Cultivating Mindful Awareness in your Pelvic Floor

My first birth prep tip has to do with the mind-body connection. Yes, the connection is real!  And yes, you can use it and train it! And even though this post is written particularly for pregnant ladies, I actually think all women can benefit from this connection.

Many of us are actually very disconnected from the workings of our pelvises.  If you have never had any problems with your pelvis (think pain, incontinence, prolapse, etc.), you likely go through your day not thinking very much about it at all. You probably go the bathroom, and have sex, and all the while never think much about the muscles and soft tissues “down there”.

However, when it comes to pregnancy and delivery I would argue that you do need to start thinking about those tissues right now, today!  – and for two main reasons:

1) There is about to be a MAJOR event happening through your pelvis. You are about to become a mother and your life is about to change in more ways than you may even be able to imagine!  But one of those ways is physically.  No matter how natural of a process childbirth is, your soft tissues are going to undergo some big changes (don’t worry, this is not necessarily a bad thing!).

Now my question is, how will you be able to reflect on the extent of that change if you don’t know what you started with? How will you know if your pelvic floor is weaker after birth? Do you know where your pelvic floor is and how it works? You need to learn what your pelvic floor baseline is before delivery! And although the earlier in pregnancy the better, it’s never too late to check in “down there”.

2) You do have some control over this area! So let’s learn how to use it to your advantage.  You will be much better off if you can consciously try to relax your pelvic floor muscles.  Your wee babe will have less resistance and an easier time coming through the birth canal if he/she is not met with a brick muscle wall on the way out.  Its teamwork between you and your baby! Plus, baby has to come out – and to prevent the use of yucky things like forceps, and to save your muscles from a nasty tear, help your body out.  Now, I know this is much easier said then done (pain tends to make us naturally tighten our muscles…), so you need to start practicing now.

That leaves us with the big questions: where is your pelvic floor?  How do you find those muscles?

Simplistically, the pelvic floor is like a sling or a hammock running from your tailbone to your pubic bone (really one could argue it’s a lot more than that, but this is a nice place to start).  If you’ve ever been taught to do traditional pelvic floor exercises (aka The Kegel) you might have been taught to “try and stop the flow of urine”… ok, that might work, but without getting into a rant let me just say that I HATE that analogy.  So let’s go back to the hammock.

Get comfortable when you try this.  Untuck your bum.  You could be lying down, on-all-fours, or sitting (in fact, if you have trouble finding these muscles, you may want to sit cross-legged).  To start, I want you to use your imagination (mind power!) and really think about where your tailbone is in your body.  And your pubic bone.  Feel them from the outside if you need to.

Now, here’s the contraction: try and bring your tailbone and pubic bone together. Voila! If you are doing this correctly, all the movement should be on the inside.  No butt squeezing, no pelvic tilting, no tummy gripping, and no breath-holding!

If this is easy for you, hooray! But it’s only half of the equation.  You should be able to RELAX your pelvic floor equally as well as you can contract it (this means with the same speed and ease). This is the skill you need for birthing your baby!

***(Note: if you are having a lot of trouble relaxing your pelvic floor, or you can’t “find” it, or you really can’t feel much of anything, it really is worth a trip to your local pelvic health physiotherapist!!! If you don’t know one, you can contact me and I can give you info about those in Canada.  You can also search online through your provincial physio association. But go while you are still pregnant!)

Now here’s where we really start to work with that mind-body connection:

In your nice and relaxed position, I want you to start by taking a couple of deep breaths.  The relaxing kind, the kind of breath that flows deep into your belly.  On your next breath, I now want you to imagine your breath flowing in through your lungs, but then traveling all the way down into the bowl of your pelvis. (Obviously the air isn’t going all that way, but just imagine that it is).  Repeat that nice deep breath a few more times, all the way into the bottom of your pelvic bowl.

On your next breath, continue that deep pelvic breath and allow your pelvic floor muscles to relax at the same time – carry that breath into what I like to call the “bottom of your bottom”. Be gentle, never should you bear down or force your breath.  On your exhale, you may notice that your pelvic floor wants to tighten up just slightly, and that’s okay.  Keep your focus on relaxing your pelvic floor on a nice deep inhale.  Try and get in the habit of doing at least 10 deep “pelvic” breaths a day! (It’s sometimes a nice routine to do while you are lying in bed before sleeping.  Feel free to do more! And definitely try it in all kinds of positions.  You never know what position you might be in to delivery your baby.)

Once you feel like you’ve really got the hang of directing your breathing down into your pelvis and relaxing the pelvic floor on the “inhale” (give yourself at least a week of practice), I want you to reverse the exercise.  This time you are still doing that nice deep belly breath, but you are going to focus on relaxing your pelvic floor during the exhalation. It’s a bit trickier but it will get easier with practice!

It is absolutely essential you practice relaxing your pelvic floor on both the inhale and the exhale.  When it comes to the “pushing” part of labour, you will likely be exhaling!  Since that is the stage where baby travels through all those pelvic floor muscles, you must be able to relax and exhale at the same time.

Spend the time connecting to your pelvis now.  Practice conscious relaxation now, when it’s easy.  Practice it enough that it becomes a tool you can use during your delivery. (If you can’t relax your pelvic floor when you are just sitting there, how will you be able to if it hurts?)

We always put so much emphasis on the birth of a lovely healthy baby… and that is definitely important… but all too often we forget about mommy – your health is important too! Take the time to develop skills for your birthing toolkit – you won’t regret it!

** p.s. this post has been modified slightly from its original version… basically I ditched the word “delivery”.  As it was so smartly pointed out to me, pizzas are delivered, not babies! Lets empower women with the word “birth”!