Why You Need a Pelvic Floor PT on Your Birth Team

When you think about your birth team who is on it? 

Your partner? A midwife or an OBGYN? A doula? Labor and delivery nurses? Your mom? Your sister? Your best friend? 

What about a pelvic floor PT?

Pelvic floor physical therapists can be an important ally in pregnancy, birth, and postpartum. Many women come to pelvic floor PT postpartum due to leaking, prolapse, or pelvic pain. But many times, pelvic floor dysfunction starts to show up in pregnancy (or even prior).  Additionally, many birth prep classes focus on breathing, interventions, labor stages, and signs of labor but skip over pelvic floor anatomy, how to push, and ways to reduce the risk of pelvic floor injuries. 

Everyone on your birth team has a role. A pelvic floor PT is the expert in your musculoskeletal system, your pre/postnatal exercise programming, and pain or pelvic floor dysfunction. 

During pregnancy, a pelvic floor PT can help you understand your pelvic floor. Many women come into therapy thinking that they know how to contract and relax their pelvic floor, but find they are doing it incorrectly. Some are unable to let go of tension, others bear down when they intend to lift. Some hold their breath to bear down. Simple observation and palpation of the perineum can give you a lot of information about how well your pelvic floor is working.

Excess tension in pelvic floor muscles can prolong the second stage of labor, increase the risk of tears, and make pushing difficult. There is so much value in having someone help you practice pushing with an open glottis, how to relax muscles that are under stretch, perform safe perineal stretching, and learning how to breathe and stretch to relax pelvic floor tension during contractions.  

Labor is a physical and mental endurance event. Having solid knowledge of how your body works helps keep things moving. The more you understand the more tools you have to move your body in labor to open different parts of the pelvis as baby works their way down. It can also keep you calm in moments of chaos or when pain levels get intense. 

You need a strong pelvic floor to support your body in pregnancy and postpartum, but you also need a flexible pelvic floor for birth and daily function. There's a lot of noise about what you should be doing in pregnancy-- how many Kegels to do a day, how to prevent diastasis, what's "normal" in pregnancy, what's safe. The reality is that none of it is one size fits all. Having an expert who actually evaluates your needs is going to get you the best possible advice. Education, customized exercise routines, manual therapy for aches and pains and even help selecting support wear or braces can all be part of your prenatal care.

A bit of preventative care goes a long way. So many women start off with small bad habits (like pushing to pee or peeing just in case) which may not cause leaking prior to pregnancy but find that in their third trimester or postpartum they are leaking constantly. Even just learning how to push confidently can help avoid injuries from being coached to purple push if it isn't necessary. 

Pelvic Floor PT care in pregnancy and postpartum should be standard practice. It sadly is not, but more women are seeking better care standards. Our practice model aims to carry women through their whole pregnancy. We bake in birth prep, custom exercise programming, and in-person visits with manual therapy to set you up for success. Having the continuity of care through pregnancy and early postpartum helps prevent treatable, common pelvic floor problems from going untreated and normalized. 

Want to learn more about how a pelvic floor PT can fit onto your birth team? Set up your free 30 min consultation with us today so we can sit down and answer all your questions.