Pelvic Floor Exercise for Pregnant Mums

Exercising for the birth is vital to promote natural birth. There are exercises which can help pregnant mums to prepare for the birth.

This article can be read in conjunction with Exercise in Pregnancy, which gives advice on sports and exercises which are suitable in pregnancy. This article concentrates on pelvic floor exercise, which helps to prepare for the birth itself.

Is it safe to exercise in late pregnancy?

Exercise in late pregnancy is vital. As the baby gets into position for the birth it is important that you are active and maintain a good posture. Most babies settle into a head down position and ideally have their back facing out to your front. In midwife jargon this is called ‘occipito anterior’ as the back of baby’s head is facing mum’s front. It’s the perfect position for baby to snugly fit their head into mum’s pelvis, right next to the cervix, so they can engineer their way out, quickly and smoothly.

If mum is slumping on the sofa for half of the pregnancy it is very easy for the baby to settle with their back against your back – which makes their head seem larger in relation to your pelvis. The diameters of the part of baby’s head which will come first are actually larger when the baby is in this position. It is known as occipito posterior, or ‘face to pubes’. Labour is often longer and more painful and difficult.

The old fashioned advice of cleaning out the oven in late pregnancy couldn’t be better! By kneeling down and leaning forward, you are actually using gravity to get baby into the ideal position and widening the pelvic outlet that baby will pass through. Just consider that animals on all fours rarely have any problems birthing.

If your midwife has told you that your baby is facing back to back then try these tips to help baby to turn around :

• Don’t lie on your back or sit slumped
• Lean forward as much as possible
• Sit on your dining chair ‘back to front’ leaning on the back of the chair
• Lie on your side with your bump resting on the bed
• Do old fashioned housework/gardening/play with your toddler all on your hands and knees
• Try swimming if that appeals
• Walking and being active will help baby to turn too

If you are unable to exercise due to medical conditions, such as heart conditions, threatened miscarriage/labour, or raised blood pressure, then resting on your side rather than your back will help to engineer baby into the right position.

What are pelvic floor exercises?

The perineum is a group of muscles between the vagina and the anus/rectum. It is covered with skin. There are superficial and deep perineal muscles and these form part of the pelvic floor. The perineum is shaped like an upside down pyramid.

The pelvic floor is a hammock shaped group of muscles, which have several functions:

• Support of abdominal and pelvic organs, which are substantial!
• Sexual intercourse – the muscles become engorged with blood during sexual arousal, enabling orgasm
• Childbirth – the muscles stretch to allow the baby to pass through and then return to normal again
• Continence of urine and faeces are controlled by urethral and anal sphincters, which form part of the pelvic floor.

We all need to do pelvic floor exercises in order to maintain their strength and functions for the rest of our lives.

Pelvic floor exercises are vital to your ongoing health, not just in the post natal period, but for ever after too. Now let’s de-mystify these exercises that everyone talks about.

Easy pelvic floor exercise in 6 simple steps

The simplest way of teaching pelvic floor exercises was explained by a continence nurse a few years ago:

1. Sit on a chair with your feet on the floor
2. Lean forward until your elbows are resting on your knees (or just as far forward as what’s comfortable for you)
3. Tighten your bum muscles, or back passage, as though you were preventing yourself from passing wind (these are the easiest muscles ‘to find’
4. Pull those muscles up towards your belly button, until you feel your vagina tighten too and you will then feel a pull in your lower abdominal muscles too (all good!)
5. Aim to hold for 10 seconds then SLOWLY relax the muscles. This is one ‘set’, repeat 10 times aiming for 10 seconds each hold
6. Repeat 10 times a day.

The last step is really important. Just like building up arm or leg muscles, repeating those exercises a number of times is crucial to build strength. Your pelvic floor muscles are no different!

If at first you can’t hold for the count of 10, that’s fine, just hold for a few seconds then slowly let go. Aim to keep building over a number of weeks until you can easily for 10 seconds, for 10 reps, 10 times a day.

You will soon feel a difference:

• During sexual intercourse, which will be more enjoyable
• When jumping up and down, or sneezing, you are much less likely to leak urine
• Your lower abdomen will feel flatter and firmer! Honest!

Many women sustain tears to their perineum, or have episiotomies, during childbirth. However, contrary to public opinion, even women that have planned Caesarean section, or do not have any perineal damage, can experience weakened pelvic floors after childbirth!

Let’s get exercising those pelvic floors!

Finally for the birth…

Stay as upright and as active as possible. There is no perfect position, but changing your position regularly will help baby to negotiate their passage. At the end of the day it’s a round peg in a round hole, it might just need some manoeuvring! Any position which has you leaning forward will help to open up the pelvis, which in turn will aid the birth. Good luck and stay upright.

Exercise in pregnancy gives great advice on which sports are recommended in pregnancy, as well as tips on staying healthy in pregnancy. Our article Post Natal Exercises gives some great tips on staying healthy after the birth too.