Pregnancy can be an exciting and sometimes overwhelming 9 months as your body grows and changes as you prepare to bring a new life into this world. From the multiple visits with your healthcare provider, the prenatal classes and preparing your home for the arrival of a new family member it can be a very busy time. I often have many patients question whether they should have a pelvic physiotherapy examination during their pregnancy, particularly if they aren’t having any symptoms?
A common misconception about pelvic physiotherapy is that it really only helps after labour, in the postpartum period to address problems that can arise. This just isn’t true! In the same way we work with patients training for a marathon or our athletes preparing for the big game we can help you prepare for the challenges you might face during pregnancy and labour!
So, what exactly can pelvic physiotherapy help with?
Exercise and Pregnancy
Did you know that a supervised exercise program (cardiovascular exercise 3x/week) during pregnancy has been associated with a shortened stage one and stage two labour 1. Whether you already have an exercise program that you want to continue with or you want to become more active during your pregnancy, your pelvic physiotherapist can help with the following:
- Review exercises that are safe for you to perform throughout pregnancy
- Modify your workouts as your body grows and changes
- Maintain pelvic floor and inner core strength throughout your pregnancy in preparation for labour
Pelvic Girdle Pain
Pregnancy related pelvic girdle pain is described as any pain experienced in the pubic symphysis (front of the pelvis) or sacroiliac joints (low back) during pregnancy 2. Pain is often reported as early as 14 weeks gestation and as late as 30 weeks, with as high as 60-70% of women reporting some pelvic girdle pain by late pregnancy 2. What many women don’t know is that pelvic physiotherapy can help to make you more comfortable throughout your pregnancy and reduce or even eliminate your pelvic girdle pain. Treatment may include:
- Soft tissue massage or gently joint mobilization to improve tension in the joints and muscles around your pelvis and low back
- Tips and tricks to modify your movement patterns as easy tasks such as rolling in bed and getting up out of a chair become more difficult
Address Urinary Incontinence (Leakage)
Pelvic physiotherapy is often associated with addressing urinary incontinence or leakage that can occur after a vaginal delivery, but if you start to experience urinary incontinence during pregnancy it is important to address it! Strengthening in the prenatal period has been shown to help to prevent stress incontinence in the postpartum period 3. That means pelvic floor strengthening can be preventative when performed throughout your pregnancy 4.
As your due date comes near, pelvic physiotherapy can also help you prepare for the main event. Your pelvic physiotherapist will likely have you come in for a final visit around 36 weeks where they address the following:
- Positioning to optimize delivery
- Discuss pelvic floor exercises and breathing techniques to help during labour
- Perineal stretching
So, think about physiotherapy during pregnancy as your prehab for labour and the postpartum period!
- Barakat et al. Exercise during pregnancy is associated with a shorter duration of labor. A randomized clinical trial (2018) European Journal of Obstetrics and Gynecology and Reproductive Biology. Vol 224:33-40
- 2008 European Guidelines for the Diagnosis and Treatment of Pelvic Girdle Pain
- Reilly et al. Prevention of postpartum stress incontinence in primigravidae with increased bladder neck mobility: a randomised controlled trial of antenatal pelvic floor exercises*(2014). An international Journal of Obstetrics and Gynaecology. Vol 121(7)58-66
- Morkved et al. Pelvic floor muscle training during pregnancy to prevent urinary incontinence: a single-blind randomized controlled trial. (2003) Obstetrics and Gynecology Vol 101(2):313-319