Skip to main content Skip to home page

    Pregnancy and Pelvic Health

    Kim S., Physical Therapist Pelvic Health and Wellness Center at The Women's Hospital 03/20/2019
    Let's talk about physical challenges of pregnancy. From conception to the birth of your baby, changes in your body are happening from head to toe. These changes are due to hormone levels adjusting, loosening of ligaments and connective tissue, enlargement of breasts and abdomen, and the growth of your baby fighting your organs for space. As a result of these changes, your body must adapt! During the adjustment periods there are some common symptoms that pregnant women appreciate. Some of these symptoms are normal and some are not. Some of the symptoms we can control on our own and some may need special attention.

    Postural changes will occur during the pregnancy and are accentuated as the baby grows. With this growth, the abdominal wall lengthens and distends pushing the hips forward as our center of gravity is altered. The low back muscles will shorten and the spine and pelvis appreciate an increased load and stress. Due to these changes, up to 70 % of pregnant women experience back pain. The pelvis, on many occasions, is the culprit in producing this pain. Symptoms may vary from groin or inner thigh pain to pubic or sacroiliac joint pain (pain below the waist line). Pain just above the pubic bone may also be a symptom. While many think these are just the normal pains of pregnancy, the reality is these pains may be signaling an issue that could persist long after the baby arrives. By being proactive in caring for these musculoskeletal issues, it may prevent problems in the future such as urinary leakage, pain with intercourse and pelvic or low back pain.

    Pregnant women are very active today during their pregnancies, caring for other children, caring for the home, and/or working outside the home. Pain makes it difficult to complete these daily functions. If you are having consistent trouble or pain walking up and down stairs, standing on one leg to dress, transitionally moving in bed or out of a chair, or walking for prolonged periods, there are treatment options that may reduce your pain. By caring for these problems during the pregnancy, postpartum activities such as lifting the baby and car seats, breast feeding and caring for other children become less painful tasks.

    Another issue rarely talked about is urinary leakage that may be occurring. The bladder is certainly challenged as your baby is growing and taking up space in your body. The bladder decreases its capacity to store urine causing you to void/urinate more frequently. Your pelvic floor muscles that lie between your legs like a hammock will distend and lengthen during pregnancy due to increased downward pressure from the baby above, loosening of connective tissue, and increased fluid in this area, particularly in the later stages of pregnancy. When the bladder is filling and attempting to hold urine, the pelvic floor muscles should have some tension and support. If you sneeze or cough or bend over quickly with a full bladder, the increased abdominal pressure may be too much for the weakened pelvic floor muscles to combat and leakage will occur. Strengthening the pelvic floor muscles during pregnancy may not only help with this leakage buy may also be beneficial in reducing back pain, hemorrhoids or vaginal varicosities, and even decrease trauma to the perineum with a vaginal delivery. Perineal repairs from tearing or episiotomies may heal more quickly following delivery as well.

    Urinary incontinence may occur following a vaginal delivery due to the significant stretching of the pelvic floor muscles. As these muscles heal, leakage should stop completely. Leaking with coughing, sneezing, or exercising following delivery is not normal months and years later, however is common and accepted by mothers as normal. Women often seek care for the leakage, but not until the problem has persisted for 5-7 years. After completing a short course in physical therapy the majority of these women will get complete resolution of symptoms and often ask "Why did I wait?"

    The Pelvic Health and Wellness Center at The Women's Hospital is specifically dedicated to your pelvic health before, during, and after delivery. If you are experiencing any of the problems discussed, speak to your physician regarding referral to one of our specialized therapists or phone us to see if we can help.
Top Back to top