In the prenatal classes that I teach, I’ve had mamas coming up to me, a little shy, sharing that when they sneeze/cough/laugh, or sometimes while getting up from a sitting position, urine seems to leak out uncontrollably. This is also known as incontinence, and is common both during pregnancy and post-birth. While I reassure mamas that they needn’t feel embarrassed by this, there are things that you can do to improve the situation.
*Disclaimer: Do bear in mind that I’m sharing about this based on my knowledge as a Pilates teacher, and I’m explaining things in a layman manner for most people to understand. However, if you require professional advice, it’s best to see a physiotherapist who is trained in pelvic floor health.
Firstly, what is the pelvic floor?
Most people aren’t acquainted with it. If you practice Pilates regularly, you might have heard of it, but often it’s difficult to understand these intricate muscles that are deep inside your body. An simple way to think of the pelvic floor is like a hammock stretching from your tailbone (at the back) to your pubic bone (in the front). It is a band of muscles that support your pelvic organs such as your uterus, bladder and bowels.
Okay…and how do I find it?
Excuse the slight technical talk – the pelvic floor contains your sphincters which are the muscles surrounding your urethra and anus, allowing you to control your pee & poo. So a way to help you “find” your pelvic floor muscles is to try to stop your urine flow midway the next time you’re peeing. Those muscles that you use to “hold your pee” (like how I often describe it in class) are your pelvic floor muscles.
What happens to the pelvic floor during pregnancy & birth?
During pregnancy, several things happen to the pelvic floor. For starters, with your growing baby, the uterus increases in weight and your pelvic floor has to work harder to support this. For fitspo mamas who continue with high impact activities such as running/HIIT during their 2nd & 3rd trimesters (I do not recommend this!), the impact on their pelvic floor is further exacerbated. Also, muscle-relaxing hormones during pregnancy prepare your body for the birth and cause the pelvic floor to loosen.
During birth, your pelvic floor also goes through a lot! In a vaginal birth, the pelvic floor is stretched and strained to accommodate the delivery of your baby. And C-sec mamas aren’t spared too! Remember that it is a major abdominal surgery after all – cutting through multiple layers does result in a weakened abdominal wall and pelvic floor.
What do I do about this then??
First and foremost mamas, accept that your body is going through a lot during pregnancy and birth. In all my pre/post natal classes, I remind my clients of the importance of respecting their bodies and amazing work that its doing by carrying and birthing their babies. Work with your body instead of against it.
During pregnancy: Strengthen AND stretch your pelvic floor. Often, the worry of incontinence gets mama motivated into practicing the kegels to strengthen her pelvic floor muscles, which is great! But hold up a moment – remember what I mentioned above about the changes in your body during pregnancy and birth? Your hormones are causing your pelvic floor to relax, your pelvic floor muscles are built to stretch during birth – and it is important to keep this in mind! Over-strengthening of the pelvic floor during pregnancy is working against what your body is doing to birth your baby. Instead, aim for balance between keeping your pelvic floor both strong and supple during pregnancy to minimise incontinence, and yet allow it to be flexible for the birth.
After birth: That’s when you can do all the strengthening that you want! But once again, listen to your body. You have gone through a lot during the birth, appreciate for body for the work its done! Focus on gentle rehabilitation post-birth (breathing exercises can be done even on the day itself, once you feel ready), and gradually build up as your body recovers.
This post was more of an introduction to what the pelvic floor is – I believe that it is important to understand it before actually trying to do something about it. I decided to split this topic into 2 sections, otherwise it’s gonna get too long. In my next post, I will share some exercises that you can do to strengthen and stretch your pelvic floor during pregnancy and after birth. Hit the subscribe to be notified when my next post is up 😉