How Pregnancy And Childbirth Impact Pelvic Floor Health

The journey of pregnancy and childbirth is truly astonishing. Not only is new life brought into the world, but there is also somewhat a rebirth of the woman in terms of her outlook on life and the way her body changes.

The pelvic floor is one of those areas of the body that is most affected during the process of carrying and delivering a baby because it is made up of muscles and connective tissues that support structures such as the uterus, vagina, and bladder.  

A good understanding of how pregnancy and childbirth impact the pelvic floor is very important because it allows one to be prepared for possible issues and also alerts on when to seek medical help.

The Pelvic Floor

The pelvic floor is a complex, multilayered, dynamic system that runs from the tailbone behind to the pubic bone in front. It is dome-shaped and made up of soft tissue such as fascia, ligaments, and muscles. These serve major functions in the body: 

1. It acts as a hammock, supporting the pelvic organs such as the rectum, bladder, uterus, and vagina. This support is especially important during pregnancy and childbirth. 
2. It plays an important role in maintaining urinary and fecal continence through the sphincteric function of its muscles preventing the passage of urine or faeces from the urethra and rectum respectively and through the relaxation of same muscles to allow movement of the same.
3. Through voluntary contraction of the pelvic floor muscles it enhances sexual stimulation, playing an important role in arousal and sexual satisfaction.
4. The floor provides resistance to increases in intra-abdominal and pelvic pressures from actions such as carrying heavy weight, sneezing, coughing, and straining during micturition or defecation.

Impact Of Pregnancy And Childbirth On The Pelvic Floor

The pelvic floor is susceptible to a lot of changes during pregnancy and delivery due to its pivotal role in the support of the uterus and vagina. The effects of hormones and the weight of the uterus can alter the structure and function of the pelvic floor, leading to various outcomes.

Effect Of Hormonal Changes On The Pelvic Floor

Throughout pregnancy, several hormones, including relaxin, estradiol, progesterone, and cortisol, increase significantly in the body in order to support the growing baby. Unfortunately, these hormonal changes also affect the integrity of the pelvic floor. 

Progesterone and relaxin cause relaxation of the pelvic floor muscles to prepare the body for delivery while estradiol and cortisol alter the collagen composition of connectives tissues. Together, these hormones affect the strength and elasticity of the pelvic floor making it more prone to injury and dysfunction.

Pressure Effects On The Pelvic Floor

Physical pressure from the fetus, amniotic fluid, and placenta put a strain on the pelvic floor, causing it to stretch and elongate. This makes it harder for the pelvic floor to maintain its function and can weaken its ability to support the pelvic organs.

Further, stretching of the muscles and connective tissues occurs during vaginal delivery to accommodate the passage of the baby, which can lead to temporary or permanent damage to the floor. Again, trauma from instrumental vaginal delivery or perineal tears can affect the pelvic floor and surrounding tissues. 

Common Pelvic Floor Issues Postpartum

The postpartum period usually unveils challenges related to pelvic floor health. Common issues seen are:

Urinary Incontinence

Because of the pressures from pregnancy and delivery and the resultant weakening of the pelvic muscles, a great majority of women will experience mild to moderate stress urinary incontinence starting right from the pregnancy. This is usually evident during activities such as coughing or sneezing, and it can be a source of embarrassment.

Pelvic Organ Prolapse

This happens when the weakened muscles allow the pelvic organs to move from their natural anatomic locations, often pressing against the vaginal wall or prolapsing into the vaginal canal, leading to symptoms such as pressure in the pelvis, sensation of a swelling in the vagina or bulging at the vaginal canal. 

Pain And Discomfort

Painful intercourse as a result of overactivity of the pelvic floor and difficulty in achieving orgasm from disruption in the rhythmic contractions of the pelvic muscles are common manifestations of pelvic floor dysfunction from pregnancy and delivery.

While most of these conditions are temporary and improve with time and exercise, a minority may go on to need further help, such as vaginal rejuvenation treatments, to enhance physical and emotional health.

Tips For Maintaining Pelvic Floor Health During And After Pregnancy And Childbirth

Pelvic Floor Exercises

Just like other muscles in the body, the pelvic floor muscles can be targeted and strengthened. Kegels exercise involves lifting and tightening the pelvic floor muscles for a few seconds, as if trying to hold urine or flatus and then releasing them. Repeat this action at least 8-10 times, several times a day for great results.

Avoid Constipation

Constipation is common in pregnancy due to the relaxation effects of progesterone on the smooth muscles of the stomach and intestines. This however  increases intra abdominal pressure, exerting more strain on the pelvic floor. To combat constipation, ensure adequate hydration and intake of fiber-rich foods. 

Maintain A Healthy Weight And Stay Fit

Excessive weight can increase intra-abdominal and pelvic pressures, putting more stress on the pelvic floor. Activities such as walking and swimming help to manage weight and maintain fitness. 

Seek Medical Advice

Persistent urinary incontinence, organ prolapse, pelvic pain, or painful sexual encounters may warrant a consultation with your healthcare provider. Guided rehabilitation and vaginal rejuvenation treatments are able to address complications related to pelvic floor dysfunction, especially when time and pelvic floor exercises have failed to improve symptoms.

Conclusion

Pregnancy and childbirth place significant strain on the pelvic floor, hence understanding the impact and adopting proactive measures can help to maintain pelvic health and wellness. Engaging in pelvic floor exercises, being active and maintaining a healthy weight can improve pelvic floor strength and function for most women, while others may need more advanced care.By taking an informed approach, women can navigate this period with greater confidence and enjoy the joys of motherhood while prioritizing their own health and quality of life.