Unlocking Comfort: How Prenatal Pelvic Floor Physical Therapy Can Transform Your Pregnancy Experience

During my pregnancy with my son, I was acutely aware of the upcoming changes to my life and envisioned both the joys and challenges that come with having a newborn. I spent hours daydreaming about long days packed with cuddles, endless diaper changes, and the inevitable sleep deprivation that seemed to come standard with parenthood. However, little did I know that the changes to my body would catch me off guard. Other mothers warned me about the possibility of bladder control issues, leading me to a frantic state of wondering whether postpartum life would involve me constantly crossing my legs whenever I laughed or sneezed. Fantastic, right?

As a first-time mom, I knew postpartum panties would be a part of my post-birth essentials, but the idea of investing in long-term diapers just to manage incontinence was not something I could remotely wrap my head around. To my surprise, I discovered there is a proactive, empowering approach to help women like us mitigate these distressing symptoms: pelvic floor therapy during pregnancy. Intrigued and wanting a thorough understanding of this myself, I spoke with Dr. Nikki Berner, PT, DPT, a licensed and board-certified physical therapist and the founder of The Fem Method Pelvic Health. She helped enlighten me on the advantages of pelvic floor physical therapy while expecting. It turns out that having bladder leakage isn’t something women should accept as a normal part of the journey.

To provide some clarity, the pelvic floor is a group of muscles that create a supportive sling or hammock across the bottom of the pelvis. These muscles are crucial because they support the bladder, urethra, intestines, and rectum. However, during pregnancy, factors such as hormonal fluctuations and the growing weight of the fetus can lead to these muscles becoming lax or weakened.

Now, you might be wondering if it’s absolutely necessary to see a pelvic floor therapist during pregnancy. While it’s not a requirement, certain symptoms signal it may be time to seek help. For instance, if you’re experiencing dysfunction in the SI joints (which connect the pelvis to the lower spine), round ligament pain (that nagging discomfort in the lower abdomen or groin), or bladder leakage, these could be important signs to consult a specialist. Additional indicators include low back or hip pain, and pelvic girdle pain. But even if you’re just feeling a little off, a pelvic floor therapist can provide guidance and a tailored approach.

You might have also heard of Kegel exercises, which are designed to strengthen pelvic floor muscles by lifting and holding them, then relaxing. They seem to be held up as the golden solution for pelvic floor dysfunction, but here’s the catch: Dr. Berner notes that Kegels only engage a fraction of your pelvic floor muscles, and they often aren’t done correctly. So, while they can be a piece of the puzzle, they’re not a catch-all.

Now, you may ask, how exactly can a pelvic floor therapist assist you during pregnancy? It’s common for women to hear the phrase “It’s normal” whenever they raise their concerns about the changes their bodies are going through. But just because something is common doesn’t mean you have to suffer in silence. Pelvic floor therapists can become invaluable allies in your prenatal journey. Each person’s experience is unique, meaning care plans should be customized. At the heart of therapy is a focus on a few key areas.

If you’re feeling unsure about your specific needs or just want to be proactive, consulting a pelvic floor therapist is a smart move. They can help by providing early education on proper nutrition and managing the constipation that often plagues expectant mothers, alongside bowel control strategies. A comprehensive prenatal physical therapy assessment is essential. This assessment evaluates the strength and mobility of your hips, spine, and pelvis while identifying any existing dysfunctions.

As you prepare for the big day, back pain can become a frequent unwelcome companion, especially if your pelvic floor feels unstable. Dr. Berner employs specific breathing techniques during various birth positions to alleviate pelvic floor tension, ensuring your body is relaxed and ready for delivery. These techniques are emphasized throughout therapy, allowing you to develop a familiar response when labor does begin, making the experience feel somewhat less daunting.

Let’s not forget that pelvic floor care shouldn’t stop once your little one arrives. It’s equally crucial to learn how to protect your body during the postpartum phase. Engaging in pelvic floor therapy while pregnant helps you prepare for issues that may arise after the baby comes home. This could include learning safe lifting techniques, how to effectively engage your core, or mobility exercises that ease discomfort—all aimed at optimizing bathroom visits (goodbye, unexpected leaks!) and promoting a smoother recovery.

When looking for a pelvic floor therapy program, consider what you hope to get out of it. Everyone has different levels of desired involvement, so ask about the team structure. Who will you be working with—a lead therapist or multiple clinicians? And verify their credentials; not all providers are created equal. As Dr. Berner mentions, physical therapists and occupational therapists gain specialized training as pelvic floor “rehabilitation providers.” Those not in those fields may not have the skills necessary to conduct proper evaluations, which you definitely want when it comes to your health.

Think about how hands-on you want to be in your treatment. If frequent in-person appointments feel overwhelming, know that virtual consultations can also be valuable. Lastly, it’s crucial to choose a program that fits your individual needs. Don’t hesitate to ask your therapist about their experience with cases akin to yours, and ensure your treatment plan aligns with how you need your body to function.

Consulting with a pelvic floor therapist serves as a powerful way to take control of your health. Dr. Berner often sees her clients leave therapy feeling empowered, ready to embrace their birthing experiences rather than dreading them. Remember, knowledge is power: the more informed you are about what to expect, the more confidence you’ll carry into labor, which can lead to better outcomes. So the next time someone suggests that experiencing incontinence is a permanent issue, share a knowing smile—without needing to cross your legs—and pass along your pelvic floor therapist’s details.