Dr Michelle O'Driscoll: Pregnant? Time to look after your pelvic floor

In her weekly column in WoW! Dr Michelle O'Driscoll talks the pelvic floor and why we need to exercise it
Dr Michelle O'Driscoll: Pregnant? Time to look after your pelvic floor

"When these muscles are strong and functioning correctly, you can be assured full control over all bodily functions, particularly while coughing, sneezing, laughing and exercising."

PREGNANT and wondering if you’re doing all you should be doing in terms of health?

The amount of advice that you receive around nutrition, vaccinations and appropriate foods can be overwhelming.

An important consideration that can get overlooked, however, is strengthening your pelvic floor via appropriate exercises known as ‘kegals’.

Ideally, all women should do these several times a day, but they become particularly important in pregnancy. But what exactly is the pelvic floor, and why do we need to exercise it?

The pelvic floor is a layer of muscles that run from the pubic bone in front, to the lower spine at the back. These muscles act for all the world like a hammock or a sling, and their function is to hold all the organs in this area in place; womb, vagina, bladder, bowel and rectum.

When these muscles are strong and functioning correctly, you can be assured full control over all bodily functions, particularly while coughing, sneezing, laughing and exercising.

One in three Irish women experience pelvic floor dysfunction, however, the most common type being weakness during and after pregnancy.

Pregnancy can cause this weakness due to physical pressure and strain during gestation and childbirth, particularly after multiple pregnancies. Constipation and straining of the stool can further exacerbate the issue. Hormonal changes in pregnancy also contribute to weakness in this area. A hormone called progesterone increases significantly during pregnancy, and acts as a muscle relaxant. This allows the joints and ligaments to shift and make room for a growing baby, but can also weaken the control on urinary flow.

This is a very common issue, and nothing to be embarrassed about, but neither should it be taken lightly. Severe cases can lead to the requirement of surgery in later years.

It’s easy to forget to do any pelvic floor exercises because issues of weakness may not be apparent until later on, when the damage is done. It’s only when a leak occurs after you sneeze, or you have to cross your legs at the thought of jumping on a trampoline, that you realise the importance of these exercises, and perhaps regret not practicing them sooner!

But by acting early, and being diligent with your pelvic floor exercise routine, you are preventing issues later on down the track. Kegals strengthen these muscles, and help the body to cope with the growing weight of your baby, as well as encouraging healing more easily post-partum.

Research has shown that those who carry out the exercises during their first pregnancy are less likely to have problems with bladder control later on.

Pelvic floor exercises are straightforward, and can be done with nobody knowing that you’re doing them. Do them while applying your make-up, sitting in traffic, or brushing your teeth.

They should be completed three times a day if possible, but once or twice is better than not doing them at all. Link them to a daily activity to improve compliance.

Here’s how you should approach them:

Breathe normally through the exercises Choose any comfortable position, usually sitting or lying down.

Tighten the muscles of your back passage like your preventing the passing of wind, and at the same time tighten the muscles towards the front like you’re stopping the flow of urine.

What you feel working now is your pelvic floor muscles.

Now tighten these muscles around the back passage, the vagina and the urethra (urine passage) at the same time, and hold for 5-10 seconds if possible. Now release.

Repeat this process ten times.

It is possible to complete a shorter version of this process by squeezing and lifting the pelvic floor muscles, and releasing as quickly as possible. Repeat this 10 times also.

Another way of incorporating the exercises into daily life is to tighten the muscles and lift them while you cough or sneeze — a real challenge but very effective if you remember to do it.

If you feel pain in your abdomen or back while doing these exercises, you may not be doing them properly and should review them with your doctor or physio.

Act in advance, and do all you can to keep those muscles strong, engaged, and functioning well. That way, you can enjoy a good belly-laugh with friends without the worry of a leak! It’s never too late to start, and long after your baby is delivered you can add it to your daily routine.

These muscles act for all the world like a hammock or a sling and their function is to hold all the organs in this area in place...

ABOUT MICHELLE

  Dr Michelle O’Driscollis a Lecturer of Clinical Pharmacy in UCC, while continuing to work in the community pharmacy setting. Her research lies in the area of mental health education, and through her company InTuition she delivers health promotion workshops to corporate and academic organisations nationally.

More in this section

Sponsored Content