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 26 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. It wraps around the bladder, rectum, and both uterus and vagina (or prostate in men). 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. Having trouble visualizing the pelvic floor? Head to our video series with Dr. Amy Hoover, where she explains it.
What about during pregnancy?
During pregnancy, your pelvic floor muscles are working harder than they were pre-pregnancy, providing a solid foundation 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?
Now, let’s get into some common symptoms during pregnancy and postpartum. While some of these symptoms can feel scary, they are also all treatable and it can be helpful to prepare for them.
The pelvic floor muscles may be strained or injured during vaginal delivery. There are other reasons it might be strained, for example, during surgery or with age. The most common side effect is urinary incontinence.
OAB or Overactive Bladder
An overactive bladder, or the frequent or very pressing need to urinate, can be incredibly uncomfortable and frustrating. OAB is extremely common — 40% of women in the U.S. have OAB symptoms.
Urinary incontinence is the inability to control your bladder, which can result in leaking urine. There are two types: stress incontinence and urge incontinence. Stress incontinence might be triggered by coughing, sneezing, or laughing. Urge incontinence, which is a form of OAB, involves the involuntary loss of urine associated with a sudden need to pass 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.
The inability to control gas. This is common but can be extremely frustrating. As with fecal urgency and incontinence (below), strengthening your pelvic floor muscles can help.
Fecal urgency and incontinence
The inability to control bowel movements. 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.
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.
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 head here or talk to your provider.
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. For more information on pelvic floor strengthening head here.
And once you get good at them, you can do your kegels from anywhere, no equipment needed. To learn more, watch our pelvic floor strengthening series here.
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.
- “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.