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Pelvic floor: childbirth and post partum
Strengthening the pelvic muscles behind the pelvic floor is important for childbirth and postpartum and a series of exercises called Kegels are aimed at recovering the pelvic floor.
There are several ways to perform Kegel exercises, but all are based on contracting and relaxing the pubococcygeus or pc muscle (also known as pelvic floor muscle) repeatedly in order to build strength and endurance and prevent urinary incontinence and other problems.
Strengthening pelvic floor muscles will help you:
- Cure or prevent incontinence aggravated by the baby placing weight on your bladder during pregnancy.
- Make delivery easier with less tearing and pain after childbirth.
- Increase blood circulation in the rectal area, helping tears or episiotomy to heal faster, and reduce the chance of haemorrhoids.
- Prevent prolapse (out of place) of the uterus, bladder, and other organs in the area after having a baby.
- Return to normal activity after giving birth without fear of incontinence when you laugh, cough, sneeze or jump.
- Increase sexual pleasure. Kegel exercises are essential for toning vaginal muscles and returning to a normal sexual life after childbirth.
Postpartum incontinence affects about 30% of women, and haemorrhoids 50% of pregnant women. Both problems can be avoided by doing daily Kegel exercises.
Incontinence is caused by a weakening of the pelvic floor muscles. These hold the lower abdomen like a protective and flexible arc-shaped hammock, and offers the support the uterus, bowel and bladder needs.
Three organs pass through the pelvic floor to outside the body: the urethra, vagina and rectum.
The easiest way to identify the perineal muscle is to stop the flow of urine at intervals. If you can, even if only partially, you’ve located the muscles that must be exercised during Kegel exercises. Sit comfortably with your legs apart, try to stop the flow of urine and then let it flow again without moving your legs. If you can do it effortlessly, it means that you have strong pelvic muscles.
Here are a number of exercises you can try
- Squeeze the muscles as you did when you tried to stop urinating, contracting them upwards.
- Squeeze for a count of five and breathe evenly.
- Relax for five more seconds.
Repeat 10 times.
- Try to progressively increase the contraction and relaxation time.
- Start for 5 seconds and add 5 seconds until you reach 20.
- The longer you keep the muscles contracted the stronger they become.
- Squeeze and relax the muscles as fast as you can till you get tired of after approximately 2 or 3 minutes (whichever comes first).
Start with 10 repetitions four times a day until reaching 50 repetitions per day.
This exercise requires some concentration, but the results are very good. Your vagina is a muscular tube with sections in a ring place one on top of another. Imagine that each section is a different floor of a building, and that you make a lift go up and down by squeezing each section. Gently move the lift up to the first floor. Hold for a second and then draw up to the second floor. Continue to move up as many floors as you can (usually no more than five). Hold for a second on each floor on the way down. When you reach the ground floor, try to go to the basement, pushing the pelvic muscles down for a few seconds (like you push during labour). A lift ups and downs stressing each section. Finally, try to relax the muscle completely for a few seconds. Above all, do not forget to breathe slowly and avoid using the abdominal muscles to help perform the exercise.
Some pelvic floor muscles are arranged in a figure eight, but with three rings. One ring is around the urethra, other around the vagina and the last around the anus. Contract these muscles from front to back and relax them back and forth.
Do these exercises as many times as you can each day. The aim is to be able to do this exercise without people noticing. When you start to do them, they may seem uncomfortable and strange, but you will soon see that you can do them without other people noticing.
Until you master the technique it is preferable that you lie comfortably on your back with your feet flat on the floor and knees bent. Keep your entire back pressed to the floor, leaving no gap in the lower back. Try to imagine that you are pulling the muscles up. Do it slowly and concentrate until you can’t do any more. Hold, breathe evenly, let go very slowly and relax. Repeat 15 times.