Birth Prep: Prepare Your Pelvic Floor for Childbirth

How should I set my body up for a successful birth?  What should I do to save my pelvic floor and how should I prepare my pelvic floor for childbirth?  How can I make my birth easier?  How can I prevent tearing?  I get these questions a lot and I LOVE treating women with this curiosity during pregnancy and a proactive mindset!  And in this article I am not going to outline a list of exercises that you "should do" because here's the thing - it's different for everyone and there are likely TONS of good and appropriate things you can do. So, to connect the dots and and help you sift through the information, I am going to talk about concepts of what is important and why to help you create a framework of understanding.

I truly believe that working with a woman during pregnancy gives her the information that she needs for INFORMED decision making in the birthing room. Let’s face it, giving birth does come with some pain and is also intimidating, especially if it is your first time.  Heading into an unknown situation can be nerve wracking, despite how excited you are for your baby to come into the world.  And when you enter with some fear and confusion, it’s much more difficult to understand recommendations that are coming at you, so getting ahead of it is key. 

I teach pregnant women different options and how to interact with the recommendations that are coming at her to know what is right in her individual body.  In my opinion, there are so many birth education courses that go through the stages of labor and the process of birth, but leave out the parts that help a woman trust the process and understand the role of her own body and intuition during birth.  Fear and confusion can lead to a higher likelihood of interventions and feelings of disappointment with birth.  I hear it all the time….”Why didn’t anyone tell me about this or that?” 

I will get off of my soap box now, and this is what birth prep looks like from my lens: 

Here are the over-arching principles of what I work on with someone who is pregnant to help their body efficiently support the pregnancy and keep connection with the deep core and pelvis, to set them up for an easier birth, and to prepare for a good postpartum recovery.  Also, if you are experiencing pain, leaking, or instability as her baby grows, we can take care of that before it causes difficulty during birth.  You do NOT have to wait until your baby is born for pain to go away. 

1. Alignment. 

   Keeping your pelvis and ribcage in balance is important to support the growing baby.  There are, of course, natural adaptations that occur in your body as your belly grows, and your posture does change.  However, there is a big difference in understanding the changes and working with them, versus just succumbing to them because you don’t know the difference.  Changes in alignment can affect pain, the way your muscles work, and can lead to increased chance of incontinence (leaking pee) and diastasis (abdominal separation).  This balance and ability to move without tension patterns help with the process of birth.  And, in the postpartum period, we need to make sure any postural adaptations or tension patterns that have developed during pregnancy do not become a habit because it will lead to compensations.

   
   

2. Pelvic Floor Connection. 

   What is interesting to note is that maintaining connection to your pelvic floor is important as it is related to your inner core system, but it’s job during birth is to get out of the way!  Women think they need to do more kegels so the pelvic floor is “strong” for birth, but that is a myth.  For good function, your pelvic floor needs to be adaptable and responsive to all of your movements without having to "grip". During birth, it needs to be supple and able to lengthen and open in order to let baby out! And what’s the first thing your body will do when there is pain from a contraction or fear in your mind?  It will naturally tense up to protect you, which CLOSES the pelvic floor!  Just knowing and embodying this will help you during birth - I help you learn how to work with your contractions and with your body to allow baby to descend.  This takes awareness, breathwork, and movement.  Also, maintaining connection and the ability to lengthen the pelvic floor will help prevent tearing during birth.

1. Tension Patterns. 

   It is normal if some tension patterns develop in your body during pregnancy.  However, they can start to affect your alignment, your breathing patterns, your movement, and baby’s position, so finding the patterns and releasing them is important.  Your habits also fall into this category - there are so many things we do in a day that if we we were aware of the implications on our pelvic floor and core, we can make movement work for us!

   
   

2. Mobility.

   Leading up to birth we make as much room as we can in the pelvis - learning how to lengthen pelvic floor, open the hips, make sure the tailbone can move, and open the sit bones.  Your pelvis, hips, and body needs to move in different directions during labor in order to help baby to descend into the birth canal so we need to preserve this ability, and also teach you what to do and when to do it.  However, just mobilizing or stretching doesn’t do the trick - having stability to control the position of your pelvis is really important.  Being "loosey goosey" leads to it’s own set of problems!

   
   

3. Pushing. 

   Positions matter….but there is no “right” one so you need to learn how to know what feels good in your body so you are able to choose and change when you feel it’s right for YOU.  Positions during birth affect our pelvic bones, pelvic floor, baby position, and progression of labor. Having understanding and a plan is key.  For example, having an epidural does not mean that you can’t change positions, although many people think it does. Also, how you breathe during a contraction and during pushing comes from understanding how your body interacts with your breath, so you can choose and feel what works for you, which might change throughout labor.  You are in charge of this process and know what is best for your body!  

4. Early postpartum. 

   We talk through understanding expectations, what can be surprising, what’s normal and what’s not, and how to help your healing in the early phases.  For example, what surprised me most after my first baby was the complete lack of control in my core - it felt like a noodle!  I now teach women to expect that and how to get the abdominal wall to start coming back together.

Learning these concepts during pregnancy will often help increase confidence and trust, and improve the chances of a strong, smooth, and well-informed birth! Nervous system regulation during birth is really important for a smooth process — knowing how to interact with your body and baby, how to honor what feels good to you, what questions to ask, and what advice to listen to can add some calm into a chaotic moment! Also, all of this can help avoid some of the common pregnancy and postpartum complaints, such as pelvic floor weakness, pain, leaking pee, core instability, so that's a bonus!

For more information, feel free to contact me or book an appointment! Also, look out for my Birth Prep Series (a series of 3 virtual classes) coming soon!