Everything you want (need) to know about the pelvic floor

You can think of the pelvic floor as a muscular hammock that is strung between your pubic bone in the front and your sacrum at the back. These muscles work closely together. It is not possible to contract just one part of the pelvic floor muscles; the pelvic floor always contracts as a whole. This happens in part without us knowing, for example holding your urine without having the feeling of needing to go to the toilet. But there is also a large part that we have conscious control over. 

A female pelvic floor has three openings: the urethra, the vagina and the anus. In short, the functions of the pelvic floor are:

• Supporting the pelvic organs. The bladder, the womb and the bowels.

• Gives the pelvis stability.

• Allows the holding and passing of urine and stool. But also stopping wind.

• The pelvic floor has an important role during sexual activities. For example, being able to relax it during sex or having an orgasm.

• And finally, the pelvic floor plays an important role during labour. When you are able to relax the pelvic floor during delivering, labour will be easier.
  
  

The pelvic floor should be resilient like a trampoline. When you have a resilient pelvic floor, there is good control over the muscles and the pelvic floor can be contracted as well as relaxed at the right moments.

When your pelvic floor muscles don't work well (together), this can be because:

• The muscles are too tense, or overactive.

• The muscles are too weak, or underactive.

• The muscles aren't able to react at the right time because coordination has been disturbed.
  
  

It is difficult to see from the outside If the pelvic floor is overactive or underactive or whether the coordination isn't optimal. 

If you are having complaints of the pelvic floor like loss of urine, not being able to hold stool or wind, a pressing or ball feeling in the vagina, obstipation or pain during intercourse, we advise you to contact a registered pelvic floor therapist.

Note: complaints don't have to arise straight after delivery. For some women, complaints can occur when they go through menopause. Complaints can in many cases be prevented or reduced by (keeping on) doing pelvic floor exercises during and after pregnancy.

During pregnancy your womb increases in size and weight. Thereby is pressing on your organs and your pelvic floor. It gets tougher for your pelvic floor the more your baby grows.

Besides this, your body produces hormones like 'relaxin' during pregnancy, which weakens the pelvic floor muscles and the surrounding ligaments and tissue. This enables your body to make space for the baby.

It is important to do pelvic floor exercises during pregnancy to learn how to properly relax the pelvic floor and avoid complaints. Being able to relax the pelvic floor makes labour easier. It makes labour easier. And when you have a well-trained pelvic floor, you can more quickly find and train the pelvic floor after pregnancy, for optimal recovery.

During pregnancy and delivery, the pelvic floor has had to endure a lot. Nine months of extra pressure on the pelvic floor because of carrying your baby. And during delivery extra strain on the pelvic floor can arise when the baby goes through the birth canal. The pelvic floor will have to recover from this.

After a caesarean section, the pelvic floor has still endured nine months of extra pressure and will have to recover from this. Recovery won't go at the same pace for everyone. It is partly dependent on factors like how well trained the pelvic floor is and complications during labour. We know that it takes all pelvic floors quite some time to fully recover after labour, even when there are no complaints at all. This is why it is important to avoid high impact activities, like running and jumping, for at least the first 12 weeks after delivery.

The pelvic floor can be trained throughout the pregnancy and start training the pelvic floor the day after delivery. Initially, a couple of contractions every day is enough to connect with the pelvic floor and to improve coordination of the pelvic floor muscles. After about a week you can slowly start to build up the exercises. You can find a schedule for building up the pelvic floor exercises on the Member App.

A well-functioning pelvic floor is important to avoid complaints. This is why it is important to do daily pelvic floor exercises if you are able to. It would be ideal if you could keep with it for at least six months after delivery. You also train all other muscle groups in your body to remain fit after all. Don't start running or jumping until at least 12 weeks after pregnancy. Even when you don't have any complaints like loss of urine. After 12 weeks, slowly build up.

This exercise is suitable for everyone, so both during pregnancy and afterwards. You can train the pelvic floor in several positions, for example when lying down, standing or seated, allowing you to do the exercise during all daily activities. So even when you're behind your desk at work or queuing at the supermarket!

A good exercise to feel the pelvic floor and to learn how to contract it in the clock exercise. You can do this exercise in several positions. Remember to keep breathing during the exercise. The clock exercise goes as follows:

• Think of your pelvic floor as a clock. Your pubic bone is 12, your tail bone is 6, the left inside is 3 and the right inside is 9

• Keep breathing in and out calmly

• Breath out and imagine that you bring the 12 and the 6 to the centre of the clock, the 3 and the 9 as well and slowly lift the pelvic floor.

• Hold the tension for 1-2 counts without holding your breath.

• Relax the pelvic floor in 3 counts, stay relaxed for 7 more counts. Keep breathing calmly. Then contract again.

• Repeat this exercise 10 times.
  
  

A correct contraction gives tension in the pelvic floor as well as in the deep abdominal muscles. You can feel this by placing your fingers against the soft tissue right next to the hip bones.

On the Mom in Balance Member App, you can find videos with explanations of specific exercises for during pregnancy and after delivery.