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Pregnancy and the pelvic floor

The pelvic floor is the group of muscles that provide support to the pelvic organs (uterus, bladder, rectum) and are important in ensuring proper bladder and bowel function.

Studies (and the experience of many women) have shown that pregnancy itself, as well as childbirth, can have an impact on how this important group of muscles do their job.

Some of the effects that pregnancy and childbirth can have include urinary and bowel incontinence and prolapse of the pelvic organs. It has been estimated that up to 50% of incontinence and 75% of prolapse can be attributed to pregnancy and childbirth.

How do pregnancy and childbirth affect the pelvic floor?

There appear to be multiple ways in which pregnancy itself (hormonal influences, pressure from the growing baby and uterus) and the mode of delivery can affect the pelvic floor.

Labour and vaginal delivery can cause upset to the muscles themselves or the nerves that supply them which can then lead to pelvic floor issues.

Even women who deliver their babies by caesarean section can still have pelvic floor problems after delivery.

How can we minimise the chance of pregnancy associated pelvic floor problems?

This area is still under investigation as being able to prevent or limit pelvic floor disorders would greatly improve the quality of life for many women.

The current evidence does not support elective caesarean section for the prevention of pelvic floor problems in the future.

Avoiding “routine” episiotomy and managing labour so that the need for instrumental delivery is minimised should be a goal we aim for.

Pelvic floor muscle exercises performed during pregnancy and after delivery have been shown to be of short term benefit and possibly of long term benefit as well, particularly with respect to urinary incontinence.

The involvement of a physiotherapist with skills in this area can be a real benefit, particularly if it has been a complicated delivery.

The above information doesn’t take the place of a medical consultation so please seek further advice if you have further concerns.

Download the PDF of this article.

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Greenslopes Obstetrics & Gynaecology is closely aligned with the Greenslopes Private Hospital which opened Brisbane’s newest maternity facility in February 2013.

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