5 Secrets To Improve Pre/PostNatal Health

Lots of women get pregnant and have babies – there’s no secret there. While this is such a common milestone in life for many women, and such a normal physiologic process, we often dance around the subject of the impact pregnancy has on the body. 

Whether you’re planning on getting pregnant, currently pregnant, or in the post-natal period of recent delivery, physical therapy with an emphasis on the muscles of the pelvic floor and women’s health should be a topic we openly discuss rather than it remaining a mystery. 

We’ll let you in on a little secret – or, rather, five – about just how impactful working with a physical therapist pre- and postnatally can be for women:

1. Hormones change – A LOT – with pregnancy and delivery.

Females are used to hormonal changes and how these impact their bodies and their moods. But hormones related to pregnancy are a different story. Immediately upon becoming pregnant, two hormonal increases occur. These hormones and progesterone and relaxin, which cause ligaments to become more lax, or loosen (it’s referred to as “ligamentous laxity”). This makes sense – it creates more space in the body to help the baby grow and eventually be delivered. But this means that that were once stable, have suddenly become more mobile. This affects the pelvis, spine, and joints all over the body. 

On top of ligaments loosening and creating less stable joints, hormonal changes in pregnancy tend to lead to fluid retention. It’s not uncommon for pregnant women to experience swelling in their feet and legs.

So what can PTs do to help? 

The stronger your muscles are around your joints, the less of an impact this ligamentous laxity will have on you. From a prenatal standpoint, that means there’s a lot of preemptive strengthening to do to best prep your body for the future hormonal changes. During pregnancy and postnatally, working with a PT who is well-versed in these changes can help you to safely continue strengthening during and post-pregnancy. 

In terms of fluid retention, a PT can perform manual therapy and massage techniques to aid in circulation and drainage, immediately decreasing any swelling.

2. Your posture is going to look quite different with that growing belly.

As a fetus grows, your posture starts to take on a new shape. Your center of gravity shifts a little higher and more forward, which forces your body to, of course, compensate. The normal arch (called “lordosis”) in the low back is going to become much more pronounced, which places a lot more pressure on the spine and pelvis. Your head is going to be a little more forward, causing tension in the neck. Sleeping positions may be altered and less comfortable, and day to day activities may be more difficult.

Additionally, your breathing may be affected from this new pregnancy posture. Your diaphragm – a dome shaped muscle for breathing – can become restricted with a growing fetus too. This means pregnancy-related shortness of breath can be something you experience. 

Where does a PT come in here?

Before pregnancy, a PT can work with you on making sure your core muscles are strengthened in order to handle the new demands on your low back and pelvis during pregnancy. A strong, stable core protects the spine from pain and discomfort. During pregnancy and postnatally, continued strengthening in safe positions will be the focus, as well as postural education, helping with safe and comfortable sleeping positions, and working on diaphragmatic breathing techniques to decrease shortness of breath.

3. Muscle weakness can happen from certain muscles becoming over-stretched during pregnancy.

As you can imagine, all these postural changes result in some changes in muscle length. The abdominal muscles, for example, become overstretched as the belly grows. This can lead to abdominal weakness, and even diastasis recti, which is an overstretching of the connective tissue around the abdominal muscles. This overstretching leads to organs and the belly button protruding outward, and can lead to low back pain and a possible hernia. It also leads to weaker core muscles after pregnancy, which can prolong recovery.

How do PTs help with diastasis recti?

In a preventative course of prenatal PT, strengthening the core and abdominal muscles to support the future pregnancy will be paramount. As the pregnancy progresses and the baby is ultimately delivered, this strengthening continues with specific guidelines and expertise to not further damage the abdominal connective tissue. PTs use a number of manual therapy and strengthening techniques – like proprioceptive neuromuscular reeducation (PNF) to train the deep core muscles to engage during pregnancy in order to facilitate faster and stronger recovery postpartum.

4. Your pelvic floor is made up of muscles – and these muscles need to be strong to support your pregnancy.

You can think of the muscles of the pelvic floor like a hammock, with the weight of anything on top of it (like a baby, for example) pushing down onto it. Before a baby is delivered, you can even just imagine that the weight placed on the pelvic floor increases as the baby grows. A lot of side-effects of pregnancy are really of an over-stretched and weakened pelvic floor, and they are deemed as just “part of the process” – but they don’t HAVE to be. We mean things like low back pain, urinary incontinence, sexual function issues, and increased pelvic pressure. These don’t have to be just an expected part of pregnancy – you CAN prevent and treat them by strengthening the pelvic floor muscles pre, during, and post pregnancy. 

Not only did these muscles get over-stretched and weakened during pregnancy, but labor causes trauma – strain or tears – in the pelvic musculature. But just six weeks postpartum, women are given the “all clear” to return to normal functioning. As you can imagine, if these pelvic floor muscles aren’t properly strengthened, things like urinary incontinence, painful intercourse, and low back pain can persist. It doesn’t have to be your new normal to deal with these issues! 

What’s the PT’s role here?

A PT can help with pelvic strengthening, deep breathing, core strengthening, and relaxation techniques to decrease the occurrence of urinary incontinence, pelvic pain, painful intercourse, and generalized weakness. As you may expect, all of this can be done preventatively prenatally to prepare you for an optimal pregnancy, labor and delivery, and postnatal experience.

5. If you have a C-Section, you may have some persistent scars.

If your delivery is via C-Section, you’ll likely have some stubborn scarring on your abdomen. While many women don’t love the physical appearance of scars, the impact they have isn’t merely an aesthetic one. After C-Section, scar tissue will build up where the incisions were made. Many women experience low back pain, SI joint pain, digestive issues, and hip pain that actually result from adhesions to other structures by the scar tissue build up. We can think of scar tissue much like an iceberg – the scar you see externally only accounts for a mere 10% of the actual tissue underneath the surface. 

How can a PT help with that?

PTs are trained in scar mobilization techniques to break up scar tissue at the surfaces and beneath it. Even if your C-Section was years ago, scar mobilization techniques can be hugely beneficial. 

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Pregnancy is a beautiful, exciting process. But that doesn’t mean it can’t be uncomfortable or confusing at times. As pelvic floor and women’s health physical therapy is becoming more well-known, women are getting the chance to talk about pregnancy-related changes in a way that wasn’t possible before. Women should be proud of their bodies for this life-changing event, but also well-informed of how to best prevent, treat, and heal and pregnancy-related issues. 

Are you thinking about having a baby? Currently pregnant? In the postnatal period? Or are you a woman who would love the benefits of working with a physical therapist focusing on women’s health and the pelvic floor? Come see us at Old Bull Athletics and learn how we can empower you to achieve strength to keep you resilient at any and all stages of life.