Pelvic Floor Therapy Pregnancy

Prenatal pelvic floor therapy may be beneficial for low risk pregnancies, including first time pregnancies.

  • A 2020 meta-analysis states, “about one‐third of women have urinary incontinence and up to one‐tenth have fecal incontinence after childbirth.” (Woodley, et al. 2020)

Perineal massage by a pelvic PT, both during pregnancy and during the second stage of labor, is effective in reducing perineal injury (decreased risk of episiotomy and tearing).

Pregnancy

Pelvic floor exercises during pregnancy Oakland CA

“When to start pelvic floor exercises during pregnancy?”

  • The Woodley et al. 2020 review “provides evidence that early, structured pelvic floor muscle training in early pregnancy for continent women may prevent the onset of urinary incontinence in late pregnancy and postpartum.”

  • You can start as soon as you are ready- it is never too early or too late to begin to learn how to coordinate your pelvic floor muscles!

Why is pelvic floor muscle training recommended during pregnancy?

  • Trained pelvic muscles might be less vulnerable to injury and they may be easier to retrain during the postpartum rehabilitation process. Contact us for prenatal pelvic floor exercises.

  • You can reduce your risk for future urinary incontinence by treating urinary incontinence during pregnancy. (Hage-Fransen MAH et al. 2021)

  • Is prenatal internal pelvic floor therapy safe?

    Pelvic floor internal therapy and pelvic floor exercises during pregnancy are safe after the first trimester, and if you do not have the following: high blood pressure/pre-eclampsia, uterine contractions, vaginal bleeding, uncontrolled dizziness, throbbing headaches, shortness of breath, numbness and tingling, incompetent cervix diagnosis, placenta previa, severe anemia, decreased fetal movement during exercise, chest pains, or amniotic fluid leakage.

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  • Do I need a prescription from my MD?

    If your OBGYN or midwife has cleared you for sexual intercourse and exercise, then pelvic floor therapy is completely safe. You can work with a PT up to 45 days without a referral, and after that time we just need your MD to sign the plan of care.

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  • When can I do perineal massage?

    Perineal massage is encouraged at any time in the pregnancy. We can offer this service after your first trimester.

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  • What is perineal massage?

    At Bodyful, perineal massage is more than just stretching "tight" muscles. It is a nervous system informed technique that helps your pelvic floor practice being exposed to pressure and stretch while still being able to regulate with breath so reflexive tightening does not occur. This can help to prevent tearing.

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Pelvic floor relaxation exercises prenatal PT Oakland CA

How to relax pelvic floor muscles for birth?

If you are looking for prenatal pelvic physical therapy to prepare you for labor and delivery, pelvic floor muscle training is a great place to start. You will get feedback about how your pelvic floor muscles respond to cues to push, hold, cough, relax, and to different labor positions.

  • “Pelvic floor muscle training during pregnancy proves to be an effective preventive intervention for reducing the risk of urinary incontinence and the occurrence of third- or fourth-degree perineal tears.” (Zhang D et al. 2023)

  • Prenatal pelvic floor muscle training “might be effective at shortening the first and second stage of labor” in the first-time pregnant person. (Du 2015)

What about perineal massage to reduce tearing?

“Pelvic floor muscle training and perineal massage improved childbirth-related parameters and pelvic floor symptoms.” (Schreiner 2018)

  • If this is your first pregnancy, there is strong evidence that supports the use of perineal massage during pregnancy, and during the second stage of labor, to reduce perineal injury. (Yin et al. 2024)

  • Training your pelvic floor muscles during pregnancy to relax and stretch, can also improve pelvic floor function, such as decreased risk for fecal incontinence, flatus incontinence, and urinary incontinence.

If you are experiencing pain during pregnancy, please contact us!

The longer you experience pain, the more challenging it can be to rewire your brain’s relationship to your symptoms, and it can potentially complicate your pain prognosis in the future.

If you are unable to visit us in person, we can offer Telehealth visits to California residents.

Join Dr. Charette for Reformer Pilates pregnancy modifications!