Things to know about pregnancy ; The pelvic floor muscles
The muscles that make up the pelvic floor support the uterus, bowel and bladder, rather like a sling holding the pelvic organs in place. They lie in two main groups, forming a figure of eight around the urethra, vagina and anus. The muscle fibres originate front and back from high up on the pubic and sacral bones. The layers of muscle overlap and are therefore thickest at the perineum.
The action of progesterone
The pregnancy hormone progesterone prepares the body for birth by softening joints and ligaments, and that includes the pelvic floor muscles. If pressure from the
enlarging uterus causes the pelvic floor to become weak, this can lead to vague aches and fatigue, to urinary.incontinence and leakage, and possibly, at worst, even to prolapse of the uterus after childbirth.
About half the women who have had children later suffer from some weakness
of the pelvic floor and may have “stress” incontinence – slight leakage of urine when they laugh, cough, sneeze, or lift.
To counter this, a set of exercises to strengthen the pelvic floor muscles has been developed by physiotherapists working in the area of childbirth. They are known as the Kegel exercises, after Dr Arnold Kegel of the University of California in Los Angeles, one of the first physicians to recognize how important these muscles are. Pelvic floor exercises are recommended for all women. It’s best to begin doing the exercises before pregnancy and continue afterwards (they are probably even more important in older women). If you possibly can, make the exercises part of your daily routine.
When exercising, do about five contractions of five seconds each. Once you’ve mastered the exercises, you can do them wherever you are – sitting at home, standing in a queue or walking – but do remember to practise as often as you can. They will also be useful in the second stage of labour when the baby’s head is about to be born.
Locating the pelvic floor muscles
Lie down with a pillow under your head and one under your knees. Cross one leg over the other and squeeze your legs tightly together. Tighten the buttock muscles and pull up as if you feel the need to empty your bladder but must wait. This helps you find your pelvic floor muscles, which you’ll feel tighten inside your vagina.
Another way to locate the muscles is to interrupt the flow mid-stream when you pass urine because the muscles that control the flow of urine are your pelvic floor muscles. Only do this to find out where the muscles are and always empty your bladder completely afterwards. When doing the exercises ignore the abdominal and buttock muscles and use only those of the pelvic floor.
Isolating the sphincter muscles
Lie down as above but with your legs relaxed and not crossed. Place a clean fingertip on the opening of your vagina and contract your pelvic floor muscles. You will be able to feel the contraction of the vaginal sphincter. The sphincter at the opening of the urethra is more difficult to isolate than the pelvic floor muscles because of its proximity to the vagina. But the sphincter muscles are also tightened when you contract the pelvic floor muscles. Now place your finger at the opening of your bowels and, with a larger movement, contract the muscle around the anus. You will feel the anal sphincter tightening.
Things to do when pregnant
PREPARING FOR THE BIRTH OF THE BABY’S HEAD
Things to know about pregnancy third trimester, Having an increased awareness of the pelvic floor muscles and how they feel when relaxed will help prepare you for the birth of your baby’s head.
Lie on a bed, your back supported, but your feet and knees apart. Gradually relax your thighs and pelvic floor muscles so that your knees fall wider and wider apart (your feet will roll gently onto their outer edges). Practise painting in this position as the midwife will ask you to do when it is time for your baby’s head to pass gently out of the birth canal.
Lie on a bed with your knees bent, feet together and your back supplied. Press your knees together hand and tighten your pelvic floor muscles at the same time. Notice the feeling of tension along your inner thighs and between your legs; many women involuntarily tense these muscles when their baby’s head is stretching the outlet of the birth canal. Now relax your muscles, and this time notice I carefully the different feel of your muscles. This open feeling is what you should aim for when you are giving birth.
PELVIC FLOOR EXERCISES
Things to know about pregnancy for first time moms, are three basic Kegel exercises that will help you to strengthen your pelvic floor muscles and keep them well toned during pregnancy.
Contract and release
Lie on your back with your legs apart. Draw up the pelvic floor muscles, concentrating hard on the muscles of the vaginal Sphincter. Hold this position for two to three seconds arid then completely, relax. You can try to slacken the muscles a little more and notice the release in tension. Do three of these contractions in succession.
Imagine the pelvic floor is a lift, stopping at various levels in a department store. Aim to contract the muscles gradually in five stages with a short stop at each level, not letting go between levels. Then allow the pelvic floor to descend, releasing the contraction level by level. When you reach the starting point, ground level, allow the pelvic floor muscles to relax completely so that you feel a slight bulging downwards. If you actually push downwards below this level, you can lower the pelvic floor even further, and the vaginal lips will open slightly. To do this, you need to hold your breath or blow out and then you should be able to feel the lips of the vagina opening. This is the position in which your pelvic floor should be while your baby’s head is being born.
Grip your partner’s penis with your vagina. Hold for a few seconds before releasing. Repeat this exercise a couple of times. Your partner can tell you how hard you are squeezing and will know when the strength of the squeeze is diminishing.
If he can’t feel much, then you will know that you must keep exercising your pelvic muscles.