By: Angela Gonsalves PT, DPT, PRPC

When most people think about pelvic floor physical therapy, they may associate it with working together during pregnancy or recovery after a baby is born. And while that’s a huge part of what our pelvic health therapists can help with, there’s a conversation that doesn’t happen nearly enough, which is, “What can you do to prepare before you’re pregnant?”

Whether you’re actively trying to conceive, in the early stages of family planning, or just thinking ahead, getting a pelvic floor baseline before pregnancy can make a significant difference in how your body handles everything that comes next.

The Habits You Have Now Influence Your Pregnancy and Recovery Later

One of the first things a pelvic health physical therapist does with a pre-pregnancy patient is to assess their baseline. That means looking at,

  • How is your body moving?
  • How is your breathing?
  • How is your pelvic floor currently functioning?

Pregnancy doesn’t necessarily create new habits, but it does amplify the ones you already have!

If you’re breathing inefficiently, compensating with your posture, or have existing pelvic tension you don’t even know about, those patterns will be highlighted and often worsened as your body changes over nine months. Catching those things early, before the added demands of pregnancy, helps you be prepared for what is ahead.

You Need Strength AND Flexibility!

There’s a common misconception that when it comes to planning for pregnancy, the stronger the pelvic floor, the better. The reality is actually much more nuanced.

Your pelvic floor needs to be both strong AND flexible. These might sound like opposites, but they work together to make sure things go smoothly. A pelvic floor that is tight and can’t relax is just as much of a concern as one that lacks strength, especially when it comes to labor. Pushing requires the ability to release and breathe through that process, not just bear down. A pelvic floor that can’t relax makes that significantly harder.

Our goal for having you come in early is to figure out where your body is at and work on those things together early.

What Pre-Pregnancy Pelvic Floor Physical Therapy Actually Looks Like

Treatment isn’t one-size-fits-all, but there are common threads. Early on, the focus tends to be on postural strength, specifically the back, upper back, and hips, which are all critical for keeping your body stable and moving well as your belly grows and your center of gravity shifts. As pregnancy progresses, the focus transitions to breathing mechanics and, toward the later stages, mobility work that supports labor preparation, including positions and exercises that can help with the labor process itself.

You Don’t Have to Stop Moving When You Are Pregnant

A lot of people assume they need to scale back significantly once they’re pregnant, or that exercise could somehow put the pregnancy at risk. Outside of a high-risk pregnancy, that fear isn’t supported by the research. Stopping physical activity carries its own risks, and even maintaining something low-impact with light strength training is significantly better than doing nothing.

The goal isn’t to hit your best PRs, but to maintain your current level of activity in a way that is honoring what your body needs. If you were running 20 miles a week before getting pregnant, the focus may shift from hitting that mile mark to matching the effort level that felt comfortable before.

That said, please note that pain and leakage are never things you simply have to live and are treatable, so make sure to call if you experience these things.

Make Pelvic Floor Physical Therapy Part of Your Family Planning

One of the biggest things I would want people to know is that when it comes to pelvic floor health, it always helpful to be proactive instead of reactive. Most people in their planning will find their OBGYN, put aside space in their home for a nursery, find daycare, etc. But one of the most important, but forgotten, steps is finding a great pelvic floor therapist that can help you every step of the way.

You don’t have to have pain or a diagnosed issue to benefit from pelvic floor physical therapy before, during, or after pregnancy. Compared to other healthcare providers, a physical or occupational therapist is someone you spend a significant amount of one-on-one time in your care with. We can help you advocate for yourself as you transition from pre-family planning to pregnancy, to postpartum.

Let us help you prepare for this next exciting chapter of your life!

Ready to get started? Schedule an appointment with a Spooner pelvic health physical therapist at a location near you.