Pelvic floor in pregnancy and postpartum: what you need to know

Giulia Mori has been attracted to a specific branch of rehabilitation since the beginning of her career: urogynecological rehabilitation, also known as female pelvic floor rehabilitation. At her professional studio, located in Alpignano in the first belt in the province of Turin ( www.fisioterapia-alpignano.it ), she follows women of all ages: from the very young 16-18 years, to pregnant and postpartum mothers, to women in menopause.

Giulia, we often hear about the pelvic floor but many women are not aware of the function of the muscles that make it up. What is it about?

The pelvic floor forms the basis of our pelvis, it is made up of muscles and connective tissue and crossed by the three orifices which are the urethra, the vagina and the anus; thus constituted, by contracting and relaxing it performs the following important functions:

• support the viscera of the small pelvis (bladder, uterus, rectum);
• ensure urinary and faecal continence together with the sphincters;
• allow reproduction and the passage of the newborn at the time of delivery.

Nowadays women work out, go to the gym, keep fit. Why would it be important for pelvic floor training to become a routine as well?

Beautiful question. We have seen before that the pelvic floor as well as other parts of our body is made up of muscles, exactly like a back, a leg, etc.

If we train the various parts of the body in the gym or with exercises to keep us strong and healthy, why not also train the pelvic floor with exercises to keep it healthy for as long as possible?

It should be trained in all age groups to avoid and prevent the following problems:

• involuntary loss of urine, wind or stool after exertion,
• prolapse of the pelvic viscera,
• dysfunctions during sexual intercourse such as pain on penetration.

Then there are three moments in which more constant training is needed in a woman’s life: pregnancy, postpartum and menopause.  

Can the exercises be done at all stages of a woman’s life or are there specific exercises for pregnancy and postpartum?

It should be noted that the exercises must first of all be adapted from woman to woman.

In general, however, we can say that during pregnancy exercises aimed at the elasticity of the pelvic floor will be given in order to allow the newborn to pass. Strength exercises are also important : in fact, it is necessary to support the weight of a belly that continues to grow for nine months.

In the postpartum they absolutely must be done and are used for reinforcement based on the type of birth (cesarean, natural, any stitches, etc.).

There are many studies that indicate that good exercises in this phase can prevent damage to the pelvic floor even after years.

What are the most common pelvic floor mistakes?

There are several things that should not be done to maintain a healthy pelvic floor:

• The “stop pee” , an old method that was recommended by gynecologists at the dawn of knowledge of the pelvic floor which consists in blocking the flow of urine. We women have a so-called passive release system to pee: blocking it actively stresses it and creates a possible rise of urine in the urethra tube with the risk of infection.
• Don’t push when you pee. It’s true, we are often in a hurry or in dirty bathrooms and we try to do it as soon as possible by pushing. For the same reason mentioned above, we have to “let go” of urine without pushing it.
• Constipation . Having to push too much tires the pelvic floor, weakening it.
• Lifting heavy weights incorrectly . For both our back and pelvic floor, let’s remember to bend our legs and use our abs correctly to avoid pressure on the lower lumbar tract and pelvic muscles.

Why is it important to attend specific courses to learn how to train the pelvic floor?

Using a professional can first of all establish the current state of the woman’s muscles and adapt the exercises to measure for the woman and her current condition.

The condition can be a pregnancy or a menopause and in these cases the professional can best guide the woman to resolve her symptoms (urine leakage, prolapse…) or even better can prevent this from happening in order to keep her healthy too. this small piece of our body, but as we have seen absolutely important!