Pregnancy and childbirth is such a unique time in a woman's life, there is nothing that comes to mind that is even comparable. Your body is changing in so many ways physically, emotionally, and even mentally it can be hard to keep up! However, its often something that you don't learn much about until you get there and experience it first hand.
While the main focus during pregnancy for most mums-to-be is often on just THE BIRTH, everything you do during your pregnancy, and even before you become pregnant can have an impact on your body's ability to be strong and functional before and after delivery. With everything else going on in your body, and likely your life, maintaining strength and mobility can be difficult, especially while carrying a baby to full term, not to mention the huge event that is the birth and the challenge of recovering well afterwards.
Pregnancy and birth is a very natural event for the human body, and one that I believe we should be able to perform without repercussions like pain or pelvic floor issues later on.
While some women have can feel great and seem to just sail through their pregnancies and deliveries, let me tell you that in my experience as a pre and post-natal pelvic floor physiotherapist, a lot of women don't. And young women, who are otherwise healthy and fit, can suffer from conditions like pelvic pain, prolapse, incontinence, and abdominal separation that can significantly impact their ability to even just carry their babies around, let alone return to intense exercise.
But why is this the case if it is such a natural occurrence?
While pregnancy and childbirth is very natural, the world we live in today is not. It is not simply having babies that causes these pelvic floor related issues, rather the addition of the increased loads and hormonal laxity that come with pregnancy, placed on top of a body that may not be well equipped to deal with these extra stresses.
We often assume that most of the 'damage' is done during a vaginal delivery, and while yes, this can be true particularly with the use of forceps during delivery, this is not always the case. Women who have had C-sections have just as much chance of experiencing pelvic floor dysfunction in the long term as those who have had a vaginal delivery (prevalence of pelvic floor disorders reference), and I can confirm this coincides with the women I see in my practice, many of whom have had C-sections.
If you were going to run a marathon, you would, of course, train for it first. This would help you to build up the physical endurance, motor patterns and strength required to complete this amazing task.
If you want to have a natural pregnancy, a smooth delivery and a good recovery postpartum, you must also train and prepare appropriately.
While we can never guarantee that pregnancy and birth will go according to plan, here are a few things to keep in mind...
A stable pelvis, one that can remain mobile, strong and pain-free (and is able to cope with the loads and hormones experienced during pregnancy) requires good mobility and strength of the surrounding muscles, not just the deep core (pelvic floor, abdominal muscles, diaphragm and spinal stabilizers), but also every muscle that attaches to the pelvis including the gluteals, quadriceps, adductors, hamstrings, hip flexors, deep hip rotators etc.
A healthy pelvic floor also requires a strong base (healthy feet, a strong butt and the aforementioned stable pelvis) and good daily habits to facilitate good function and avoid over-straining the muscles
Vaginal delivery requires good mobility of the pelvis and supple quality of the pelvic floor muscles in order to allow baby through smoothly and reduce the occurrence of perineal trauma and need for medical intervention (like forceps or episiotomies)
Labour can last a long time for some women and can involve some awkward positions - good physical strength and mobility will allow you to move and push more effectively when the big day arrives.
Babies get heavy, yo. Caring for a newborn seems easy enough at first, before you realize how much actual time you spend holding them and how quickly they grow. Your core and pelvic floor are often in recovery mode post-partum, but if you don't have the strength necessary to carry and lift your baby (not to mention all the other baby-things like car-seats and prams), you do end up generating a lot more pressure and downward force onto your pelvic organs and muscles - which can lead to future dysfunction.
The way we move throughout our daily lives in our modern world - one where we no longer have to walk miles every day or squat up and down to get things and go to the bathroom - has left us much less prepared physically for the demands of pregnancy. Therefore, specific preparation is required to help reduce your chances of experiencing dysfunction later on.
This is why I am so passionate about getting good education, awareness and tools out to women BEFORE they have their babies to give them the best chance possible of minimize future issues, rather than just having to deal with them afterwards.
And to be frank, the preparation - maintaining good mobility and strength of all of your body parts, building good habits like daily walking, incorporating a variety of movements and positions throughout your day, cutting down on copious amounts of sitting time etc. is really just good for general health, no matter what age or stage of life you are in.
We have just launched a FREE Video series on preparing your pelvic floor for pregnancy, birth and beyond at www.babecourses.com. And if you would like to further your learning and preparation, we have created a whole online program, our Prenatal BABEs Course which is also available by clicking here.
For more info and very clear statistics on the prevalence of PFD Postpartum vs. Delivery Method, check out Mama Lion Strong's blog here.
