Pregnancy and childbirth is an exciting and unique time in a woman’s life. The body is changing in so many ways physically, emotionally and mentally. Sometimes pregnancies can feel fantastic and easy and other times pregnancy can be exhausting & stressful. As a pelvic floor physiotherapist, it is my goal to empower women with the knowledge, guidance & exercises needed to meet the challenges that pregnancy, childbirth & postpartum may bring. Knowing when to see a pelvic health physiotherapist can optimize your body’s function & well-being.
PRE-NATAL CHECK UP
Consult a pelvic health physiotherapist DURING your pregnancy if you have ANY of the following:
- Pain in your pubic bone, groin, back, pelvis, tailbone, ribs, sciatic pain
Incontinence or leakage (bladder/bowel) - Abdominal Diastasis Recti (doming of the abdomen)
- Pelvic Organ Prolapse (heaviness or pressure in your pelvic area)
- Difficulties doing everyday tasks such as rolling over, walking or getting in/out of a vehicle
- Vaginal varicose veins
- Any questions about preparing for labour and delivery
If you have a low risk pregnancy, a pelvic physiotherapy internal exam is safe and is a great way to see how your pelvic floor is doing. You want to have a strong pelvic floor during pregnancy to minimize the impact of pregnancy and delivery, but you also want to be able to relax and lengthen those muscles during labour. Doing a few sessions during pregnancy after your first trimester, can help you find out where your strength is, learn how to effectively contract and relax the pelvic floor, and give you the tools you need to start retraining your pelvic floor and core after your baby arrives.
If you are experiencing any of the symptoms listed in the table, it is important to have these issues addressed during pregnancy, as they can continue to worsen during the pregnancy and linger into postpartum.
Did you know that pelvic floor physiotherapists can also prepare you for labour and delivery?
At 34 weeks of pregnancy, we begin to prepare you for labour and delivery. We switch our focus from strengthening the pelvic floor to relaxing the pelvic floor muscles. We do this by a variety of breathing techniques, stretches, stretching and massaging the perineum. During delivery, it is the uterus that pushes out the baby, while the pelvic floor muscles need to get out of the way! The more relaxed and stretched these muscles are, we can help reduce the chances of tearing or an episiotomy! We will also educate you on optimal pushing and birthing positions. You don’t only have to push lying on your back!
Having an elective C-section or maybe an emergency c-section? – this still applies to you!
It is the pregnancy itself that can contribute to pelvic floor issues such as incontinence, prolapse, or pelvic pain, not only the method of birth.
Currently 1 in 3 births will be a cesarean in Canada.
Many women are given very little education and support when it comes to the recovery process. We will address any underlying issues and help prepare you for the recovery process including activity modifications, restrictions, scar management for the incision (very important!!) and getting back into strengthening your pelvic floor and core.
POSTPARTUM
Consult a pelvic health physiotherapist after delivery if you have any of the following:
- Pain or scarring from c-section incision, tearing or episiotomy
- On-going or new pain in your pubic bone, groin, back, pelvis, tailbone, ribs, sciatic pain
- Leaking urine, gas or stool when you laugh, cough or sneeze
- Not making it to the bathroom in time
- Abdominal Diastasis Recti (doming of the abdomen)
- Pelvic Organ Prolapse (heaviness or pressure in your pelvic area)
- Pain with intercourse
Postpartum Recovery
If you have had children and are at least 6 weeks after delivery, it is a good idea to have a pelvic assessment done. Similar to a pre-natal assessment, we will review how to correctly train the pelvic floor and core muscles. We will also talk about self-care, check for any areas of discomfort, talk about getting back to intercourse, and chat about any of your pelvic questions and concerns. Many mothers have pelvic floor impairments that do not lead to specific problems until years later in menopause. Addressing these changes early, even if you do not leak or have prolapse, is a good way to make sure you do not develop problems in the future.
Pelvic Floor Assessment & Treatments
During a pelvic floor assessment, the following is typically addressed through an external and internal exam:
- Posture & Pelvic Alignment: It is very important to gain postural awareness during pregnancy. A growing baby changes our center of gravity and can cause us to adopt poor postural habits – putting extra pressure on our joints.
- Movement Patterns: We will assess how you transition in bed, get out of bed, get up from a chair, how you lift heavier objects etc.
- Pelvic Floor Muscle Activity & Tone: We will assess the strength and tone of your pelvic floor muscles and abdominals to ensure you are engaging them correctly. Many women are told to “just do kegels” however without a proper assessment – many women are incorrectly activating these muscles and for some women, doing kegels may not be appropriate at all and may make their pelvic issues worse.
- Current Pelvic Floor Dysfunctions: Weakness or tightness in your pelvic floor muscles that may be contributing to any pain, incontinence, constipation or pelvic organ prolapse.
Pelvic Floor Treatments will typically include the following:
- Proper breathing techniques
- Strengthening or relaxing your pelvic floor muscles correctly
- Postural exercises to avoid “Mommy Posture”
- Proper core engagement and safe exercises to prevent or reduce diastasis recti
- Bladder retraining
- Education on proper postures and movement patterns
- Treatment of lower back pain, hip pain, pubic bone pain
- Scar desensitization and massages for any tearing of the perineum or c-section incisions
Every woman’s pregnancy experience is an individual journey. It is very important that you feel informed and supported along the way, even when unexpected twists and turns may occur in your journey.
Having a prenatal or post-partum pelvic floor physiotherapy assessment will let you know how your pelvic floor and core muscles are working, which will help guide you to a more comfortable and confident pregnancy, childbirth and postpartum recovery.
To help ease your concerns and answer any questions, I am offering a COMPLIMENTARY 10-MINUTE PHONE CONSULTATION!
We can chat and determine if Pelvic Health Physiotherapy will benefit you! Don’t delay, call 905-503-2767 or email me: erin.albaum@aurorasportsmed.ca to learn more!
Erin Albaum, MScPT
Registered Physiotherapist – Pelvic Health