Prepare Your Body and Mind for Labor and Birth

Pregnancy and childbirth are some of the most physically and mentally transformative events a person can experience. As your body adapts to accommodate your growing baby, pelvic floor muscle training can help throughout pregnancy and beyond. In addition, mindset preparation can be an essential part of relaxation and anxiety reduction before, during, and after delivery.

What does pelvic floor physical therapy involve, and how does it change throughout pregnancy?

Because every pregnancy is unique, it is best to have at least one pelvic floor evaluation performed to establish a baseline, ensure safety, and create a customized treatment plan before beginning pelvic floor exercises. Clinicians trained in pelvic floor health can:

• Ask questions about your health history that may impact pelvic floor muscle function
• Perform an internal and external exam to target problem areas or, if utilizing virtual care, walk you through a self-exam of the pelvic floor muscles
• Teach you how to prepare your body for labor and instruct you on personalized exercises to make labor easier

As pregnancy progresses, your clinician can gradually modify pelvic floor physical therapy exercises to meet your individual goals. Your program may begin with positions that make it easier to connect with the pelvic floor muscles and then progress to positions that introduce more of a challenge. For example, if your pelvic floor is tight, your clinician may start by teaching you how to release your pelvic floor muscles by practicing a Happy Baby Pose with breathing techniques. If an unmedicated birth is your desired outcome, you may progress to learning effective pushing techniques on hands and knees.

Are pelvic floor exercises and therapy relevant to people planning both vaginal and c-section births?

Yes. Regardless of how you deliver, pelvic floor health is important during pregnancy and postpartum. It is estimated that about half of all pregnant people experience symptoms of weakened pelvic floor muscles. This may eventually cause issues with bladder and bowel control and sexual discomfort.

During pregnancy, strain increases on these muscles as they support the baby’s weight, the placenta, uterus, and increased blood volume. Hormones, such as relaxin, are also secreted to prepare for birth, loosening ligaments and contributing to pelvic joint flexibility and instability.

What specific stretches, strengthening moves, and mobility work are most helpful?

Until you are able to see a pelvic floor physical therapist, learning about how your pelvic floor muscles work during labor and about pelvic floor exercises you can practice during pregnancy can help you identify specific muscles and increase flexibility. Keep in mind that some well intentioned pregnant people are practicing pelvic floor muscle exercises, and are actually doing them incorrectly. Proper muscle identification and exercise technique is key to supporting your changing body and growing baby.

How can I physically prepare your body for labor and birth during each trimester?

First trimester

Regular exercise in general is a healthy habit to adopt or maintain to support during pregnancy.

Staying active with cardio and strengthening exercises can improve your body’s ability to:

• Adapt to its constantly changing shape
• Carry the extra weight of pregnancy by strengthening muscles and joints
• Prepare for and increase endurance needed for labor

A good exercise routine includes an adequate warm up before and cool down after exercises. Aim for 30 minutes each day of activities you enjoy and feel comfortable doing. These can include walking, running, dancing, yoga, swimming, and aerobics classes.

Additionally, for pelvic floor exercises during pregnancy, it’s never too early to start. You can start working on foundation exercises even in the first trimester!

Second trimester

As your baby continues growing in the second trimester, the uterus rises above the pelvis. You may start to experience an increase in urinary incontinence. Depending on the type of incontinence you may experience, pelvic floor exercises can help strengthen or relax muscles to provide relief. A pelvic floor physical therapist can help identify which exercises will be most beneficial and instruct you on how to perform them effectively.

Third trimester

If you plan to deliver vaginally, the focus of pelvic floor physical therapy shifts to learning how to prepare for labor in the third trimester. This is accomplished by learning how to relax and lengthen your pelvic floor muscles. Also, focusing on deep abdominal and breathing exercises can help you prepare for the pushing phase of labor.

In addition, the perineal muscles and tissues between your vagina and anus can undergo significant stretching during the pushing stage of labor. Perineal massage is a great way to help get your body ready for labor and delivery, starting around the 35^th week. Your pelvic floor physical therapy clinician can teach you effective massage techniques that you can perform yourself.

Why is pelvic floor lengthening/relaxation so important in late pregnancy and labor?

To facilitate vaginal childbirth, the pelvic floor muscles must stretch and thin out. Physical therapy for labor prep may include squat stretches that can increase hip muscle and pelvic floor flexibility and diaphragmatic breathing to help relax and lengthen these muscles.

How can pelvic floor physical therapy be useful for planned c-section deliveries?

Exercises during the third trimester that continue to progressively condition the pelvic floor and abdominal muscles can reduce muscle weakness and nerve strain muscles as your due date approaches, particularly if constipation has been a problem. After delivery, your pelvic floor physical therapist can provide individualized post-surgery guidance and support for recovery from a c-section.

How can you prepare mentally and emotionally for labor?

Spend some time visualizing your delivery and reflecting on the fact that things can happen during labor that are not in your control and aren’t anyone’s fault. Pay attention to emotions that come up and give yourself permission to feel them. You can use your feelings to provide useful information that helps you create a plan that includes your preferences; allows plenty of space for flexibility, since every birth is unique; and focuses on the end goal of a safe delivery for you and your baby.

What are some practical mindset strategies as the due date approaches?

• You can get questions answered and become informed about current best practices and birthing options by attending in-person or virtual childbirth education classes. Research suggests that participation in prenatal classes can help improve maternal emotional well-being before and after delivery. These classes cover all sorts of topics, including the physiology of childbirth, pain management techniques, and general tips on how to mentally prepare for labor.
• Pre-natal yoga classes can teach breathing, stretching, and relaxation poses that are specifically beneficial in pregnancy and labor. They can help combat stress and anxiety symptoms during pregnancy.
• Establishing mental health care with a professional who is trained to work with pregnant people can be a proactive step towards anxiety reduction and learning effective coping strategies. Working with a mental health professional even help prevent symptoms of postpartum depression, but if these do occur, you will already have a familiar resource who is ready to provide help and support. Seven Starling and Mavida Health are great resources for those looking to connect with a mental healthcare provider.

Whether this is your first pregnancy or you have given birth before, practicing pelvic floor physical therapy and mental preparation exercises can help you feel empowered during your pregnancy journey and delivery. At Origin, our pelvic health specialists understand the unique challenges of pregnancy. Book a visit today to help you prepare for a smooth-as-possible delivery and postpartum recovery. You’ve got this!

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