What precautions can be taken to help
the pelvic floor during and after pregnancy?
The pelvic floor significant pressures and changes during and after pregnancy. It is stressed by weight gain and forces, increased muscle tension, and lacerations during childbirth. But what precautions can be taken to prepare the body for this joyful event and avoid damage and consequences for pelvic
First of all, let’s get to know the pelvic floor
The pelvic floor is undoubtedly a crucial pillar for women’s health. It is a region composed of a complex network of muscles located in the lower part of the pelvis. These muscles have a supportive role and function to maintain the pelvic organs (such as the uterus, rectum, bladder, and urethra) in the correct position. Taking care of these muscles, strengthening them, and keeping them toned is essential to ensure their proper functioning. Under normal conditions of tone and elasticity, the muscle bands ensure adequate physiological functions such as urination, defecation, sexual functions, and reproduction.
However, lacking proper muscular support predisposes the occurrence of dysfunctions such as gynecological disorders, chronic pelvic pain, urinary and fecal incontinence, hemorrhoids, sexual issues, and in severe cases, prolapse of the bladder, uterus, or rectum. Giving the right attention to this area is crucial in every stage of life, from adolescence to menopause. During the fertile years, the pelvic floor muscles play a role in sexual pleasure, and exercising them can improve muscle tone and orgasmic contractions. During pregnancy, these muscles bear the weight of a new life, and during childbirth, they are subjected to significant stress and stretching. Finally, during menopause, they can weaken and atrophy due to age and hormonal deficiency.
Pregrancy: a period of pressure on the pelvic floor
Pregnancy is a very delicate period for the pelvic floor. A woman’s body undergoes physiological changes during gestation that put significant strain on the abilities of this muscle group, including:
- hormonal imbalances, especially the increase in progesterone, which softens and relaxes all muscle structures;
- changes in postural alignment,as the fetus grows, the mother’s center of gravity shifts forward, and the lower part of the spine begins to arch;
- weight of the baby, which exerts downward pressure, especially on the bladder.
All these changes lead to a significant increase in pressure on the pelvic floor, and in a weakened area, dysfunctions such as urinary incontinence and, less commonly, gas/fecal incontinence may occur.
Childbirth and perineal massage
Childbirth represents the most stressful moment for the pelvic floor. During the expulsion phase, it accompanies the delivery of the baby, which is why it is important for the muscles to be sufficiently elastic. Preparing the perineum for childbirth through a few simple targeted exercises will improve elasticity and promote an ideal body posture. In particular, perineal massage during pregnancy offers numerous benefits and advantages:
- it improves the elasticity of superficial perineal structures;
- it increases blood flow and oxygenation of perineal tissues;
- it reduces the likelihood of spontaneous tears or the need for an episiotomy;
- it helps women become aware of the area.
The postpartum period: a moment of transition
The Italian Ministry of Health defines the postpartum period as the “time period that begins immediately after childbirth and ends with the return of the genital organs to their pre-pregnancy anatomical and functional conditions.” During this period, it is crucial not to neglect the pelvic floor. For this reason, there are some important dates that new mothers should mark in their calendars:
- Around 40 days after childbirth, it is important to have an obstetric-gynecological check-up. After this time interval, the reproductive system has returned to normal, the uterus has regained its size, and postpartum bleeding has usually stopped. During the gynecological visit, the specialist checks if the size of the uterus has reduced and if any lacerations caused by childbirth, episiotomy, or cesarean section have fully healed.
- Two months after childbirth, it is beneficial to have an evaluation by a physiotherapist who specializes in pelvic floor rehabilitation. This evaluation aims to identify any loss of muscle tone, the presence of abdominal diastasis (a condition that can cause lower back pain, intestinal problems, and digestive issues), and to plan a personalized rehabilitation program.
If a dysfunction is identified during the evaluation, it is important for the new mother to diligently follow the treatment plan and the instructions provided by the specialist. The main goal of a pelvic floor strengthening or rehabilitation program is to increase awareness of the importance of this area and improve its condition to achieve greater psycho-physical well-being. Approaching these therapies with a positive and correct mindset, addressing all the behaviors or habits that contribute to the weakening of the pelvic floor every day, and being motivated are essential to move in the right direction. Choosing to be guided by a pelvic floor specialist during and after childbirth and consistently practicing the most suitable exercises (formulated by the specialist based on individual conditions) are all behaviors that help experience the sweet moment of motherhood with serenity, without being overwhelmed by unpleasant symptoms or suffering from damage and consequences to pelvic health.
The contents of this page are for informational use only and in no case should they replace the opinion, diagnosis or treatment prescribed by your doctor. The response to the same treatment can vary from one patient to another. Always consult with your doctor on any information relating to diagnosis and treatment and scrupulously follow his instructions.