Pelvic Floor Physiotherapy during Pregnancy

Seeing a pelvic floor/women’s health physiotherapist during your pregnancy can have many benefits, even if you are not experiencing any pain or symptoms currently. Read on to find out why….

Pregnancy is an amazing time in our lives with our body going through so many changes to grow a human!  As a result of these changes, at some point in your pregnancy you may experience varying challenges with exercise or even routine day to day activities.  Understanding why these changes occur and tips/tricks on how to manage these challenges if they occur, can help make your pregnancy much more comfortable and enhance your postnatal recovery.

A physiotherapy assessment in your second trimester (around 14-16 weeks) can be valuable in helping identify any current or emerging issues or risk factors for pelvic floor or musculoskeletal dysfunction during the pregnancy and commence treatment early for optimal outcomes. Common pregnancy complaints may include:

• upper or lower back pain

• pelvic girdle pain (SIJ (sacroiliac joint) pain, pubic symphysis (pubic bone) dysfunction (PSD) or tailbone (coccyx) pain)

• wrist pain (carpal tunnel syndrome or De Quervains tenosynovitis)

• round ligament pain

• rib pain

• constipation

• urinary incontinence

• foot/arch pain

• varicose veins - vulva and/or legs

• diastasis rectus (abdominal muscle separation or DRAM)

• and more..

The second trimester is is also a perfect time to check how your pelvic floor muscles are functioning and treat any dysfunction that may be present ahead of the birth. Did you know it is important to not only know how to contract your muscles (as in a ‘kegel’), but also how to relax the pelvic floor muscles properly during childbirth, passing urine or a bowel motion? Clues that your pelvic floor might be overactive or tense include pain with sex, difficulty emptying your bladder or bowel, pelvic pain or pain/difficulty with tampon insertion or gynaecology exams. If this sounds familiar, a pelvic floor assessment is highly recommended (with your consent) to learn how to relax the muscles for the birth. There are certain times and circumstances in pregnancy when an internal pelvic floor muscle assessment is not recommended and your pelvic floor physiotherapist can explain this further during your consultation if applicable. If an internal examination is not for you, don’t worry, there are other ways you can be assessed.

Your physiotherapist can also provide:

• Healthy bladder and bowel habits education

• Postural education

• Activity modification

• Safe exercise in pregnancy guidelines

• Gentle pregnancy stretches and exercises

• A self-management home program

• Targeted hands-on physiotherapy treatment of any concerns as required

• Prescription of a pregnancy belt/support as required

In the third trimester (around 33-34 weeks) a birth preparation appointment is recommended to discuss:

• Conservative pain relief options in pregnancy including the use of TENS and partner massage techniques

• Positioning for first and second stages of labour

• Preparing the perineum for birth to help reduce the risk of significant tears

• Further educate and review pelvic floor relaxation

• Optimal breathing techniques

• Early postnatal recovery tips to help you through those first 6 weeks

If this post resonates and you are looking for support during your pregnancy, contact us for an appointment.