If you don’t consider yourself an anatomy wiz, you may have never heard of the pelvic floor. But while you can’t see the pelvic floor muscles when they flex (unlike your bicep or abdomen muscles), they are incredibly important. These muscles support the uterus, bladder, and rectum and can be strengthened with pelvic floor exercises.
While there are pelvic floor-related conditions unrelated to pregnancy, we won’t be discussing those here.
What is the pelvic floor?
The pelvic floor is the set of muscles beneath your pelvic organs that support them, often referred to as a hammock For those with female reproductive organs, the hammock wraps around the bladder, rectum, and both uterus and vagina . Pelvic floor muscles control bladder and bowel function — this is why you can feel the muscles relaxing when, for example, you go to the bathroom. They also work together with other muscles to stabilize your spine.
What about during pregnancy?
During pregnancy, your pelvic floor muscles are working harder than they were pre-pregnancy, providing support for your expanding uterus. This increased pressure can cause many people to experience frequent urination, lower back pain, or incontinence during pregnancy.
What about postpartum?
Due to the increased work of the pelvic floor muscles and tissues during vaginal birth, some people may experience conditions such as urinary incontinence. There may be other postpartum conditions that occur such as prolapse, which is when an organ moves from its original position, but these are less common.
Urinary incontinence
Urinary incontinence (UI) is the inability to control your bladder, which can result in leaking urine. There are several types though the major two types are: stress incontinence and urge incontinence. Stress incontinence might be triggered by coughing, sneezing, or laughing. Urge incontinence, which is a form of overactive bladder (below), involves a sudden need to pass urine followed by involuntary loss of urine.
UI is particularly common during pregnancy and after birth as it can be the result of strained pelvic floor muscles and/or hormone changes. If you’re finding that urinary incontinence is impacting your day by preventing you from doing certain activities that you enjoy, that’s your sign to contact a provider.
Pelvic organ prolapse
A prolapse, or shifting of the uterus, bladder or rectum, may cause increased feeling of fullness and/or pressure in the vagina. Some may experience problems with urinary and bowel habits or have discomfort with sex.
Fecal urgency and incontinence
Though rare, fecal incontinence, or the inability to control bowel movements, may occur after birth. As with urinary incontinence, those with fecal incontinence can experience a range of severity, from small occasional bowel accidents to complete loss of bowel control.
Seeking treatment
While many people feel uncomfortable or embarrassed about these symptoms, we guarantee you that your provider really has seen it all before. There are treatment options and you deserve to have access to them. There are a variety of specialists that treat pelvic floor conditions such as urogynecologists, urologists and pelvic floor physical therapists.
Pelvic floor exercises
Exercises (like kegels) can strengthen your pelvic floor muscles, and address or prevent issues of urinary and/or fecal incontinence. To learn more about how to do these exercises talk to your provider or seek out a specialist or pelvic floor physical therapist
Kegels
A kegel is an exercise that involves tightening and lifting the pelvic floor. Doing kegels is a simple and effective way to improve symptoms associated with a strained or weakened pelvic floor.
And once you get good at them, you can do your kegels from anywhere, no equipment needed.
This content was reviewed by Dr. Lisa Hickman and Dr. Katie Propst. Dr. Hickman runs the Childbirth Pelvic Floor Disorders Clinic at The Ohio State University Wexner Medical Center. Dr. Propst runs the Postpartum Care Clinic at Cleveland Clinic.
Sources
- “Accidental Bowel Leakage.” American Urogynecologic Society. 2016. https://www.augs.org/assets/2/6/ABL.pdf.
- “Pelvic Floor Dysfunction: Symptoms, Causes & Treatment.” Cleveland Clinic. my.clevelandclinic.org/health/diseases/14459-pelvic-floor-dysfunction.
- Mayo Clinic Pelvic Floor Dysfunction Program in Minnesota. Mayo Clinic. February 5, 2021. https://www.mayoclinic.org/departments-centers/pelvic-floor-dysfunction-program/overview/ovc-20467221.
- Mayo Clinic Staff. “What to expect after a vaginal birth. Mayo Clinic. Mayo Clinic. March 11, 2020. https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/postpartum-care/art-20047233.
- Yvonne Butler Tobah, M.D. “What can I do to treat hemorrhoids during pregnancy?” Mayo Clinic. Mayo Clinic. August 16, 2019. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/hemorrhoids-during-pregnancy/faq-20058149.
