The Rotherham NHS Foundation Trust

Antenatal pelvic floor exercises

Obstetrics & Gynaecology

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Antenatal pelvic floor exercises

Introduction Your Midwife will have stressed the importance of pelvic floor exercises during your pregnancy, but these exercises are important throughout life, not just in pregnancy and after delivery. When done properly and regularly, pelvic floor muscles will improve the strength of the pelvic floor. Strong pelvic floor muscles help you to: l Have an easier birth. l Relieve constipation. l Help prevent the embarrassment of passing urine when you laugh or cough. l Improve your sex life. Pelvic floor muscles The pelvic floor muscles are a group of muscles which run from the pubic bone to the base of the spine; they are stretched like a hammock. These muscles: l Provide support for the pelvic organs, the intestines, bladder, uterus and baby. l They help to control the bladder and bowel, they close the urethra (bladder outlet) and back passage (anus). l They are important in sexual function. l They assist in childbirth. l Help to stabilize the spine.

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Antenatal pelvic floor exercises

Diagram of pelvic floor muscles

Fallopian Tube and Ovary

Spine Womb (Uterus) Womb entrance

Bladder Pubic Bone

Rectum

Bladder outlet supported by Pelvic Floor Muscles

Anus

Urethra Vagina Vulva

Pelvic Floor Muscles support the Bladder, Womb and Rectum

How the pelvic floor muscles work The pelvic floor muscles are kept firm and slightly tense to prevent leakage of urine, wind and faeces from the bowel. The muscles relax when you pass urine or have a bowel movement, tightening afterwards so retaining control. Weak muscles means less control. The pelvic floor muscles are also important to help increase sexual awareness for both partners during sexual intercourse.

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Antenatal pelvic floor exercises

Effects of pregnancy and childbirth During pregnancy, a hormone relaxin is released throughout the body. It softens the tissues, allowing the body to expand as the baby grows. It also allows the pelvic floor to stretch wide as you give birth. The softening effect of the relaxin and the pressure from the increasing weight of the baby make it difficult for the pelvic floor muscles to keep the pelvic organs in their correct position. The pelvic floor muscles and ligaments are stretched at birth. Why do pelvic floor muscles not work properly The muscles can be damaged l During pregnancy. l After childbirth. l Due to raised BMI. How will exercising these muscles help l Exercising strengthens the muscles to improve support. l Improve bladder and bowel control to prevent leakage. l Being more aware of them helps you to relax them during childbirth, so helps during delivery. l Reduces constipation. l Exercising after birth will help to regain the strength and may help to ease perineal pain. l May also help to preventing prolapse in later life. l Pelvic floor exercises are for life. 5

Antenatal pelvic floor exercises

Identifying the pelvic floor muscles In order to identify the pelvic floor muscles you need to imagine you are trying to stop yourself from passing urine, or wind. The feeling is of’ lift and squeeze’, closing and drawing up of the front and back passages at the same time should be exercising the pelvic floor muscles. To start with, you will need to concentrate. How to check you are doing the exercises correctly l Insert your fingers into the vagina, tighten the pelvic floor muscles, you should feel the muscles move around your fingers. l During sex, try to exercise the pelvic floor, ask your partner if he can feel the muscles tightening. l Check with a mirror, the skin between the anus and vagina (perineum) should move away from the mirror. l You can stop yourself passing urine mid flow with the pelvic floor muscles but you must only try this once and make sure you empty the bladder completely. l It is important that you use the correct muscles, specialist continence nurses and specialist physiotherapists can help.

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Antenatal pelvic floor exercises

Try not to l Squeeze your buttocks. l Hold your breath. l Bring your knee’s together. l Lift your shoulders, eyebrows or toes. How often do I need to do pelvic floor exercise? l Like any exercise it takes time to strengthen the muscles. Persevere and do the exercises regularly. l It is recommended that pelvic floor exercises are done daily for at least three months, then a few times a week for maintenance. l Use a trigger to remind you to do your exercises, washing up, a phone ringing, cooking. l Don’t forget to use the pelvic floor when you most need it, squeeze every time you cough or sneeze. Exercises l Aim to do a mixture of fast and slow ‘lifts’. l Repeat 5 to 6 times gradually increasing to 10. l Sitting with your feet flat on the floor, or lying down. l Gradually increase holding time to 10 seconds. l Repeat 3 to 4 times a day.

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Antenatal pelvic floor exercises

The exercises Slow exercises l Close and draw up the muscles around your back passage, as if you are stopping yourself from passing wind (don’t tighten your buttocks). l Close and draw up the muscles around your vagina and urethra, as though trying to stop the flow of urine. l Hold to a count of 5 (if this is difficult, hold for 2 then 3, gradually increasing to 5) breathe normally throughout. When you can feel the hold and relax you can hold for 5 seconds. l Slowly relax and let go. l Relax for 5 seconds then repeat. Fast exercises l As before draw up the pelvic floor muscles. l Hold for 1 second. l Relax for 5 seconds. Remember Pelvic floor muscle exercises are for life. They should become something you just do! For further information or advice please contact: Department of Physiotharapy Telephone 01709 424400 Department of Urology Telephone 01709 426322 8

Antenatal pelvic floor exercises

Notes

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Antenatal pelvic floor exercises

How to contact us Department of Physiotharapy Telephone 01709 424400 Department of Urology Telephone 01709 426322

Useful websites www.nhs.uk www.gov.uk www.therotherhamft.nhs.uk www.patient.co.uk

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We value your comments If you have any comments or concerns about the care we have Useful contact numbers provided please let us know, or NHS 111 Service alternatively you can write to: Telephone 111 Patient Services Health Info The Rotherham NHS Telephone 01709 427190 Foundation Trust Stop Smoking Service Rotherham Hospital Telephone 01709 422444 Moorgate Road A&E Oakwood Telephone 01709 424455 Rotherham For GP out of hours, S60 2UD contact your surgery Telephone 01709 424461 Email [email protected]

Produced by Mandy Kingston, August 2010. Revised October 2011, August 2013. Revision due October 2015. Version:3.0 ©The Rotherham NHS Foundation Trust 2013. All rights reserved.

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