renforcement du plancher pelvien grossesse et post accouchement

Pelvic floor strengthening

19-20 weeks pregnant, Postnatal

Do you know how important it is to tone your pelvic floor? In this article, we’ll look at different ways of doing this, to avoid certain inconveniences that could arise over time or following years after childbirth, linked to its weakening.

All the indications that follow are appropriate, both for a new mother and for the women around you.

What is a pelvic floor?

The pelvic floor is the set of muscles, ligaments and tissues that support all the organs and structures in the pelvis: the bladder, uterus and bowel. The pelvic floor is often compared to a hammock.By this definition, you’ll understand that if the pelvic floor is weakened, more relaxed and less toned, there will also be a downward descent of the structures. This, in turn, causes a number of unpleasant pressures and symptoms for women, such as urine loss, organ descent (prolapse) and/or an impact on their sex life.

Image - plancher pelvien normal versus plancher pelvien affaibli

The main causes of a weakening of a pregnant woman’s the pelvic floor :

  • Pregnancy and childbirth are one reason. Imagine all the work the pelvic floor has to do, the stretching, when the baby develops, grows, and gains weight in the pelvis, more specifically in the “hammock”. This affects both women who give birth vaginally and via a caesarean section. For vaginal childbirth, you should also imagine how the pelvic floor’s muscle structure works hard when pushing out the baby. The average pushing time for a first baby is 90 minutes, which is a long time for these organs and structures.

    Given birth several times and having pregnancies that are close to each other increases this phenomenon if the woman hasn’t strengthened her pelvic floor between pregnancies.

  • During menopause and normal ageing, there are significant hormonal changes. The steep reduction of some hormones also leads to reduce elasticity and a natural weakening of the pelvic floor. Estrogen is essential for a woman in her childbearing years for fertility but tends to lower during menopause. The woman’s pelvis can become narrower.
  • Hereditary factors can also play a role in the appearance of this type of problem (family history). Obesity, constipation, chronic cough, poor physical health, neurological disorders and prior surgery can also be potential causes of a weakened pelvic floor.

How can I know if my pelvic floor is losing its tone?

Women will often see a specialist for observed symptoms.

Symptoms of a Weakened Pelvic Floor :

  1. Without a doubt, urine loss is the most frequent symptom reported by women associated with the muscle    weakening of their pelvic floor. Many don’t talk about this to their doctor. They keep their  accidental urine loss (unable to hold it in) secret. This is called stress urinary inconsistency (SUI). Most of the time the urine loss is caused by pressure on the bladder when a woman sneezes, coughs, jumps, walks, laughs or dances.
  2. Prolapse is also a symptom that can indicate that the pelvic floor’s muscle structure is weakened. Prolapse is a condition where the vaginal mucosa slips down (you can see a bump in the vagina), or the uterus, bladder and/or rectum slip out of place. If you don’t do anything to firm up the pelvic floor’s support and control, these conditions can aggravate over time and require a procedure to solve the problem (surgery).
  3. Sexual sensations can also diminish if the pelvic floor weakens, and can be the cause of reduced feelings and satisfaction during sex.

How to Re-Educate a Pelvic Floor?

Firming up the pelvic floor can make a difference in many ways.

  • Do Kegel exercises regularly during the postnatal period. Make it part of your daily routine.
  • Avoid impact exercises for at least two months after childbirth.
  • Avoid constipation.
  • After a few months, some will use geisha balls for perineal re-education. They contract muscles to keep them in the vagina while standing up. Geisha balls, even if they are better known for providing intimate pleasure, can help strengthen the vaginal and perineal muscle structures.

You should consult a physiotherapist specialising in the pelvic floor to evaluate your condition and to teach you strengthening exercises, such as Kegel exercises. Know how to do Kegel exercises properly can somethimes be tricky!

Do you want to know more about the pelvic floor? Come and watch my video on the Pelvic Floor with the participation of Marie-Ève, a physiotherapist specializing in the subject.

Marie Fortier
The Baby Expert

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