Pregnancy is a time of incredible change for women, both physically and emotionally. While many moms-to-be are familiar with morning sickness, back pain, and cravings, there’s one area of the body that often gets overlooked: the pelvic floor. These muscles are the foundation of your core, supporting your bladder, uterus, and bowels, and they play a critical role during pregnancy, labor, and postpartum recovery.
But how do you know if your pelvic floor needs extra support during pregnancy? Here are five signs to watch for and why addressing these concerns early can make a big difference in your pregnancy journey and birth experience.
5 Signs your Pelvic Floor needs Attention during Pregnancy
1. Leaking when you cough, sneeze, or laugh
Urinary incontinence during pregnancy is often brushed off as “just part of the process,” but it’s a key sign that your pelvic floor is under strain. This type of leakage, known as stress urinary incontinence, occurs when activities like coughing, sneezing, or laughing increase pressure in your abdomen, and your pelvic floor muscles aren’t able to keep the urethra closed effectively.
As your baby grows, your uterus adds more weight to your pelvic floor. Hormonal changes also cause these muscles to soften in preparation for delivery, making it harder for them to maintain their usual strength and function. Ignoring stress incontinence during pregnancy can lead to long-term issues postpartum, such as more severe incontinence or pelvic pressure to your bladder and pelvic floor, making it even harder for these muscles to keep up. While stress incontinence is common, it’s not something you should ignore—it signals that your pelvic floor might be struggling to adapt to the demands of pregnancy.
A lot of women are under the impression that they can’t do anything during pregnancy, so they will just wait until after delivery to get help. We are here to tell you that’s just not true! We have worked with many women experiencing incontinence during pregnancy, and while it can be more of an uphill battle with pregnancy because things are continually changing, you can definitely gain strength while pregnant and can improve incontinence!
Targeted pelvic floor exercises and full body strengthening can help. Contrary to popular belief, not all pelvic floor exercises are about “squeezing” or tightening. A pelvic floor therapist can help you identify the right balance of strengthening and relaxation techniques to improve your muscle function and prevent leaks. Learning how to manage the extra pressure in your abdomen, and learning a few key tips for those times of increased pressure can prevent it from worsening and help strengthen your muscles for better bladder control throughout your pregnancy and postpartum. These exercises can also reduce the risk of long-term incontinence after birth, making them a worthwhile investment in your health.
2. Increased pressure or heaviness in your pelvic floor
A sensation of heaviness or pressure in your pelvic area can feel unsettling, especially if it gets worse as the day progresses. This symptom often points to pelvic organ prolapse—a condition where the pelvic organs (like the bladder, uterus, or rectum) start to shift downward and press against the walls of the vagina.
During pregnancy, this issue can arise as your body works to support not only your growing baby but also the additional fluid, placenta, and other pregnancy-related changes. While pelvic organ prolapse might sound alarming, it is more common than many realize and it’s often manageable with proper care. Ignoring these feelings of heaviness, however, can lead to discomfort during pregnancy and a more pronounced prolapse after delivery.
Simple lifestyle changes, like avoiding heavy lifting and managing constipation, can reduce strain on your pelvic floor. Additionally, pelvic floor therapy can help strengthen and support these muscles, redistributing the weight more effectively and relieving that uncomfortable sense of pressure. A pelvic floor therapist can also perform hands on muscle work to help relax and stretch tight muscles of the pelvic floor, which often lead to increased symptoms. Pressure management education can also be extremely valuable when it comes to pelvic organ prolapse. Early intervention is key to keeping your pelvic floor healthy and resilient.
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3. Lower back or pelvic pain
Pregnancy and back pain often go hand in hand, but when lower back or pelvic pain becomes persistent, your pelvic floor might be contributing to the problem. (And you don’t have to suffer through it – we can help!) These muscles are deeply connected to your core and work alongside your abdominal and back muscles to stabilize your spine and pelvis. When your pelvic floor is weak or unbalanced, it can throw off this delicate system, leading to pain in other areas. The low back and hip muscles may try to step in and “help”, which can actually cause or worsen the pain.
The hormone changes that occur during pregnancy can also contribute to lower back and pelvic pain and while we cannot change your hormones, we can offer modifications for activities that aggravate your symptoms, strengthen the areas around the pain, and even recommend adaptive equipment like belts or bands.
Pregnancy introduces unique challenges, like changes in your posture and the added weight of your growing baby, which can exacerbate these issues. For example, as your center of gravity shifts, you may find yourself leaning backward more often, placing additional strain on your lower back and hips. And fun fact, your spine actually changes shape during pregnancy to accommodate your growing belly so you don’t fall over! It’s a super cool adaptation, but can also lead to discomfort.
Pelvic floor therapy at Moms in Motion PT addresses this pain by focusing on the root cause. Through a combination of strengthening exercises, mobility work, and body alignment, you can relieve tension and restore balance to your muscles. This not only eases pain but also prepares your body for the physical demands of labor and delivery, when a coordinated pelvic floor is essential.
4. Pain during intercourse
Pain or discomfort during intercourse while pregnant is a common but often overlooked symptom of pelvic floor dysfunction. This pain is typically caused by overly tight or overactive pelvic floor muscles. While it might seem counterintuitive, your pelvic floor can be too tense, limiting its ability to relax and stretch effectively.
Sometimes a tense pelvic floor is in response to other symptoms like heaviness or leaking. You might be consciously or subconsciously clenching your pelvic floor (and/or your butt muscles) to “keep everything in”. But this leads to more tension and often causes pain.
Tight pelvic floor muscles can also lead to discomfort during daily activities, like sitting for long periods or walking. If left unaddressed, these muscles may become even tighter as pregnancy progresses, potentially leading to challenges during labor. A flexible, coordinated pelvic floor is crucial for allowing the baby to move through the birth canal, so preparing these muscles ahead of time can make a significant difference in your birth experience.
Pelvic floor therapy can help you learn to release and relax these muscles through gentle stretches, breathing exercises, and manual therapy techniques. By addressing pain during intercourse, you’re not only improving your quality of life during pregnancy but also preparing your body for a smoother delivery.
At Moms in Motion PT, we have a signature program, “BirthEase: Your Pelvic Prep Guide” where we walk you through what happens in your pelvis during labor and delivery, guide you through movements to prepare your pelvis for labor and to optimize the position of your baby, teach you and/or your partner how to perform perineal massage, we go over positions and movements for each stage of labor, we practice how to push effectively and efficiently, we talk about how your partner can help before and during labor, we teach you breathing strategies for pushing, and we go over what to expect postpartum!
5. Difficult emptying your bladder or bowel
Pregnancy hormones often slow down digestion and affect bladder function, but consistent difficulty in emptying your bladder or bowels can point to pelvic floor dysfunction. Overly tense pelvic floor muscles can make it hard to fully relax when you’re trying to go to the bathroom, leading to incomplete emptying, constipation, or feelings of urinary urgency.
These issues can become a vicious cycle. Straining during bowel movements puts additional pressure on your pelvic floor, which can weaken or damage these muscles over time. Similarly, holding your urine for too long can contribute to bladder irritation and increase the risk of urinary tract infections.
Addressing these concerns involves more than just drinking more water or eating fiber-rich foods (though those are important too!). Pelvic floor therapy focuses on improving muscle coordination, so you can relax your pelvic floor when needed and engage it effectively during other activities. We work with a lot of women to retrain how to relax the pelvic floor when sitting on the toilet. It sounds like it should be intuitive, but a lot of women need a little coaching. Learning these techniques during pregnancy can set you up for better bladder and bowel health postpartum as well.
Frequently Asked Question about Pelvic Floor Health during Pregnancy:
Does pelvic floor therapy work?
Pelvic floor therapy is a specialized approach to improving the function of the pelvic floor muscles. It typically involves exercises to strengthen or relax these muscles, manual therapy to release tension, and education on body alignment and pressure management. A pelvic floor therapist works with you to develop a customized plan to improve your symptoms and overall quality of life.
Can pelvic floor dysfunction be cured?
Yes, in many cases, pelvic floor dysfunction can be significantly improved or even resolved with the right treatment plan. Pelvic floor therapy, lifestyle adjustments, and targeted exercises often help restore strength, coordination, and flexibility to the pelvic floor muscles. Early intervention is key for the best outcomes, so don’t hesitate to seek support.
Can pelvic floor dysfunction cause back pain?
Absolutely. Your pelvic floor muscles are a crucial part of your core and work in tandem with your back and abdominal muscles to stabilize your body. When these muscles are weak, tight, or unbalanced, they can contribute to lower back or pelvic pain by throwing off this delicate system. Pelvic floor therapy can help address the root cause and alleviate this discomfort.
Does pelvic floor therapy work?
Yes, pelvic floor therapy is highly effective for addressing a wide range of pelvic health concerns. From incontinence and prolapse to back pain and painful intercourse, a pelvic floor therapist can guide you through exercises, stretches, and manual techniques tailored to your specific needs, helping you regain strength, mobility, and control.
Can you do pelvic floor exercises while pregnant?
Yes! In fact, doing pelvic floor exercises during pregnancy can help prevent issues like incontinence and prolapse while preparing your body for labor and postpartum recovery. A pelvic floor therapist can ensure you’re doing the exercises correctly and safely, as not all pelvic floor exercises are about tightening—some involve learning how to relax these muscles effectively.
Why early intervention matters
The pelvic floor is often described as the “unsung hero” of pregnancy and childbirth, and for good reason. But they often get blamed as the cause of dysfunction, but they are actually often the victim, not the perpetrator!
The pelvic floor muscles are constantly working behind the scenes to support your growing baby, stabilize your body, and prepare for delivery. But without proper care, they can become overwhelmed, leading to discomfort, complications, and a more challenging postpartum recovery.
The earlier you address pelvic floor issues, the better. Pregnancy is an ideal time to work on strengthening and relaxing these muscles because your body is already preparing for the significant changes of labor and birth. By tuning into the signs your pelvic floor needs attention, you’re not only improving your pregnancy experience but also setting the stage for a healthier recovery.
How a Pelvic Floor Therapist can help
A pelvic floor therapist can be a game changer in navigating these challenges. Pelvic floor therapists are trained to assess your unique needs and create a personalized plan to address your symptoms. This might include:
- Guided exercises to strengthen or relax your pelvic floor muscles.
- Postural adjustments to reduce strain on your back, hips, pelvis, and even your neck.
- Education on labor positions and breathing techniques to protect your pelvic floor during delivery.
- Modifications to daily activities to minimize the stress on your body and pelvic floor.
- Manual therapy (hands on therapy) to release tight muscles, improve circulation, and decrease any aches and pains you are experiencing.
- Appropriate recommendations for any support garments, belts, bands, or other assistive devices!
Most importantly, pelvic floor therapy empowers you with knowledge and tools to care for your body both during pregnancy and beyond.
Take the first step today
Your pelvic floor is the foundation of your pregnancy journey (whether you know it or not!) Paying attention to its signals can help you feel stronger, more comfortable, and better prepared for childbirth. If any of these signs resonate with you, don’t wait—reach out to a pelvic floor therapist for an evaluation. With the right support, you can experience a healthier, more empowered pregnancy and give your body the care it deserves.
If you want to work with us at Moms in Motion PT, head over to our website at https://www.momsinmotionpt.com and fill out our appointment request form. We are a mobile pelvic health practice, which means all our appointments are in the comfort of YOUR OWN HOME! We service most of the Twin Cities metro and offer virtual appointments for anyone outside our driving radius. We would love to help you out!
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