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Labor and Birth: Tips for Pushing with Prolapse

Over 50% of women are diagnosed with pelvic organ prolapse (POP).

Common symptoms of POP include:

  • Heaviness or pressure, feeling like something is falling out

  • Frequent voiding or urge to pass urine

  • Incomplete emptying of bladder

  • Urinary leakage

  • Frequent urinary tract infections

Many women with prolapse are fearful of making the prolapse worse if having another vaginal birth, specifically during the "pushing" phase of birth.

Here are 3 tips to prepare for birth to protect and maintain the health of your prolapse.

TIP 1: Learn to relax your pelvic floor.

Your uterus and uterine contractions help push the baby, not your pelvic floor. If you've been told to do Kegels and strengthen your pelvic floor to the max, stop and think. Your pelvic floor muscles are like the exit door! If that exit door is super tight, think about how much HARDER you would have to PUSH! How do I know if my pelvic floor is tight? A pelvic floor therapist will perform an external and internal pelvic floor examination to assess the health of your muscles. So, learn how to relax your pelvic floor with a pelvic floor therapist!

Tip 2: Fetal positioning is important.

How the baby enters the pelvis is just as important as how the baby exits. If the baby is entering the pelvis not symmetrically, it can lead to problems. This is why it's important that your pelvis is in optimal alignment and symmetry. Having muscles tight on one side of the pelvis or hip can cause the baby to sit "off to the side in the pelvis. Knowing what exercises and stretches to do during your pregnancy, and also during labor can help optimize fetal positioning.

Tip 3: Open glottis pushing.

How you push is important! If you're holding your breath and closing your throat when you push, it will make your pelvic floor muscles tight. Instead of thinking about PUSHING your baby out, think about BREATHING your baby out. Keep all your muscles soft as you gentle exhale and think about softening your pelvic floor as you push.

If you are currently pregnant and want to learn how to prepare for labor and birth, book an appointment here.

I teach pregnant women the following during pelvic floor therapy:

  • Pushing techniques and labor positions

  • Pelvic floor relaxation exercises and massage to decrease risk of tears

  • Exercises to open the pelvis to allow baby to descend through labor and delivery positions

  • How your birth partner can support you during labor


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