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During pregnancy your body goes through many changes to help you grow, carry, and birth your baby. It can sometimes be difficult to know what normal changes are and when you should seek help. Changes can happen to your bladder, bowel, and vaginal and sexual health as your pelvic floor muscles come under more pressure.
The information below will give you self-help tips to manage these changes. It will also provide advice on when, where, and why to seek help if anything worries you or does not resolve.
Your pelvic floor
Pelvic floor muscles – Why care about them?
Your pelvic floor muscles are a group of muscles that span the base of your pelvis. They attach from the pubic bone at the front, to the coccyx bone at the back, forming the floor of your pelvis. Pelvic floor muscles have the following uses:
- Control – They help you to control wee, wind, and poo.
- Support – They act like a hammock to support your pelvic organs (bladder, womb, and bowel) and keep them in the correct position.
- Sexual function – They can help improve sex by increasing your sensation, your grip, and orgasm.
- Stability – They help to keep your pelvis and hips stable.
Pregnancy, childbirth & pelvic floor muscles
Pregnancy
Anyone who is pregnant can be affected by pelvic floor dysfunction. This is when the pelvic floor muscles are not working correctly. It is important to be aware of how pelvic floor problems occur and what you can do to reduce them.
During pregnancy
The pelvic floor muscles come under pressure from the extra weight of your growing baby, the amniotic fluid around your baby, the placenta, and the enlargement of the womb. This extra downward pressure and effect from pregnancy hormones (chemicals in the bloodstream) causes stretching and tiring of the pelvic floor muscles. The stretching means your muscles do not do their jobs as well.
Childbirth
During a vaginal birth your pelvic floor muscles will stretch for you to deliver your baby. Some women may sustain tearing of the perineum (the area between the vagina and the anus) and the pelvic floor muscles which will take time to heal. Third- and fourth-degree tears. This can affect how well the muscle works. After birth, the nerves that make the pelvic floor muscles work may not be doing this so well which means that your muscles feel weak.
What can I do to help my pelvic floor?
Getting Help
It is common to be embarrassed or to think that pelvic floor problems are normal while you are pregnant and after childbirth. Pelvic floor symptoms are rarely spoken about and there are lots of reasons why. Some people feel uncomfortable speaking about pelvic floor issues and simply ‘put up with’ symptoms that can affect their daily life.
Other reasons may include:
Who can help?
In Suffolk and north east Essex, we have launched a pelvic health service for everyone who is having a baby. To support your pelvic health during pregnancy and birth you will be provided with the following:
- Information about pelvic floor exercises including access to the NHS-endorsed ‘Squeezy’ app, which will support you with pelvic floor exercises
- An invitation to answer pelvic floor self-assessment questions at regular points during pregnancy and after birthing your baby. From this, you can access targeted support and services if you have any of the symptoms or are at risk of pelvic health problems.
Do you have any bladder or bowel problems?
Do you feel like you have a separation in your stomach muscles?
Do you have any lower back, groin, hip or buttock pain?
Do you have any heaviness, pain or discomfort in your vagina?
If the answer is ‘yes’ to any of the questions 1-4 above, self-help is available on our pelvic health videos.
Additionally, face-to-face Perinatal Pelvic Health Physiotherapy services are available across Suffolk and north east Essex from the time you find out you are pregnant, up to a year after you give birth. Visit: physioselfrefer.co.uk or call 03330 433966
You will need to register for an account and then complete the self-referral online. You should be contacted by email or phone within two working days with recommended treatment options. (Remember to check your junk mailbox).If you feel worried and would like more advice you can speak to your midwife throughout your pregnancy and up to 28 days after the birth of your baby.
Free Perinatal Pelvic Health Physiotherapy services are available from the time you find out you are pregnant, up to a year after you give birth.
Simply register online and then complete the self-referral form. You should be contacted by email or phone within two working days with recommended treatment options. (Remember to check your junk mailbox).
If you feel worried and would like more advice you can speak to your midwife throughout your pregnancy and up to 28 days after the birth of your baby.
We need your views
To ensure that the care we offer meets your needs, we would like to hear about your experiences and suggestions for improvement. The results of this survey will be used to understand what we are doing right and how we can improve.
The information will only be shared with others in a way that would not identify you.
Explanation point
| Term | Description |
|---|---|
| Placenta | A pancake-shaped organ that attaches to the lining of your womb (uterus) and connects to your baby through the umbilical cord. |
| Physiotherapy | A treatment that helps to restore movement and function when someone is affected by injury, illness, or disability. |
Acknowledgments:
- The content of these pelvic health web pages has been adapted from the Norfolk & Waveney NHS Integrated Care System (Just One Norfolk) who have kindly given permission for this.
- Some of the video content on our pelvic health web pages is from the MyHealthLondon team, who have kindly given permission for us to share. The London Maternity Clinical Network worked in collaboration with Imperial College Healthcare Trust, alongside service-user representatives, Maternity Voices Partnership and other NHS professionals to create a series of videos about the changes of the body before, during and after birth and will provide information and useful advice about supporting your body’s journey through pregnancy and beyond.