Congratulations on your pregnancy!

This is such an important time in your life and not just because you’re welcoming a new member to the family. If you have not already, you will experience significant physiological, psychological and social changes. Some of these changes can lead to lasting discomfort. A registered physiotherapist (specifically one that specialises in the pelvic floor) can help you throughout your pregnancy to alleviate pain and discomfort, prepare you for an optimal birth and help with the calm during the overwhelming postpartum time.

 Here are just a few of the benefits of adding a physiotherapist to your village.

 What is a Pelvic Floor Physiotherapist?

 A pelvic floor physiotherapist has received advanced training in assessing and treating the pelvis and pelvic floor. The pregnancy and the postpartum period are an important part of a pelvic floor physiotherapist’s training. During pregnancy, physiotherapy may be beneficial for the following reasons:

 To Treat Pain and Discomfort

Not all, but many women associate pregnancy with pain. I’m here to tell you that there is help!  Common complaints during pregnancy are:

• pregnancy related low-back pain
• pubic symphasis dysfunction
• carpel tunnel syndrome
• ligament pain
• sciatica; and
• rib pain.

This is not a comprehensive list but for these and other issues, a physiotherapist can help by using manual therapy techniques and teaching you therapeutic exercises to do at home that may help alleviate some (or all!) of your pregnancy related discomfort.

To Optimize Your Pelvic Floor

Evidence shows that pelvic floor muscle training during pregnancy will help to reduce pregnancy related low-back pain and lower the rate of a prolonged second stage of labour (which spans from the time when the cervix is open 10 cm to when your baby is born).

A pelvic floor physiotherapist can teach you how to correctly identify and control your pelvic floor muscles. You will learn techniques to practice during your pregnancy that can prepare you for delivery but will also aide in the postpartum period with the recovery of your pelvic floor.

Additionally, a pelvic floor physiotherapist can teach you about perineal stretching, which involves the gentle, manual stretching of the tissues that shape the birth canal. When done regularly in the last few weeks of pregnancy, this may help decrease the severity of tearing of the perinum and the need of an episiotomy.

Optimal Baby Positioning

During pregnancy, many people are familiar with babies turning “head down” or being in a “breech position” (not in the head down position).  Some babies will stay breech until delivery, in which case your obstetrician will discuss your birthing options (many breech babies will be born via a planned caesarian section).

A baby who is head down and facing your back (occipito-anterior) is the most optimal position for birth. This will allow the baby to tuck their chin into their chest and have the narrowest part of their head exiting the birth canal first. If your baby is head down and facing your tummy instead of your back (occipito-posterior) this increases the chance of having a prolonged labour. Research shows that labours with babies in an occipito-anterior position are:

• Less likely to have an emergency caesarean-section.
• More likely to have a faster and more straightforward labour and delivery.
• May require less pain relief during labour.

For these reasons, a pelvic floor physiotherapist can help you with techniques and exercises to help your baby get into the most optimal position.

A physiotherapist can help with the many changes that your body is going through, while coaching you mentally through one of the most important events of your life. They remedy common pregnancy related discomforts, plus enhance your body’s ability to have a smoother pregnancy and birth.

Written by Michelle Monk, Registered Physiotherapist, The Centre for Sport and Orthopedic Medicine

Michelle Monk, RPT, MSc. PT, BA(Hons) Pelvic Floor Physiotherapist
Michelle graduated with a Master's of Science in Physiotherapy from McMaster University. She is passionate about treating the pelvic floor. She respects this area of the body can be sensitive and under talked about but is keen to fill the gap for women (and men!) for treatment of pelvic floor problems. She advocates for not only early treatment of dysfunctions but taking preventative measures as well.