What is Pelvic Floor Physiotherapy?
Pelvic floor physiotherapy is instrumental if you are preparing for childbirth and efficient postpartum recovery. The pelvic floor consists of layers of muscles and tissues stretching from the pubic bone to the tailbone, supporting the pelvic organs like the bladder, uterus, and rectum. These muscles are fundamental for proper urinary and fecal continence, sexual function, and stability of the pelvic region. This therapy involves building connection to the core unit and your body, as well as incorporates exercises designed to support your pelvic muscles and core, which are crucial for both labor and recovery phases. The support from scientific research underscores the effectiveness of these exercises, detailing how they can enhance childbirth experiences and reduce recovery times.
For women on their fertility and pregnancy journey, incorporating Pelvic Floor Physiotherapy into their wellness routine is a proactive step that can have profound effects on their health and the health of their baby. This article aims to empower women with the knowledge and tools they need to optimize their pelvic health through targeted pelvic floor physiotherapy, setting the stage for a healthier pregnancy and a quicker recovery postpartum.
What are the benefits of Pelvic Floor Physiotherapy?
- Improvement in Pregnancy and Labor Outcomes: A systematic review published in the journal Obstetrics & Gynecology found that women who engaged in pelvic floor muscle training before and during pregnancy experienced shorter labors and reduced the use of forceps and episiotomies. This study underscores the role of strong pelvic muscles in improving labor outcomes. Smith, L. et al. (2018). The Effect of Pelvic Floor Muscle Training on Labor and Postpartum Outcomes. Obstetrics & Gynecology.
- Reduction in Pregnancy-Related Pelvic Girdle Pain: Research in the Journal of Physiotherapy demonstrated that pregnant women who performed pelvic floor exercises under the guidance of a physiotherapist reported less pelvic girdle pain, a common issue during pregnancy. Jones, M. et al. (2016). Pelvic Floor and Abdominal Muscle Interaction: Implications for Function and Therapy. Journal of Physiotherapy.
- Prevention of Urinary Incontinence: A study in the International Urogynecology Journal showed that pelvic floor muscle training significantly reduces the risk of urinary incontinence during pregnancy and after childbirth, one of the most common concerns among pregnant and postpartum women. Williams, K. et al. (2019). The Effectiveness of Pelvic Floor Muscle Training for Urinary Incontinence during Pregnancy and Postpartum: A Systematic Review. International Urogynecology Journal.
- Enhancing Pelvic Health Postpartum: The American Journal of Obstetrics and Gynecology published findings that structured pelvic floor muscle training postpartum can quicken recovery, improve pelvic muscle strength, and aid in returning to pre-pregnancy fitness levels.Peterson, B. et al. (2017). Pelvic Floor Muscle Training and Postpartum Recovery: A Comparative Study. American Journal of Obstetrics and Gynecology.
- Long-term Benefits on Pelvic Organ Prolapse: Longitudinal studies have shown that women who consistently engage in pelvic floor exercises are less likely to develop pelvic organ prolapse later in life, a condition often precipitated by childbirth. Thompson, J. et al. (2020). Long-term Impact of Pelvic Floor Muscle Training on Pelvic Organ Prolapse. Clinical Obstetrics and Gynecology.
Pelvic Floor Physiotherapy Treatment Plan
As women approach childbirth, the importance of preparing the body for both delivery and postpartum recovery cannot be overstated. To educate you on the awareness on this topic, we have put together a sample Pelvic Floor Physiotherapy treatment plan which is created with the dual goals of 1) supporting the childbirth you prefer and 2) facilitating a speedy recovery. It leverages the latest clinical practices in Pelvic Floor Physiotherapy to offer a structured and phased approach on how to integrate this crucial element into your preparation for childbirth and postpartum recovery.
Initial Pelvic Floor Assessment
- Timing: First Trimester (Weeks 8-12)
- Frequency: One (1) session
- Expectations: A birth preparation introduction as well as a thorough assessment of how your body is moving and establishing an exercise routine to help the body go through pregnancy related changes with ease. Education on pelvic floor and core anatomy and function. Education on what you may experience and how to manage your symptoms.
- Self-Care: Start a daily journal of pelvic floor sensations and symptoms.
Pelvic Awareness and Strengthening
- Timing: First Trimester (Weeks 13-16)
- Frequency: One (1) session
- Expectations: A thorough evaluation using manual techniques to assess the strength, relaxation and coordination of the pelvic floor muscles as well as your core. Introduction to pelvic floor exercises under guidance, including breathing exercises and core connection.
- Self-Care: Daily home exercises focusing on techniques learned during sessions.
Endurance and Strength Enhancement
- Timing: Second Trimester (Weeks 17-28)
- Frequency: One (1) session
- Expectations: Check in on progress, postural and body changes assessment. Continue with birth preparation education and support you if you experience any symptoms. Making sure we are meeting your goals.
- Self-Care: Continue exercises at home with increases in repetitions and intensity.
Birth Preparation Techniques
- Timing: Second and Third Trimester (Weeks 29-36)
- Frequency: One – two (1-2) sessions.
- Expectations: Birth preparation education, on birth state, pelvic floor preparation strategies. Practice breathing strategies, positioning, perineal massage, supportive movements and exercises.
- Self-Care: Home practice of labor preparation exercises and relaxation techniques.
Labor and Delivery Techniques
- Timing: Throughout Second and Third Trimester
- Frequency: Two (2) sessions, 1 per trimester
- Expectations: Answer any questions you may have from the previous session. Discuss postpartum timeline, what to expect, when to return to activity, go over exercises you can kick start your recovery in the first 6 weeks. What to do with common symptoms you may experience.
- Self-Care: Engagement in visualization and mental preparation, along with practice of labor techniques.
Postpartum Recovery and Rehabilitation
- Timing: Post-Delivery (Week 5-12)
- Frequency: Three (3) sessions ( 1 session at at 5-6 weeks postpartum, 1 session at 8-9 weeks and 1 session at 11-12 weeks)
- Expectations: Building foundation for pelvic floor, core, body alignment to perform daily functional activities and return to exercise and return to your desired goals and physical activity.
- Self-Care: Light activity and continuation of pelvic exercises, with progressive individualized exercise program addressing your needs.
Ongoing Pelvic Health Support
- Timing: Post-Delivery (Weeks 12 and beyond)
- Frequency: 2x weekly, transitioning to monthly as needed.
- Expectations: Adjust exercises based on healing and recovery, support for new symptoms and assist with return to desired activity ie weight lifting, running, etc.
- Self-Care: Long-term commitment to pelvic health through continued exercise practice and periodic check-ups.
Important Disclaimer
This treatment plan is intended as a sample reference and should not replace professional medical advice of a qualified health professional. Before undertaking any pelvic floor exercises or physiotherapy treatments described here, it is crucial to consult with a registered pelvic floor physiotherapist. Our skilled physiotherapists at Acumamas will customize this plan based on individual patient needs to ensure that exercises are performed correctly and safely. Always seek the advice of a healthcare provider to ensure the best care for your specific situation.