How Pelvic Floor Therapy Can Support You Through The 4 Trimesters of Childbearing

Pelvic floor therapy is a term that is getting more attention recently, but has been around for a while. Pelvic floor therapists can assist women in their preconception, pregnancy and postpartum journeys. They use a variety of different techniques to support each person’s individual needs in order to improve their ability to engage in activities that are meaningful to them.


The pelvic floor is an area of the body that most people do not think about until there is a problem. This often happens during the pregnancy and postpartum periods, however it can happen to women without a history of pregnancy and birth, and men as well. The pelvic floor is located between the 2 “sit bones” on your pelvis. It is shaped like a bowl and extends from the pubic bone (the hard bone above your clitoris), to the tailbone (the bone above your butt), and outward to the “sit bones” (the bones you feel when you sit on a really hard chair).


The pelvic floor does a variety of things to help support you in everyday life including:

  • Support

  • Sexual sensations

  • Maintaining Continence

  • Lymphatic Drainage

  • Stability


As you can see, the pelvic floor is responsible for A LOT of things, so it is safe to assume that if it is not functioning optimally, your quality of life and ease with participating in activities will diminish significantly. The pregnancy and postpartum periods are often times where the pelvic floor, and the body in general, are under extreme stress. If the pelvic floor is not properly prepared to handle the physical and emotional stresses of pregnancy and birth, the risk for “injury” or “dysfunction” is significantly increased.


So you may be asking yourself now, how can you prepare your pelvic floor for whatever life throws at it? Well, different things can be done during the 3 trimesters of pregnancy, as well as the 4th trimester, or first 3 months postpartum to minimize your risk of pelvic floor dysfunction occurring, as well as help your body recover in a more systematic and even way.


1st trimester-first ½ of 2nd trimester:

  • Get evaluated by a pelvic floor therapist to check for pelvic floor tightness and muscle imbalances surrounding pelvis

  • engage in guided meditation to help connect with your body, including your pelvic floor

  • start working on breathing downward and exhaling upwards (a pelvic floor therapist can help with this)

  • engage in safe strengthening exercises to increased overall strength and assistance with posture


Second ½ of 2nd trimester and 3rd trimester:

  • Work on integrating deep breathing into harder movements, including squats

  • Explore birth positions and find one that works best with your body and birth goals

  • Perineal massage in preparation for vaginal birth

  • Internal pelvic floor release towards end of pregnancy in preparation for birth

  • Continue with deep breathing downwards and exhaling upwards

  • Continue with strengthening, modifying as exercises become too challenging for your body at that moment in time


4th trimester (The 4th trimester describes the 1st 3 months after birth, however pelvic floor recover can be equally beneficial after the initial 3 months of the postpartum period)

  • Get re-evaluated by a trained pelvic floor therapist for tightness and muscle imbalances

  • Work on deep breathing

  • Core control with deep breathing to regain stability in the pelvis

  • Perineal scar massage if any tearing occurred during vaginal birth (after scar has closed)

  • C section scar massage after scar has closed for abdominal birth

  • Work with a women’s health occupational therapist on modifications to your environment and/or tasks to help you safely and effectively engage in activities that you want and need to do in your everyday life


What to expect at a pelvic floor therapy appointment:

  • A thorough history interview to give the therapist more information regarding your current concerns, and significant medical events that may be impacting your health and wellbeing currently

  • A breathing assessment and movement assessment to see how your body is managing pressure in your abdominal cavity

  • A external and potentially internal pelvic floor examination as the client is comfortable to check pelvic floor range of motion and strength

  • A review of findings and recommendations for treatment to achieve your goals


Be sure to download our preparing your pelvic floor handout!

Preparing your pelvic floor
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