Prenatal Pelvic Floor Physical Therapy
Prenatal pelvic floor physical therapy can help prevent issues postpartum! I wish I would have known the importance when I was pregnant. I think it would have helped prevent or lessen my tailbone pain and helped me advocate for better birthing positions during labor.
Here is a great article I found on Pelvic Floor Dysfunction Prevention in Prepartum and Postpartum periods. Here are some of the key takeaways from the article:
Prepartum patient counseling about pelvic-floor anatomy and functions and how to prevent pelvic floor dysfunction during pregnancy and after labor is a necessary point of Pelvic floor dysfunction prevention.
Women should be encouraged to perform pelvic floor muscle training in prepartum and postpartum periods which can decrease risk of urinary incontinence per study.
Pregnancy and postpartum pelvic floor rehabilitation programs orientated to pelvic floor dysfunction prevention should be a priority due to the high prevalence of pelvic organ prolapse and urinary incontinence, and the prediction for them to increase in the general female population.
Significant reduction in episiotomy rates and less third-to-fourth degree tears and postpartum perineal pain in antenatal perineal massage with pelvic floor muscle training.
The highest quality of evidence shows results that antenatal pelvic floor muscle training helps to prevent urinary incontinence in late pregnancy and reduce urinary incontinence rates after delivery. Preventative pelvic floor muscle training effect is long-lasting with the best results in continent women when they start structured pelvic floor muscle training at early pregnancy.
Tendency of improvement in sexual function postpartum by doing pelvic floor muscle training (PFMT) or PFMT combined with intravaginal transcutaneous electrical nerve stimulation (TENS). This can show improvement in vaginal laxity, arousal, lubrication, orgasm, and dyspareunia.
I agree with most of the above from this article except I find a lot of postpartum women actually need pelvic floor muscle relaxation not strengthening! Women are constantly told to “do their Kegels” but a good assessment is so important to determine what you need. And right before labor or around 36 weeks we usually suggest muscle relaxation training for birth preparation since we want the pelvic floor muscles to relax. Great article reviewing current research if you want to check out see link below.
Source:
Romeikiene, R; Bartkeviciene, D. Pelvic floor dysfunction prevention in prepartum and postpartum periods. Medicina 2021 April; 57 (4): 387. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073097/