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What happened to your pelvic floor during pregnancy?

- posted by Joan Palmer.

I wonder if any of you had even given a thought to your pelvic floor before you became pregnant.  It may have become a more familiar area early on in pregnancy when there is a massive surge in hormones that make you visit the loo more!! For others it may have been later in the pregnancy when the baby is getting bigger and it seems to be squashing your bladder or even bouncing on it making your visits to the loo more frequent again. 

It really doesn’t matter when you first became aware of it, what matters now is that if your pelvic floor is an issue for you, you can do something about it and you are not alone in having this problem. 

For those of you that haven’t noticed any symptoms, that’s great but it is also worth being aware that your pelvic floor has been through a lot. Even for those of you that may have had a c section, you have still had all the hormonal changes of pregnancy that affect tissue quality and activity and you have still had the increasing weight of a baby sitting on the pelvic floor making it harder for it to function as every week of pregnancy goes by. 

The pelvic floor should be treated like other parts of the body that are out of action for a while due to for example injury or inactivity.  The pelvic floor is a group of muscles that have to work together to function and therefore need to rehabbed just like any other muscle in the body.  Just because we can’t see it, we shouldn’t ignore it and just because it’s ‘down there’ we shouldn’t be embarrassed!

As already mentioned, changes occur in the pelvic floor during pregnancy due to big surges in hormones.  Changes also occur due to big changes in posture that happen over the course of your pregnancy due to the baby growing.  Abdominal muscles stretch and weaken as do the gluteal muscles (the bottom muscles), the lower back can become very stiff as can the muscles in front of the hips.  These changes cause a change in the position of your pelvis and as a result of this, the pelvic floor ends up sitting in a relaxed position most of the time.  When muscles are in a relaxed position they are not in their optimum position to function and are therefore not working as well as they could be and hence problems develop.  Quite often these changes in posture continue post-delivery and therefore below optimum function of the pelvic floor continues.

Other changes can occur if you have a vaginal delivery.  As you know the pelvic floor muscles will have stretched a lot, with some assistance from hormonal changes.  As a result the muscle again is not going to be able to work optimally for a while and if it is not encouraged to work, it will continue to be lazy.  If there is any tearing of the pelvic floor muscles or if you have had an episiotomy then scar tissue will have formed.  Scar tissue that isn’t managed well during its recovery, will become thickened and then make any surrounding tissue difficult to function well.

All of these issues can be addressed and symptoms of the pelvic floor improved, with corrective posture exercise, functional corrective exercise and sometimes some soft tissue massage work on any of the muscles that changed during pregnancy.

If you are concerned that your pelvic floor isn’t working as it should be then please get in touch at

You could also come along to a relaxed and informal evening that I am running with a Specialist women’s health physiotherapist at The Strand in Cheltenham Wednesday 12th July 7.45pm and find out all there is to know about looking after your pelvic floor.  If you would like to come along then book a ticket here

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