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PT for Birth Preparation pt. 1: Relaxing Your Pelvic Floor

by Manreet Sangha, DPT

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What is the pelvic floor?

The pelvic floor muscles attach from the pubic bone in the front to the tailbone in the back. They are a basket of muscles at the bottom of the pelvic bone and tailbone. They help to support your pelvic organs such as your bladder, rectum and uterus.

How can you prepare your pelvic floor muscles for labor and childbirth?

Pelvic floor muscles do not push a baby out. Their job is to get out of the way and lengthen so that the baby can come down the vaginal canal. The pushing comes from the contractions of the uterus and bearing down from the abdominal wall.

To prepare for this, there are exercises you can perform to help lengthen the pelvic floor muscles to get them ready for the opening of the birth canal. Kegels alone are not sufficient. Here we will discuss some stretches you can perform right now at home to help get your body ready for birth.

Diaphragmatic Breathing

Breathing plays a very important role in how the pelvic floor muscles function because the diaphragm and pelvic floor work together and move together. Start either in a sitting position or lying down on your back with one hand on your chest and one hand on your stomach. As you breathe, you should feel the hand on your belly rise with air. The hand on your chest should remain still - it's just there to monitor and make sure that you are not breathing through the top.

Stretches to help lengthen the pelvic floor at an early stage of pregnancy, before 25 weeks

  • Lay on your back, bring your knee to your chest and take 2 belly breaths. This mimics a deep squatting position to lengthen the pelvic floor and helps the dropping down of the pelvic floor. Perform 5-10 reps.

  • Lay on your back, bring your knees to your chest and perform belly breaths. Hold for 30 seconds. Perform 2 reps.

  • Happy Baby Stretch: Lay on your back, bring your knees to your chest and keep your hips down. Spread your knees, hold your feet and flex so your soles face the ceiling. Breathe deeply. Hold position for 30 seconds. Perform 2 reps.

Stretches/modifications when you cannot lie on your back, or after 25 weeks

  • Lay on your side, bring your top knee to your chest and perform belly breathing. If it's hard to hold your leg, you can rest your top leg up on a sofa or chair.

  • Cat Cow: Come onto your hands and knees (quadruped) with your knees nice and wide. Start by tucking your pelvis in and rounding your back to arch. This will stretch you entire spine. Be sure to breathe in deeply as you flex. Then exhale as you extend your spine. Perform 5-10 reps. This is good position to perform in any stage of your pregnancy.

  • Child's Pose: Kneel on the floor. With your toes touching, sit on your heels, separate your knees, exhale and lay your torso down between your thighs. Lengthen your tailbone away from the back of the pelvis. Lay your hands on the floor alongside your torso and release the fronts of your shoulders toward the floor. Rest in this position and perform your diaphragmatic breathing.

  • Deep Squat: This should be passive. If it's too difficult for you to lower into this position, place a pillow under your heels with your back against a wall so you can rest in this position. Focus on taking deep belly breaths - it should feel as if you're dropping you pelvic floor into your underwear. Perform 5-10 reps.

It's important to consult your doctor to ensure it's safe to start any stretch or exercise program during pregnancy. Please reach out with questions, for further guidance or to schedule an appointment with a physical therapist. For more on PT for birth preparation, check out the other part of this series:

Part 2: Strengthening Your Pelvic Floor

Part 3: Performing a Perineal Massage to Prevent Tearing During Birth

Part 4: Birthing Position Recommendations

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