Pregnancy and childbirth can have significant effects on a woman's body, including the pelvic floor. The pelvic floor consists of muscles that provide support to organs like the uterus, bladder, large intestine, and rectum.
During pregnancy and childbirth, the pelvic floor muscles may undergo changes that can impact their important functions.
These functions
include maintaining control over bowel and bladder movements, as well as
providing support to the vaginal walls and uterus. When the support provided by
these muscles is compromised, it can potentially lead to a condition called
prolapse, where organs descend from their normal positions. Additionally,
trauma to the pelvic floor muscles and nerves during childbirth can cause
pelvic pain, which may occur during or outside of sexual intercourse.
Factors That Affect The Pelvic Floor During Pregnancy
Several factors during pregnancy and childbirth can
contribute to the development of pelvic floor disorders in the future. It's
important to be aware of these factors and take appropriate measures to
maintain pelvic floor health.
1- Physical Changes
During pregnancy, about 50% of women experience pelvic floor disorder symptoms even before childbirth. Weight gain from the baby, placenta, increased blood volume, and larger uterus strains of the pelvic floor muscles, increase the risk of urinary incontinence. Constipation is also common due to the weight of the growing uterus and hormonal changes, which can weaken the pelvic floor muscles and nerves through straining and stress.
Pregnant women need to be aware of these factors and take
steps to maintain pelvic floor health. This can include exercises to strengthen
the pelvic floor, and maintaining a healthy diet that promotes regular bowel
movements.
2- Hormonal Changes
During pregnancy, hormonal changes occur and the placenta
releases relaxin, which makes the ligaments in the pelvis more flexible and
softens the cervix. This helps prepare the body for childbirth but can also
cause increased flexibility and instability in the pelvic bones.
3- Medical And Occupational History
Certain women are more prone to pelvic floor disorders, and
this risk becomes higher during pregnancy. Those with a history of chronic constipation,
connective tissue disorders, or smoking are at an increased risk. Additionally,
women who are obese or have a history of regularly engaging in heavy lifting,
whether at work or during weight training exercises, may also face a higher
risk.
Identifying Pelvic Floor Disorders
Pelvic floor disorders can be difficult to identify since
their symptoms can resemble other conditions. For example, pelvic pain may be
mistaken for endometriosis, and bladder-related symptoms can mimic pelvic floor
problems. This overlap makes it challenging to determine whether the symptoms
are specifically related to pregnancy or pelvic floor disorders. Furthermore,
the pelvic floor is not easily visible or examined by women or their healthcare
providers.
Childbirth And Pelvic Floor
Giving birth and the process of labor are considered factors that increase the risk of pelvic floor disorders. Vaginal delivery, especially during the second stage of labor when pushing is involved, puts significant stress on the pelvic floor muscles. This risk is further increased in cases of operative deliveries that use vacuum or forceps. Even labor before a cesarean section delivery can increase the risk of pelvic floor disorders.
It's important to note that some women's pelvic floors are
more resilient and can recover quickly, while others may be more susceptible to
long-term issues. Research indicates that the more vaginal deliveries a woman
has, the higher the likelihood of experiencing pelvic floor dysfunction.
Preventing Pelvic Floor Disorders
Pelvic floor disorders are not inevitable during pregnancy.
Similar to how pregnant women take prenatal vitamins and avoid alcohol to lower
the risks of certain conditions, they can also take steps to reduce the risk of
pelvic floor disorders.
1- Pregnancy Yoga And Perineal Massage
Attending birthing classes before childbirth can be helpful.
These classes often include exercises that involve stretching and breathing to
coordinate the diaphragm and pelvic floor muscles during delivery. Pregnancy
yoga and perineal massage can also be beneficial in preparing the pelvic floor
by improving tissue flexibility and stretchability, which can help minimize
the risk of perineal injuries during delivery.
2- Kegel Exercises
Kegel exercises, when done correctly, can strengthen the
pelvic floor muscles. However, it's important to note that about 40% of people
may not perform Kegels correctly initially. If you're unsure or have questions,
a physical therapist can assist you in identifying the correct muscles and
provide guidance.
Childbirth educators, nurse midwives, or OB-GYNs can
recommend specific stretches and classes tailored to prepare the pelvic floor
for childbirth.
Finally
If you experience symptoms of pelvic floor disorders during pregnancy, seeking treatment is important to prevent further complications. Making lifestyle modifications such as regular exercise, maintaining a healthy diet, and properly managing chronic constipation can also help reduce the risk of pelvic floor disorders.
