Your Pelvic Floor in Pregnancy & Childbirth

Your pelvic floor plays an important role during pregnancy: it supports your growing fetus and lets your baby out at birth. Because of all the changes that happen within the pelvis during pregnancy and delivery, there is an increased risk of pelvic floor disorders such as pelvic organ prolapse, urinary incontinence, or anal incontinence (when compared to someone who has never had a pregnancy or delivery).

Mild symptoms don’t necessarily mean disorder. However, if your symptoms stop you from living your daily life comfortably and from reaching your physical fitness goals, they can be considered a disorder. While you may be able to live with a pelvic floor disorder, it is common to experience a lot of distress, including sadness, anxiety, embarrassment, and shame. If you are feeling this way, it is important to reach out to a healthcare provider for support.

Although pregnancy hormones gradually relax your joints and muscles in preparation for birth, there is a lot of added weight and pressure from the growing fetus on your pelvic floor. Your bladder and bowel are tight in your belly during pregnancy as well, which can cause you to pee more often or leak a little, without meaning to. It can also cause some constipation, and lead you to strain during bowel movements.

The type of birth you have can also affect your pelvic floor, leading to further stretching  or even a tear. For example, if you have a vaginal birth that takes a long time or becomes unsafe for you or your baby, your doctors may have to help the baby out with forceps or a vacuum. Either one of these tools can cause tears in your pelvic floor and perineum, which is the part of your body between your vagina and your anus. During childbirth, the perineum often tears to help your baby's head to get out.

How common are these perineal tears? Out of 10 women who give birth vaginally, 4 will have no tears and 6 will have some tears.

Behind the perineum, there's a group of muscles called “the anal sphincter”. The anal sphincter muscles are what help everyone to control bowel movements and passing gas. Among women who have tears, one in ten will have a 3rd or 4th degree tear, called obstetrical anal sphincter injuries, or OASIS for short. To look for tears, your care provider should examine your rectum right after your delivery. OASIS can be hard to recognize, so this should be done carefully. Women who have had an anal sphincter tear that was properly recognized, repaired, and healed are less likely to leak stool or gas.

If you've had a tear you need to know what degree it is, so you can make informed decisions about your birth and plan for your future. Other factors in your life – like a weak pelvic floor, weight gain, aging, and repeat injuries from subsequent vaginal deliveries – can increase your risk for leaking and for more pelvic floor problems. Women with OASIS can have more pelvic floor problems as they age. That’s why it’s important to understand how to care for your bottom every time you give birth but also before and after.

Maintaining a strong pelvic floor during pregnancy and childbirth can help prevent problems as you age. To keep your pelvic floor strong you can get to know and practice pelvic floor muscle exercises.

Watch our videos on the pelvic floor and pregnancy! For best results, please watch the videos in order.