How To Prepare Your Body and Pelvic Floor For Birth

Our focus can be on prepping for how we want birth to look, alongside thinking about what our baby needs, however we are not often given much information on how to prepare our body for birth. I always say that birth is like a marathon, and pregnancy is the training season for the race. However, in reality none of us have much time, so what should we focus our energy on.

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1. ‍Work on pelvic floor exercises throughout pregnancy

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‍Pelvic floor exercises are so important during pregnancy due to the added weight on the muscles as your baby grows. Research has shown that working on pelvic floor exercises throughout pregnancy reduces the risk of incontinence in the 3rd trimester and postpartum.

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The best way to do pelvic floor exercises is to follow the steps below:

• Sit or lie in a comfortable and relaxed position
• Think about holding in wind and squeeze around the back passage.
• Then think about bringing this contraction forwards towards the pubic bone at the front of your pelvis.
• Then allow the muscle to fully relax.
• Repeat this 10 times.
• You should not feel your legs or bottoms muscles contracting, instead you should feel this movement internally.

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Ideally we should be working on pelvic floor exercises daily, remembering, like all muscles, that the pelvic floor needs to relax fully, as well as contract.

2. Practice perineal massage from 34 weeks

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Perineal massage is a technique that can be used to gradually stretch the perineal tissues in the weeks running up to birth. The perineum is the area between the vaginal opening and the anus which is most stretched during vaginal birth and is where most tears occur. Perineal massage can be used to help reduce the severity or likelihood of tearing during vaginal birth, and therefore it is recommended that all women are informed on how to do it. This is supported by extensive research and so it is worth giving it a try, if you haven’t already.

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Here is how to do it:

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• Sit in a supported and relaxed position
• Apply a natural oil to the vulva and your thumb.
• Insert your thumb just inside the vagina and gently sweep side to side, applying a gentle pressure onto the perineum.
• Then think of the area like a clock. 12 o’clock at the pubic bone and 6 o’clock towards the anus.
• Hold and stretch for 30 seconds in each direction from 3-9 o’clock. This should feel like an intense stretch, but not painful.
• You can repeat this a few times a week from 34 weeks.  

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Please check with your medical professional if you have any concerns about your cervix, placenta or have a high risk pregnancy, about whether it is appropriate for you to do.

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3. Work on diaphragmatic breathing

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The diaphragm has a close relationship with the pelvic floor and they naturally move together. Therefore, working on diaphragmatic breathing is not only calming and good for us to manage stress, but also has lots of physical benefits as well.

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Try it using the tips below:

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• In sitting, place one hand on your lower ribs at the side, and one on your tummy.
• Take a breath in, expanding your lower ribs and allowing your tummy to just rise and expand gently.
• Then allow the breath out fully.
• Repeat this slowly and steadily 10 times.

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4. Keep active

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Our bodies, minds and pelvic floor love it when we are active. It can be hard to keep up the same level of exercise or activity that you have done before pregnancy, however it is important to know that all activity counts. So even if things are different, that doesn’t make them less valid. Enjoy getting out for walks, take the stairs when you can, or enjoy more structured pregnancy yoga classes or pilates. There are so many benefits for you and your baby.

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The main thing I always encourage women to do is really get to know their bodies better, whether this is through antenatal education, hypnobirthing or seeing a pelvic health physiotherapist. Lots of pelvic health physiotherapists offer a Pregnancy MOT which helps to support you stay active, know that you are doing your pelvic floor exercises correctly and ultimately help you to feel empowered in your body. Most of us are not even sure where our pelvic floor is, and lots of us do them wrong, even with the best education.

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There is support on the NHS for anyone experiencing incontinence, pelvic girdle pain or symptoms of pelvic organ prolapse.

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My main message is that you are not alone, and education and understanding is really life changing. Living in a country where we have a healthcare system that is predominantly reactive can leave us all feeling we don’t need to do anything unless we have symptoms or experience problems. However, a helpful way to think of it is that we don’t brush our teeth once we need a filling. We brush our teeth daily to prevent problems, and I encourage you to think of your pelvic floor health in the same way. Noone regrets being too proactive, but I have met a number of women who wish they had been told about what they could have done to prevent problems.

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