Pregnancy causes a host of physical changes that affect how your body feels from head to toe. For some women, no part of the body is left unaffected — at least, that’s how it feels. But perhaps the most concentrated change occurs in the pelvis, right where your baby grows. From early in your pregnancy through birth and the postpartum period, your pelvis tilts as you adjust to your ever changing center of gravity.
There are other changes in your pelvis, too, as your pelvic floor — the set of muscles and connective tissues that support your pelvic organs — work to maintain stability in your spine and pelvis.
“The pelvic floor plays a very important role ensuring the pelvic organs function properly and performs sexual functions, along with the storage and emptying of urine and feces,” says Juraj Letko, MD, Urogynecologist and Co-Director of the Center for Pelvic Health at the University of Chicago Medicine.
As a urogynecologist, Dr. Letko is a trained obstetrician and gynecologist with a specialized focus in female and reconstructive surgery. He treats such conditions as urinary incontinence, infections, painful voiding disorders and pelvic organ prolapse.
Vaginal birth can cause damage to the pelvic floor, and pressure from ongoing constipation, chronic cough or straining when lifting heavy objects can contribute to this damage, says Dr. Letko. And, as we age, atrophy can worsen this condition.
You may never give your pelvic floor and its complex muscles a second thought. In fact, you may never have known this part of your body existed until you carry a baby and give birth. But if something goes wrong in the pelvic floor — like the inability to control urine, feces and gas — you’ll learn exactly why it is so important.
So, how do you take care of this part of your body? We share some expert advice on how to care for your pelvic floor muscles.
It’s about how you sit, and for how long
You’ve heard that sitting for too many hours in the day isn’t good for your health. It turns out that a sedentary lifestyle can negatively affect your pelvic floor muscles, too, according to Dr. Letko.
“Weakening may happen when sitting in a slouched or relaxed position, or, sitting in another strained position may cause muscle contraction and tightness and result in pelvic pain and lower back pain,” he says. “Prolonged sitting can potentially damage nerves that can contribute to painful disorders.”
Like all muscles, the pelvic floor muscles need exercise to work well, according to the International Urogynecological Association. Chances are, you’re not working those muscles while you are sitting on your sofa at home or at your desk at work, regardless of whether or not you are pregnant.
If you are sitting, however, why not tone your pelvic floor muscles at the same time?
“The best thing is to fit (pelvic floor) exercises into your daily routine, perhaps when you’re watching (television) or just before you climb into bed,” suggests NCT, the UK’s national charity for pregnancy, birth and early parenthood.
Anxiety plays a role, too
Here’s a phrase you never thought you’d hear: “pandemic pelvis.”
It’s a real thing and is worth knowing about. Just as you may grind your teeth or clench your jaw when you’re feeling anxious, you may be unconsciously tightening those pelvic floor muscles, too.
“Stress and anxiety can lead to a tightening of the pelvic floor muscles, which can result in pain or high-tone pelvic floor dysfunction,” says UChicago Medicine’s Dr. Letko. “We know the pandemic has been a high-stress period, and it could contribute to the exacerbation of these symptoms in people more prone to anxiety and stress.”
To help relieve stress, especially during pregnancy, the American College of Obstetricians and Gynecologists recommends healthy sleep habits and a healthy diet, asking for help when you need it, spending time with loved ones, physical activity and using mindful breathing.
Best exercise for pregnancy
If you’re feeling added pressure as your baby grows, your pelvic floor muscles feel it, too. And you’re probably not looking forward to future pelvic floor disorders, like leakage of urine when you cough, sneeze or exercise.
There is a way to protect your muscles before birth and potentially preempt any unwelcome pelvic floor disorders after your baby is born. Start by giving your pelvic floor muscles the care they deserve.
“With people who experience vaginal birth, the more prepared they are, the better,” Dr. Letko says. “I would compare it to a professional athlete — they recover better from injuries than a non-athletic person because they’re conditioned and prepared.”
To preempt any unwelcome pelvic floor disorders after your baby is born, and to get ready to bounce back from a vaginal birth, strengthen those muscles with Kegel exercises.
“During pregnancy, women can benefit from (Kegels) if they do them correctly,” Dr. Letko says. He offers some helpful suggestions for how to do a proper Kegel, and some things to avoid, too.
“They’re not harmful to anyone,” he says, as long as you don’t have urinary retention problems.
He also adds that Kegels are beneficial to men as well as women. “It’s like any muscle in our body. We go to a gym to address muscles in our arms and legs, but we neglect the pelvic floor muscles,” he says. “Keeping up with pelvic floor health is good.”
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