighten these muscles consciously. Tightening the pelvic floor muscles entails closing the urethra, vagina and anus and pulling these inwards and upwards. Breathe out at the same time. Then loosen and relax the muscles as you breathe in. You can do this exercise at any time of day.

Pelvic floor exercises after the birth

After the birth, the centre of gravity of the mother’s body shifts due to the change in weight distribution. The young mother has to rediscover her sense of balance.

The pelvic floor is weakened and slightly traumatised in the first weeks after the birth, and muscle strength has to be regained gradually and deliberately. The control over the pelvic floor muscles often has to be relearned and practised.

Exercise: Awareness of the pelvic floor (figure 1)

See pelvic floor exercises during pregnancy.

Exercise: Pelvic floor activation (figure 3)

Adopt a comfortable position as illustrated in figure 3, with your head resting easily on your hands. Breathe in deeply and concentrate on how the surface of your stomach expands when you breathe in and deflates when you breathe out. Then concentrate on your navel. As you breathe out, activate your pelvic floor muscles. Gently pull your navel towards your spinal column and then even higher towards your heart. As you breathe in, loosen up and relax the muscles. Repeat this exercise several times.



Figure 3 Pelvic floor activation in a position

Strengthening the pelvic floor

Move your pelvis in all directions. Tighten and relax the pelvic floor muscles rhythmically, if possible in the same rhythm as your breathing. Imagine that you are closing your urethra, vagina and anus, and breathe out simultaneously. Pull the pelvic floor inwards and upwards and pull the seat bones together firmly. Hold these muscles firmly tightened as you breathe in, and relax the muscles again completely as you breathe out. Repeat this exercise several times.



Figure 4 Perception, feeling pelvic floor activity with your hands

Tips for the mother:

• Try not to lift anything except your baby for the first six weeks.
• Always tighten your pelvic floor muscles when you pick up your baby.
• Carry your baby close to your body.
• Stand close to the changing table when you change and dress your baby.
• Place the changing pad lengthways so that your baby is facing you, and try to tighten your stomach muscles. This also gives you better eye contact with your baby.
• Stand up from bed in a sideways position. Pull up your knees while tightening your pelvic floor muscles, then hang both lower legs over the side and stand up using your hands for extra support.

Ask your doctor or midwife if you have any questions on pelvic floor exercises.


To access the articles referenced on these pages or to find out more information on Dianatal® obstetric gel, please click here.