When should I start pelvic floor physical therapy when pregnant?
This is one of the most common questions I get.
My answer is: You should start pelvic floor physical therapy as soon as possible! I would not wait until you are in your third trimester to start "preparing" for birth.
A more ideal timeline would be to see a pelvic floor physical therapist before conception! YES - before pregnancy!
Out of my all my pregnant clients, I have 4 categories:
The best answer is: Start pelvic floor physical therapy when you feel comfortable and ready!
WHY SEE A PELVIC FLOOR PHYSICAL THERAPIST FOR PREGNANCY?
During pregnancy, your body goes through significant changes. Your pelvis changes shape to accomodate the growing uterus and baby. Your rib cage expands. Your posture changes to accomodate for the significant weight gain in the front of your body. Your abdominals lengthen and become less functional as baby grows.
As you can see, there are lots of changes to a pregnant woman's body. Seeing a pelvic floor physical therapist to work on maintaining or increasing your strength, mobility, and coordination can help you have a pain-free pregnancy and smoother postpartum recovery.
Here are some items I work on with my pregnant clients:
Posture: I love to help moms have body awareness in terms of how they are standing, sitting, squatting, bending. This is important because once the baby arrives, I hear many of my moms say how much postpartum is a sport! Yes - you need to be strong, but also carrying baby in a way that won't cause injury or aches/pains!
Core strengthening: 100% of all moms will have some degree of ab separation, or diastasis recti. This has to happen because baby is growing and needs to grow somewhere - so the abdominals will lengthen and naturally "separate." Core strengthening to key to help improve pelvic floor function, alleviate back and hip pain, and improve your posture.
Hip and Pelvic Mobility: Your pelvis needs to move in all planes of motion. Your pelvis is three-dimensional. During pregnancy, you can do exercises that help open up your pelvis in all phases of labor to ensure baby has adequate room to navigate the birth canal.
Pelvic floor lengthening: Did you know your pelvic floor lengthens about 250% of its original lengthen to accomodate baby during a vaginal birth?! YES - that is crazy cool! Doing exercises to help lengthen the pelvic floor can help decrease pushing time and effort, and severity of perineal tears and episiotomies.
Birth preparation: This ranges from teaching my patients pushing and breathing techniques, laboring positions, birth ball exercises, pain-management partner assisted techniques, perineal massage, and more!
WHY NOT WAIT UNTIL 3RD TRIMESTER?
The thing is...many people start to have aches and pains in their third trimester. Whether that is round ligament pain or sciatica, you can actually do intentional prenatal exercises and stretches to PREVENT these aches and pains in your third trimester. In addition, your pelvis goes through significant changes throughout early labor, active labor and pushing. Performing specific exercises provided by a pelvic floor physical therapy to ensure your pelvis has optimal mobility for all phases of labor and birth is key to preventing plateauing in labor progress, longer pushing times, baby stuck at certain "stations" of your pelvis, and decreasing your risk of severe perineal tears or episiotomies.