Pelvic Floor Health During Pregnancy

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Thank you to our partners at Fitness Matters for hosting Elisabeth and providing her with an evaluation and the below tips and information.

I was recently invited to have a private Pelvic Floor Physical Therapy session at Fitness Matters, which being more than half-way through my third pregnancy, I desperately needed.

Perhaps you read Faith’s post on Pelvic Health After Pregnancy, but you’re currently pregnant, or considering having another child and wondering how to maintain or strengthen your important pelvic muscles in preparation for, or while carrying, a child. Below you’ll find tips and information provided to me by Pelvic Floor Physical Therapist, Anna Patitucci, during my session.

Staying Active is Important

We all know by now that staying physically active during pregnancy is a really good thing. But most of us probably don’t know that engaging your entire group of inner core muscles, including your pelvic floor is just as important, both before, during, and after pregnancy. As I mentioned, I’m on my third pregnancy after having two very large babies (9.5 lbs and 8.2 lbs), which means my muscles are stretched and I pee. A lot. Unfortunately, we’ve been told over the years that a tight core/abdomen is the ideal look for physically fit people. However, this doesn’t take into account the deep pelvic floor muscles that run from your diaphragm down to your inner core and require muscle mobility, i.e. a soft base to allow full movement for proper breathing, proper structure (holding your pee, baby, and poop in place), and proper flexibility to expand and contract as we grow a tiny human being.

All that being said, proper pregnancy workouts should include pelvic floor exercises. These involve a series of movements combined with breathing that work to tighten you muscles and can be done in a matter of minutes each day.

Peeing Isn’t Normal

One of the hardest things for me this time around has been knowing when to slow down and when to push through during my workouts. One problem I’ve noticed is that I have little pee accidents on the regs, much more often than I did previously – and this started well before my baby bump showed through.

According to Anna, this is not normal. Let me repeat that for the ladies in the back. This is not normal. I know we all have funny peeing-our-pants stories that we share among friends. Hilarious. Except. THIS IS NOT NORMAL. And according to Anna, is a clear sign when I need to pull back on an exercise and mod down or do something different. Basically, when I’m peeing during an exercise my body is telling me that it can’t hold it all together, and my muscles are not working in concert as they should be. So ladies, this is what they mean when they say listen to your body, because, and I can not stress this enough, PEEING YOUR PANTS IS NOT NORMAL.

Coning is Bad News

The second thing I’ve noticed during my workouts, and that I’d taken more notice of than the peeing, but honestly, probably not as much as I should have, is belly bulging or coning. I’m sure many of you have heard of diastasis recti, a common (and normal!) condition where your 6-pack abdominal muscles start to separate to make room for growing baby.  A small separation is fine, and probably not a cause for concern, however, anything over a 2.5 finger gap needs to be taken seriously, as it can be associated with further pelvic floor dysfunction and back pain.

Here’s the important part: if you notice ANY coning/bulging (i.e, the center of your stomach is pushing out between your abdominal muscles) STOP the exercise and modify it or do something else entirely, as this is a sign that your inner core muscles are not working properly. Anna was very clear with me on this point. In early pregnancy you may notice this when doing core exercises that directly engage your central core muscles, and later on you may notice this while doing traditional planks or exercises that use a plank structure as the base of the exercise.

Tips/Tricks for Getting Up

After Anna and I talked and information was shared, we got down into the nitty-gritty and she had me start practicing pelvic floor engaging exercises to help with everyday life, which ultimately will help in my recovery from child birth.

As I learned from Anna, the breath is all important to these movements as the pelvic floor function is closely connected with the diaphragm and works in concert with the deep abdominal muscles running down the trunk of your body and into your floor.

Here’s what she had me start with:

  • Pelvic Floor Breathing: A foundational movement, and one that will help with the peeing issue, both during and after pregnancy. Basically, you inhale, and on the exhale you perform a kegal movement (pull the bean up!)
  • Blow Before you Go: Another great foundational movement, this one partners breathing with standing and other large movements (such as picking up a child). Start seated, inhale, exhale and stand up.
  • Blow Before you Go with Log Roll: This movement is helpful in getting up from a laying position, and as a c-section birther, will be invaluable after baby comes out. First, while laying down, inhale, exhale and slowly raise both legs to a bent position. Breath again, and on the exhale roll to your side. Third, breath again, and on the exhale slowly sit up.
  • Recovery Starts in the Hospital: One of the most important bits of information I learned during my session was that all these exercises can be done immediately after birth (depending on your birth experience). Unlike traditional exercise where waiting 4-6 weeks (or longer) is critical, connecting with your breath and pelvic floor can, and should, begin right away, provided there are no medical contraindications. As an active person this provided a lot of comfort to me, and frankly something to look forward to. I’ve been dreading having to take time away from the gym but knowing I can work on my physical well-being right away is huge. Plus, as many of you know, moving around after a c-section can be quite difficult, but armed with these exercises I’m looking forward to my best recovery yet!

In sum, I honestly don’t know why Pelvic Floor PT isn’t a more ingrained part of not only prenatal healthcare and exercise, but female healthcare in general. Fitness Matters is a warm, safe, and comfortable environment with a truly friendly team. Anna was beyond knowledgeable, pleasant, and informative. She provided an evaluation based on my needs and gave me enough tools to get me through this pregnancy with a head start towards connecting to my inner core after birth.

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Elisabeth
Elisabeth, a native of southwest Ohio, has recently moved back to her home state after 3.5 years in Dallas, TX, y’all. After having their son in early 2015, Elisabeth and her husband knew it was time to make the bittersweet decision to leave Dallas and head back home. Although neither Elisabeth nor her husband are originally from Columbus, it immediately felt comfortable and welcoming, home at last. Elisabeth is mama to a darling, wacky, and scrumptious one-year-old boy, Baby Bean, and married for over four years to the man who stole her heart with a smile junior year in college. Before embarking on her life-long dream of being a stay at home mom, Elisabeth attended law school in Cleveland and then promptly decided to become a real estate agent in Dallas. Elisabeth loves making lists of all kinds, squeezing into skinny jeans whenever possible, and truly believes nothing tastes better than that first cup of morning coffee (with lots of cream). Her favorite things include Cadbury Eggs, Christmas decorations, hotel room service, and watching Baby Bean grow and change each and every day, even if that means toddlerdom is upon her! Elisabeth is passionate about parenting, and loves to learn about the many different types of parents, child-rearing, and how individual families approach various, every day challenges. She hopes her stories can help others see a new perspective, understand that no matter what, they aren’t alone, bring forth a little bit of inspiration, and ultimately help other parents through this nutty job we’ve bestowed upon ourselves.