The pelvic floor is the layer of muscles that stretch under the pelvis and support the inner organs (bowels, uterus, and bladder). I had never heard of the pelvic floor until I started learning about pregnancy and birth. Even though I was already suffering from and getting treated for a pelvic floor dysfunction long before I became pregnant, no one, not my OB or physical therapist, explained what the pelvic floor muscles did and how they could impact my well-being.
Turns out, as I would later learn, my pelvic floor could wreak a lot of havoc on my body during pregnancy and labor. My pelvic instability lead to symphysis pubis disorder that caused excruciating pelvic girdle pain that still lingers today, one year after I gave birth. The pulling on my pelvic muscles also lead to a lot of back pain.
To learn more about pelvic health, I reached out to Rachel Parrotta, DPT, a pelvic health physical therapist.
“I believe that all people would benefit from learning about their pelvic floor muscles prior to giving birth,” Dr. Parrotta said. “Since we are often unfamiliar with these muscles, it can be difficult for people to use their pelvic floor muscles in ways that help facilitate both birthing and post-partum recovery.”
Imagine, you are in labor and your care provider says, “Okay, it’s time to push.” Many birthing people may feel that bearing down feeling, that urgent need and desire to push. However, receiving an epidural can prevent people from experiencing bearing down and even from pushing effectively because the abdominal and pelvic floor muscles feel numb. Care providers do something called “coached” or “directed pushing” until the laboring person gets the hang of how to push. Your care provider will tell you when and how to push in accordance with your contractions.
This happened to me. I got an epidural during back labor and didn’t have the bear down feeling until my water broke. My midwife coached my pushing because I wasn’t using my pelvic floor muscles correctly. She told me I wasn’t doing right. She got frustrated and impatient with me. She actually shoved her finger up my bum WITHOUT INFORMED CONSENT to pinpoint the muscles I should be using – an action that still makes me shudder and feel small to this day. I don’t want this to happen to you.
Ideally, we want our pelvic floor muscles to be relaxed during the second stage of labor (pushing), as tensing those muscles can actually delay birth. You can go to a professional like Dr. Parrotta to identify your pelvic floor muscles and learn how to use them for pushing BEFORE labor.
“Learning about your pelvic floor muscles prior to birth can help prepare for a more effective pushing phase of birth, especially if a person is planning on birthing with an obstetrician and/or with an epidural,” said Dr. Parrotta.
Pushing your baby into the world is a powerful action that we are all capable of doing. Exploring your pelvic floor to ensure its health and learn about its abilities can make an impact on your birth and postpartum experiences.