There’s a common misconception that you need to have a strong pelvic floor to prepare for labor. In fact, quite the opposite is true!
While pelvic floor strength is great, it’s more important to relax and lengthen your pelvic floor for a smooth delivery and quick recovery.
As a pelvic floor specialist, I most frequently recommend perineal massage and pelvic floor breathing and stretching to help my patients deliver with ease and minimal tearing.
Perineal Massage
If perineal massage sounds unfamiliar, you’re not alone! The perineal tissue is an area of skin and muscle between the vaginal opening and anus that is not always discussed as widely as the pelvic floor. But, it plays a critical role in the delivery process as it stretches to allow the baby to pass through the birth canal.
Through perineal massage, you can better prepare your perineal tissue to stretch during labor, reducing third and fourth degree tears and providing many other benefits including:
- Reduced pain post-delivery
- Better wound healing
- A shorter second stage of labor
- Reduced fecal incontinence
- Better Apgar score for your baby (this is a standardized assessment of your baby’s well-being soon after birth)
The great news: With clearance from your doctor, you can perform perineal massage at home. Perineal massage is most helpful when started no later than 34 weeks, and you can make a significant difference with only 5-10 minutes a day, 1-3 days a week.
You can also start perineal massage in conjunction with a pelvic floor physical therapist even earlier if you have any pelvic pain or pelvic floor muscle tension. The more time you have to prep these muscles, the better!
Ready to get started? Visit my YouTube channel where I walk you through basic perineal massage techniques. For more personalized guidance, book a session with me or another experienced pelvic floor therapist near you!
Pelvic Floor Breathing and Stretching
Pelvic floor breathing and stretching are two other important ways to prepare your muscles to relax during delivery. I highly recommend meeting with a pelvic floor physical therapist, who will help you develop a plan to increase your flexibility and awareness in the muscles around your pelvis.
Ready to get started? Here are a couple simple exercises to practice at home:
Basic Diaphragmatic Breathing with Pelvic Floor Awareness
Position: Sit comfortably or lie down on your back with knees bent.
How to Do It:
- Place both hands on your lower ribs.
- Inhale deeply through your nose and try to breathe into your hands, sending air to your back, belly, and down into the pelvic floor (this is called 360 breathing).
- Exhale slowly through your mouth, allowing your belly to fall and your pelvic floor to naturally come back to a relaxed state.
Focus: Pay attention to the release in the pelvic floor on the inhale and natural return to a neutral position on the exhale. Most pregnant women breathe into their chest or too much into their belly and don’t realize how much room they have to breathe into their back, bottom cheeks and pelvic floor.
Repeat: Ten times, focusing on the gentle relaxation and expansion.
Deep Squat Stretch
This stretch opens the hips, stretches the pelvic floor, and promotes flexibility in the lower back and pelvis!
How to Do It:
- Stand with feet slightly wider than hip-width apart, toes pointing slightly outward.
- Hold on to something stable like the edge of a sink or an open door handle.
- Slowly squat down, bringing your hips as low as you can while keeping your heels on the floor.
- Place your elbows on the inside of your knees, palms together, and gently press your knees outward.
- Hold for thirty seconds to a minute, breathing deeply into the low back and pelvic area, then pull yourself up to standing.
Modification: If you need support, place a rolled towel under your heels or use a wall for balance.
In addition to teaching you how to relax your body through stretching, breathing and perineal massage, your pelvic floor physical therapist can also provide a personal perineal tear risk assessment and individualized education, preparing you to have the most positive labor experience possible!
Dr. Emily Mason
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