Looking after your pelvic health

Pregnancy places a big strain on your body and can put your pelvic health under pressure. Pelvic health relates to your bladder, bowel and reproductive organs and it is important to look after these now to prevent problems later.

One of the main ways you can look after your pelvic health is to strengthen your pelvic floor muscles, which are stretched during pregnancy and birth and can become weaker.

What are pelvic floor muscles?

The group of muscles at the base of your pelvis are known as your pelvic floor muscles. They span from your pubic bone at the front and go back to your coccyx – the small bone at the base of your spine.

These muscles play an important role in your everyday life. They help you to control your bladder and bowel movements and keep your pelvis and hips stable.

Pelvic floor muscles also act like a hammock at the base of your pelvis, providing support to the organs inside it, including your bladder, womb and bowel. These muscles help keep everything in the right place so they can work effectively.

Pelvic floor muscles are also important for sexual function and play a part in arousal and sensation.

How does pregnancy affect pelvic health?

As your baby grows and becomes heavier, the increased weight puts pressure on your pelvic floor muscles. It isn’t just your baby which has an impact – the muscles also have to cope with your uterus changing shape and getting larger and the placenta and amniotic fluid add to the downward pressure too.

The pregnancy hormone relaxin also make your muscles looser and more relaxed. This is great for helping prepare you for birth but it can also weaken your pelvic floor muscles, making it harder for you to control your bladder.

This is why you might notice that you find it harder to hold in your wee towards the end of your pregnancy. Many women find they suffer from stress incontinence, especially in the third trimester, and they may also leak urine.

How does childbirth affect pelvic health?

If you give birth vaginally, your pelvic floor muscles will need to stretch to allow your baby to be born. You may also experience some perineal tearing (where the skin between the vagina and anus tears) or need an episiotomy.

If you have an episiotomy or a tear, this will have an impact on your pelvic floor muscles and your perineum will need time to heal. Even if you managed to have a straightforward birth with no tearing, your muscles will still have been through a lot and are likely to feel much weaker in the days and weeks following the birth.

What can I do to improve my pelvic health?

Throughout your pregnancy and after your baby is born, it is important to do your pelvic floor exercises regularly. These exercises will help strengthen your muscles, which can help prevent issues like incontinence and pelvic organ prolapse (when the uterus, bowel or bladder slips from its usual position and ends up bulging into the vagina).

Don’t be embarrassed if you do experience any incontinence – talk to your midwife or GP so they can help. If your pelvic floor muscles are weakened, you may also have issues with both bladder and bowel control – many women find this difficult to talk about, but both your GP and midwife will have cared for lots of pregnant women and new mums with the same issue and can help.

How do I do pelvic floor exercises?

The good news about pelvic floor exercises is you can do them anywhere, even while you are sitting down. The aim is to tighten the muscles around your vagina and anus so imagine that you are trying to stop a stream of urine while also holding in some wind.

You don’t need to hold your breath in or actually squeeze your buttocks – instead try to squeeze and lift. Get yourself into a comfortable position and squeeze the muscles 10 to 15 times in a row.

At first, you may find it difficult but as you get used to using these muscles, try to hold each squeeze for a few seconds before you release. Build your pelvic floor exercises into your daily routine so they become a habit – you could do them every time you brush your teeth for example.

Gradually increase how many squeezes you do and how long you hold them for but don’t overdo it and take a break in between sets of squeezes.

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