Pregnancy is a transformative time for the body, but it can also be physically demanding, especially as the body prepares for labour. Strengthening your core and pelvic floor muscles is one of the most effective ways to support your body through these changes and get ready for childbirth. Physiotherapy offers exercises and techniques that can help make labour more manageable and support a smoother recovery.
Let’s explore why the core and pelvic floor muscles are so important, and look at some practical physiotherapy exercises that you can start incorporating into your pregnancy routine.
Understanding the Core and Pelvic Floor During Pregnancy
Anatomy and Changes During Pregnancy
During pregnancy, the core and pelvic floor muscles work overtime to support your changing body. The core includes your abdominal muscles, diaphragm, and back, all of which help stabilise your body and support posture. The pelvic floor muscles, located at the base of your pelvis, hold up your bladder, uterus, and bowels, providing essential support.
As your baby grows, hormonal changes in the body cause muscles and ligaments to relax, which can lead to increased pressure on the core and pelvic floor. For many women, this can cause discomfort, such as lower back pain or pelvic pressure. Strengthening these muscle groups not only helps manage these changes but also makes the body better prepared for the intense work of labour and delivery.
Role of the Pelvic Floor in Labour and Delivery
Your pelvic floor muscles play a key role in labour and delivery, as they’re involved in both supporting the baby’s weight and controlling the pace of pushing. When these muscles are strong yet flexible, they help you maintain control during labour, which can reduce the risk of tears or the need for interventions.
During childbirth, the pelvic floor muscles stretch significantly to allow the baby to pass through the birth canal. If these muscles are too tight or weak, this stretching process can be more difficult, leading to more strain and discomfort. That’s why physiotherapy exercises that balance strength with flexibility can be so helpful—they prepare your pelvic floor for the intensity of labour without causing strain.
Role of the Core in Supporting Labour and Delivery
The core also plays an essential role in supporting your body’s stability and endurance throughout pregnancy and into labour. A strong core helps keep your spine and pelvis stable, which can ease back pain and help you maintain good posture, even as your body changes.
During labour, your core muscles can aid in effective pushing, especially in the later stages. Engaging your core correctly can make each push more efficient, helping the baby move through the birth canal more smoothly. This is another reason why physiotherapy exercises that strengthen the core without overloading it are ideal for pregnant women.
Physiotherapy Exercises for the Pelvic Floor and Core
Now that we’ve covered why core and pelvic floor muscles are so important, let’s look at some physiotherapy exercises that can help strengthen these areas safely during pregnancy.
Pelvic Floor Exercises
Kegel Exercises
Kegel exercises are a classic for a reason—they’re simple, can be done anywhere, and help strengthen the pelvic floor muscles effectively. To do a Kegel, start by imagining you’re trying to stop the flow of urine. You’ll feel your pelvic floor muscles lift and engage. Hold this contraction for a few seconds, then release. It’s important to breathe naturally as you do this, avoiding any tension in the abdomen.
A good goal is to work up to holding each Kegel for about 5–10 seconds, repeating it 10–15 times per session. These exercises can be done daily and are excellent for maintaining pelvic floor strength, which is key for a controlled, smoother labour.
Deep Squats
Squats are another great way to strengthen the pelvic floor and prepare the body for the birthing position. A deep squat gently stretches the pelvic muscles and helps build stability in the legs and hips. To perform a deep squat, stand with your feet about shoulder-width apart, toes pointed slightly outward. Slowly lower your hips down as if sitting in an invisible chair, keeping your heels on the ground and your back straight.
If you’re just starting out, you can use a chair or wall for support. Aim to hold the squat for a few breaths, then come back up slowly. This exercise can be done a few times a day, and it helps to increase both pelvic flexibility and strength, making it a valuable addition to your prenatal routine.
Perineal Massage and Stretching
Perineal massage is a lesser-known but effective way to increase flexibility in the pelvic floor, which can help prevent tearing during delivery. Starting around the 34th week of pregnancy, you can try gentle perineal massage. This involves applying light pressure to the perineum (the area between the vagina and anus) to gradually improve elasticity.
A physiotherapist can guide you in this technique, showing you how to perform it safely. It’s a gentle practice that prepares the pelvic floor muscles for the stretching they’ll go through during childbirth. By doing this massage a few times a week, you can help reduce the likelihood of perineal tears.
Core Exercises
Diaphragmatic Breathing (Belly Breathing)
Diaphragmatic breathing, or belly breathing, is a foundational exercise for core stability and strength. It’s a gentle way to work your diaphragm, which plays a key role in core support, and it can also help calm the mind and body. To practice belly breathing, sit or lie down in a comfortable position. Place one hand on your chest and the other on your belly.
Take a slow, deep breath in through your nose, letting your belly rise as you fill your lungs with air. Then, exhale slowly through your mouth, feeling your belly lower. This breathing technique can be used during labour to help you stay relaxed and focused, as well as to activate your core muscles safely.
Pelvic Tilts
Pelvic tilts are an excellent way to strengthen the deep core muscles, while also easing any lower back discomfort. To do a pelvic tilt, start on your back with your knees bent and feet flat on the floor. Gently rock your pelvis so that your lower back presses against the floor, and hold this position for a few seconds before releasing.
As you progress through pregnancy, you may find it more comfortable to perform pelvic tilts while standing against a wall or while on hands and knees. This exercise builds strength in the core and helps you stay mindful of your posture, which is useful not just in labour but in everyday movements as well.
Modified Planks
While full planks may be too strenuous during pregnancy, modified planks offer similar benefits for core strength in a safer, gentler way. Start by positioning yourself on your hands and knees, with your hands directly under your shoulders. Engage your core and lift your knees slightly off the ground, holding this position for a few breaths.
If this feels comfortable, you can try extending one leg at a time for an extra challenge, but avoid holding any position that feels like it’s straining your abdominal muscles. Modified planks are great for overall core strength, and they build stability without putting too much pressure on your growing belly.
Timing and Safety Considerations
When to Start These Exercises
Starting core and pelvic floor exercises early in pregnancy, ideally in the second trimester, can help the body adapt gradually and give these muscles time to strengthen before labour. However, it’s never too late to start—even in the third trimester, these exercises can still offer significant benefits.
Each trimester brings new physical changes, so you may need to adjust your routine as your body adapts. A physiotherapist trained in prenatal care can help tailor exercises to suit your current stage of pregnancy and your individual needs. Generally, beginning with gentle movements and building up as your strength improves is a great approach.
Safety Precautions and Signs to Stop
While these exercises are generally safe, it’s important to listen to your body and take a break if you feel any discomfort or pain. Here are some safety tips to keep in mind:
- Avoid holding your breath: Breathe naturally throughout each exercise, especially during core engagement. Holding your breath can add unnecessary pressure to your abdomen and pelvic floor.
- Avoid overexertion: Physiotherapy exercises should feel challenging but not exhausting. Pregnancy hormones naturally loosen muscles and joints, so avoid stretches or movements that push too far.
- Watch for signs to stop: If you experience any sharp pain, dizziness, vaginal bleeding, or leakage of fluid, stop the exercises immediately and consult your healthcare provider.
Role of a Physiotherapist
Working with a physiotherapist who specialises in prenatal care can make a huge difference in your journey. We spoke with the team at Applied Motion, a physiotherapy clinic with expertise in Pre and Postnatal Care as well as Pelvic Floor Rehabilitation. They shared how important it is to ensure that exercises are tailored to your body’s unique needs during pregnancy. At Applied Motion, they emphasise that correct techniques for breathing, muscle control, and gradual strengthening can help expectant mothers build confidence and reduce strain.
A physiotherapist can also help address specific issues, like pelvic discomfort or lower back pain, that can arise during pregnancy. With their guidance, you can feel reassured that each exercise is safe, effective, and adapted to the changes your body is going through.
Long-Term Benefits and Postpartum Recovery
Immediate Benefits for Labour and Delivery
When core and pelvic floor muscles are conditioned through physiotherapy, they’re better able to handle the demands of labour. Strong pelvic floor muscles give you more control during the pushing stage, helping reduce the risk of tearing or other complications. At the same time, good core strength allows for more effective, controlled pushing, which can help the baby move through the birth canal more smoothly.
Labour is an intense experience, but many women find that their physiotherapy exercises help them stay focused and feel prepared. Knowing you’ve strengthened these important muscles can also boost confidence, which can have a calming effect during labour.
Postpartum Healing and Recovery
After birth, the benefits of these exercises continue as your body transitions into recovery mode. The pelvic floor and core muscles will need time to regain their previous strength and tone, especially if you’ve experienced tearing or had an episiotomy. Postpartum recovery exercises guided by physiotherapy can help you reconnect with these muscles, improve circulation, and gradually rebuild strength.
Physiotherapy can also play a key role in addressing common postpartum issues like diastasis recti (abdominal muscle separation), incontinence, and pelvic organ prolapse. By gently strengthening these areas over time, you can support your body’s natural healing process and help prevent or reduce these issues.
Many new mothers find that continuing with their physiotherapy exercises post-pregnancy also helps with everyday activities. Stronger core and pelvic floor muscles can make it easier to lift, carry, and care for your baby while keeping you more comfortable and resilient in the months that follow.
Conclusion
Preparing your body for labour is about more than just getting through the day-to-day of pregnancy. By focusing on core and pelvic floor strength through physiotherapy, you’re equipping yourself for a more supported, comfortable labour and a smoother postpartum recovery. Taking just a few minutes a day for these exercises can make a big difference in how you feel both during pregnancy and after giving birth.
Physiotherapy offers a safe, practical way to build strength, flexibility, and confidence for the incredible journey ahead. Remember, whether you’re doing Kegels, breathing exercises, or gentle stretches, these movements aren’t just about physical fitness—they’re a way to care for yourself and prepare for a positive birth experience. As always, consult a healthcare provider or prenatal physiotherapist for guidance tailored to your unique needs.
Labour and recovery may have their challenges, but with the support of these exercises, you’re giving yourself the best possible foundation for a healthy, happy experience.
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