Pregnant? 5 Reasons to See a Pelvic Floor Physical Therapist During Pregnancy

Traditionally, going to physical therapy meant rehabilitation from an injury, surgery, or other medical event. And there are still plenty of physical therapists who do this important work. 

More recently, however, the industry has shifted into the health and wellness space. Now, going to physical therapy can also mean proactively supporting your wellness goals in preparation for a big event…such as having a baby. 

Just like you may want a PT on your team to prepare for an upcoming race or surgery, many people seek out a prenatal physical therapist during pregnancy (also called a pelvic floor physical therapist) to help support their pregnancy and labor goals. In fact, some people are incorporating physical therapy into their entire fertility journey—prior to pregnancy, during pregnancy, and after pregnancy. 

So, What Exactly is Prenatal Physical Therapy and How Can it Help My Pregnancy?

Physical therapists are movement experts. We have unique knowledge in anatomy and physiology that gives us an understanding of how our bodies are supposed to function, optimally. Pregnancy is a natural time when the musculoskeletal system is working at max capacity (but of course it’s for a very good reason and is temporary!). 

Prenatal, or pelvic floor physical therapy, is a specialty within physical therapy that concentrates on supporting and strengthening the pelvic floor muscles and core so they function the way they are intended to. 

During pregnancy, the function and stability of your core, hips, pelvic floor matters more than ever. Ask anyone who has been pregnant, and they will tell you the toll it took on their body—from pain, discomfort, and added stressors to posture changes, weight gain, and hormonal changes. 

Physical therapists with specialized training in pregnancy have the added benefit of understanding how your body is changing to accommodate a growing baby, what aches and pains are common, and how to prevent or improve them. We can also teach you how to protect your pelvic floor while you give birth, and safely guide you as you return to exercise and the other activities you love postpartum. Planning a cesarean? We can give you the tools for an easier recovery.

Let’s take a look at the top 5 reasons to see a pelvic floor physical therapist during your pregnancy.

1. Balance and Strengthen your Pelvis 

During pregnancy, the pelvic floor takes on the additional job of supporting your uterus with a growing baby inside of it. As your uterus expands, it puts more pressure on your pelvic floor. Additionally, hormones work to loosen the muscles and ligaments in your pelvis to help prepare for childbirth.  Both of these changes can equate to pelvic floor problems. If the pelvic floor isn’t working optimally (such as being unstable, too loose, or too tight), you may experience more pain and discomfort during your pregnancy, as well as be at a greater risk of developing urinary incontinence and pelvic organ prolapse after pregnancy. 

An unbalanced, tight, or weak pelvis during pregnancy can cause the following symptoms:

• Pelvic and/or pubic bone pain

• Pain in the groin and/or hip area

• Low back pain

• Increased heaviness in the labia and around the vagina

• Painful sex

• Urinary and/or bowel incontinence

• Pelvic organ prolapse

Engaging in proactive pelvic floor therapy throughout your pregnancy can help ensure your pelvic floor is strong, balanced and stable enough to support your growing baby and prepare you for childbirth. It can also help alleviate many of the common pregnancy discomforts.

2. Relieve the Aches and Pains of Pregnancy 

Pelvic floor physical therapists have specialized training in pregnancy and a thorough understanding of how your body is changing to accommodate a growing baby. They are familiar with what aches and pains are common during pregnancy, as well as how to prevent or improve them. 

Seeing a prenatal physical therapist can help your better manage/rehab many of the common discomforts that go along with pregnancy, such as:

• Back pain (sciatica)

• Hip pain

• Sacroiliac joint pain (SI or SIJ pain)

• Pelvic pain or symphysis pubis pain (SPD)

• Bladder leakage

• Constipation

• Painful intercourse

A pelvic floor specialist will use a combination of manual techniques, exercises, and movement coordination to help ease painful, disruptive symptoms and make your pregnancy more comfortable.

3. Educate, Prepare and Enhance Your Pregnancy Experience

From a proactive and practical health and wellness perspective, you can see a PT during pregnancy for a variety of reasons to enhance your overall pregnancy experience. This may include:

• Education in proper posture and how to move optimally throughout your daily activities (getting in and out of the car, lifting your baby and their car seat, etc.)

• Education in how your pelvis works and strategies for strengthening your pelvic floor muscles safely

• Education in pregnancy-safe exercises that promote core strength and stability

• Education in how to modify your existing exercise program so it is safe for pregnancy

• Education in proper breathing during exercise and movement

• Strategies to prevent and heal diastasis recti (abdominal separation)

4. Prepare for Vaginal and/or Cesarean Birth – You Got This Mama!

In addition to supporting your body during pregnancy, working with a pelvic floor physical therapist can also improve your actual birthing experience. This includes:

• Teaching you different pushing strategies in preparation for a vaginal birth

• Educating you on the different birthing positions for a smooth, gentle birth 

• Showing you specific breathing and pelvic floor relaxation approaches

• Performing stretches and manual tissue work that can reduce perineal tearing

• If you are having a planned C-section, or want to prepare for that possibility, a PT can discuss what recovery will look like and what additional support you may need

• Providing partner training so they can better assist you during labor (support comfort measures, assist during positioning, offer breathing and pushing cues, provide massage, etc.)

Additionally, if you are considering a VBAC (vaginal delivery after Cesarean), a pelvic floor PT can help:

• Assess prior c-section scarring that could be affecting pelvic function

• Evaluate your pelvic floor in its current state to prepare for a vaginal birth

• Educate you on the proper pushing techniques to reduce strain on the pelvic floor during labor

5. Prepare for and Navigate Postpartum Recovery

We all feel more confident and empowered when we’re prepared, right? Well, the same is true for postpartum recovery as well! Seeing a pelvic floor physical therapist while pregnant can help prepare you for what recovery may look like and what kind of support you will need. 

After pregnancy, a postnatal physical therapist can help address common concerns such as diastasis recti, urinary incontinence, painful sex, prolapse, and constipation. They can also work on any tearing or scars from delivery, and teach you how to work on the scars at home. And with their help, they can safely guide you as you return to exercise and other activities you enjoy. 

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The bottom line? During pregnancy, your body is literally changing minute-by-minute to accommodate the needs of a growing baby. And the act of labor itself is an extremely physically demanding event that puts a lot of additional stress on your body. A pelvic floor PT can help you stay active throughout your pregnancy, alleviate many of your aches and pains, teach you how to protect your pelvic floor while you give birth, and safely guide you back to doing all the things you loved before pregnancy

If you’re pregnant, it’s never too late to start working with a pelvic floor physical therapist! Schedule your free consultation or first appointment today.