Your Pregnant Pelvic Floor


Pregnancy is “the big league” for your pelvic floor muscles. The pelvic floor in pregnancy plays a critical role in overall wellness during pregnancy and also in delivery and recovery. While it’s doing what it always does―lengthening and lifting to support your organs, continence, and posture―your pelvic floor is dealing with a significantly changed environment. Let’s explore the major changes your pelvic floor undergoes during pregnancy.

What happens to your pelvic floor during pregnancy?

First, your pelvic floor is working harder than it ever has. As your baby and uterus grow, they are getting heavier! This means there is more gravity pushing down on your pelvic floor muscles. Additionally, your body is making postural changes to accommodate breast growth and weight gain, again meaning new loads for the pelvic floor to hold up. Even in the first few weeks of pregnancy, there’s more blood in your body than ever before, causing swelling and enlargement of the vulva and pelvic region. This increase in blood flow improves tissue suppleness and hydration, and it can even cause darkening of color or increased sensitivity for some.


One of the functions your pelvic floor helps govern is digestion and continence. Because of pregnancy hormones and also because organs must shift around a growing uterus, many pregnant women experience constipation and the need to pee more frequently. Some pregnancy hormones may also cause diarrhea. Fun! But all part of the process, and a healthy pelvic floor can help alleviate these issues.

Your pelvic floor is becoming more flexible in pregnancy. The muscles of the pelvic floor are "softened" by pregnancy hormones (one is even called “relaxin”) so they can be flexible in time for the big day. As these hormones work on your pelvic ligaments and muscles, the bones that form your pelvis move away from each other. The weight of the baby and your uterus also serve to stretch and soften. For some women, this leads to pubic symphysis pain, or pain right at the pubic bone. Some shifting in the pelvis can lead to sciatica pain, or pain that runs from the back of the pelvis down one leg along the sciatic nerve. Pelvic floor pain in pregnancy due to increased flexibility is common but treatable. 


A healthy pelvic floor helps to reduce pain in pregnancy and promotes an “easier” delivery. Hopefully, you’ve had the opportunity to get well acquainted with your pelvic floor before pregnancy, but it's never too late! Each day of pregnancy may feel different from the last, and the body has to re-calibrate and re-coordinate its systems as the belly grows. A healthy, responsive pelvic floor coordinates with other stabilizing muscles in your core, so they can work as a team to help reduce pregnancy discomfort and pain. 


Additionally, being able to control and coordinate relaxation/contraction of your pelvic floor is essential for labor prep. Fully relaxing the pelvic floor during the pushing stage can potentially decrease time needed in this stage and also reduce tearing. Even for non-vaginal births, a coordinated pelvic floor can aid mothers in a smooth recovery from Caesarean surgery.

Should you exercise your pelvic floor during pregnancy?

Yes, you have a role to play. If your individual health allows, but it’s not just about working; it’s about knowing. The more you know about pelvic floor function, and the more you practice coordinating your pelvic floor muscles with everyday movement, the more supported your pregnancy and delivery will be. The pelvic floor changes each trimester so you may need to get reacquainted with your pelvic floor with each change, adapting as your hormones shift, the baby grows, and demands on the pelvic floor change. Knowing how to do an effective kegel exercise while pregnant means knowing how to both lengthen and let go of the pelvic floor muscles, as well as close, lift and activate. This is critically important during pregnancy as well as for delivery, when the pelvic floor will need to relax, open and release in order to let your baby out.  


If you are concerned by pelvic floor pain during pregnancy, we at HappySneeze recommend getting to know your pelvic floor better! Kegel exercises and learning to release your pelvic floor can be safe during pregnancy, and strengthening your pelvic floor in pregnancy will help prevent pain. However, pay attention to what your body is telling you. If you need more personalized guidance, we at HappySneeze strongly encourage you to see a pelvic floor physical therapist if that option is available to you.

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