Table of contents
Share Post

Did you know that pelvic floor physiotherapy may reduce the risk of pelvic floor trauma and tearing with a vaginal birth?

Antenatal pelvic floor physiotherapy is a newer area of pelvic floor physiotherapy, with physiotherapy in the past being mostly focused on treatment of injury following birth. Thankfully we have more and more research now into the benefits of prevention and antenatal pelvic floor physiotherapy to help prepare the pelvic floor for childbirth.

Research shows that pelvic floor strengthening and perineal massage can reduce the risk of severe vaginal tearing by five fold, perineal tearing by 65% and the risk of needing an episiotomy (a surgical cut to prevent severe tearing) by 74% (Cao et al. 2022). Pelvic floor physiotherapy focuses on strengthening and perineal massage in addition to other strategies to improve your ability to push and relax your pelvic floor muscles to assist with maximizing your chances of an uncomplicated birth.

So what will your physiotherapist do during a pregnancy pelvic floor appointment?

Your physio will usually start by asking you questions about your pregnancy and pelvic floor history. Your physio will then, with your consent, do an internal pelvic floor assessment to check the following:

  • Your ability to correctly contract your pelvic floor
  • Your pelvic floor strength
  • How well you can relax your pelvic floor
  • How flexible your pelvic floor muscles are, especially the size of the gap between the muscles (where the baby is born through)
  • May do an external measurement, from your urethra (where urine comes out) to your anus, to help determine the gap between the deep pelvic floor muscles
  • See if you can push correctly

Your physio will then design a program to help lengthen and strengthen your pelvic floor muscles and improve your pushing technique, to help maximize your chances of a natural vaginal birth with reduced risk of trauma to your pelvic floor.

Birth is unpredictable in nature and sometimes pelvic floor trauma happens despite all of our best attempts, however by preparing your pelvic floor for birth gives you and your pelvic floor the best chance of having a great outcome.

Reference

Cao, X., Yang, Q., Wang, Q., Hu, S., Hou, L., Sun, M., Lai, H., Wu, C., Wu, Y., Xiao, L., Luo, X., Tian, J., Ge, L., & Luo, C. (2022). PFMT relevant strategies to prevent perineal trauma: A systematic review and network meta-analysis. Archives of Gynecology and Obstetrics. https://doi.org/10.1007/s00404-022-06769-w

Related Articles