How to Improve Your Pelvic Health During Pregnancy

Bladder control, sexual dysfunction, pelvic and lower back pain are common symptoms of pelvic health issues.  But pelvic health shouldn’t be something we think of only when there’s a problem.   Being proactive about pelvic health can help to avoid many long term problems. For expectant mothers, working on improving pelvic health during pregnancy can not only help during labor and delivery, but also in the postpartum period. 

Find out more about the Train4Birth program from Dr. Monika Patel DPT, CSCS and how you can improve your pelvic health during pregnancy.

How to Improve Your Pelvic Health During Pregnancy
*This is a guest post and all opinions are those of the author. This post may also contain affiliate and/or paid links. Rest assured that I only work with companies and individuals that I trust. While some of those companies and individuals may work in the medical field, this post is not intended to be a substitution for medical advice. Always speak to your doctor if you have concerns about your mental or physical health.
How to Improve Your Pelvic Health During Pregnancy

When my employers first asked me to specialize in pelvic health, well, I wasn’t so sure.  At the time, I’d just finished my year-long orthopedic fellowship through the Institute of Advanced Musculoskeletal Treatments (IAMT) with some of the top manual therapists in the country.

All these thoughts and reservations went through my head- I didn’t want to specialize “too soon.” I’d just finished with 4 years of intensive learning and I wanted a “break.” I didn’t want the “emotional strain” I’d heard about when working in this field. I didn’t know exactly what it would involve. And, I was really super-super shy about anything remotely reproductive related and didn’t think I had the courage to talk to people about it.

So, I politely declined for 2 years and continued on with my mostly orthopedic caseload.

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Until, I felt a pull.

Do you ever have those moments where something just keeps re-occurring in your life until, finally, you listen?  

It was like that with pelvic health in my career. I decided to listen to what my employers had to say about how my skills might match the field they patiently had in store for me. There are so many times that we have to make decisions for ourselves or our families that we aren’t always sure of, that it felt almost nice to have a professional track with mentorship and guidance presented promisingly.

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So, I decided to shadow a pelvic health therapist and was really amazed at all she knew and what she could help people with that literally no other healthcare provider could. Even midwives and OBGYNs don’t necessarily know the pelvic floor musculature by name or how movement or pregnancy truly affects the pelvis.

The therapist I shadowed did an internal mobilization of a soccer player’s coccyx that had gotten dislocated with a harsh fall. That teenager was unable to walk in the clinic herself without a wheelchair, never mind play her favorite sport, and was able to walk out of the clinic, independently, and pain-free following the 2 minute mobilization.

I was hooked.

As soon as my year long-training commenced, I was able to help people who’d had incontinence for 20+ years.  I helped people who had stopped going out to have dinner with friends for fear they’d laugh too hard and leak regain confidence, control, and strength and actually join a supper club.

I was able to help men who’d been catheterized after prostate cancer regain their ability to pee again independently (which is linked to pride).

I was able to help a mother who had sustained a grade 3 tear during delivery of her baby heal postpartum without a trace.

And, just as my employers predicted, I loved it.

Strengthen Your Pelvic Floor Muscles with Perifit
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It felt refreshing, rather than daunting, to talk about the things less talked about and topics often ignored for far too long in the medical world.  So, I decided to delve into another yearlong program in pelvic health. The pelvis really is such a keystone to the entire body’s musculoskeletal system that it started to seem negligent to ignore approaching any and all patients with this knowledge.

Sure enough, not only did the people I could serve expand, but the rate at which I was able to get anyone with, for example, low back pain better greatly improved. The body is so interlinked and if you, our your healthcare team, ignore the pelvis, that’s like running a race without ever tying your shoes.

What Does a Pelvic Health Physical Therapist Do?

You might wonder what else a pelvic health physical therapist knows or could help you with. Here’s a quick glimpse:

    • How to help prevent, identify, and treat the three (really four) main kinds of incontinence: stress, urge, frequency and/or a mixture of any of the above.
    • How to help protect and activate the 4 muscles that make up the deep core so that they all work together with good and almost subconscious coordination to avoid.
    • How to palpate all the ligaments and the 35 muscles that attach to the sacrum.
    • How to palpate and check function of all 3 layers of the pelvic floor.
    • How to assess the pelvic floor for internal trigger points.
    • How to teach people good bowel, bladder, and sexual function habits.
    • How to care for the pudendal nerve, the nerve that extends out from the sacrum and is in charge of innervating bowel and bladder structures.
    • How to make pregnancy, both pre and post partum, a much less fear-based experience.

Gosh, and so much more.

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When it comes to postpartum care, countries like France literally subsidize what they call “perineal re-education”. (There’s a great essay by write Claire Lundberg called “The French Government Wants to Tone my Vagina”) because they know that even if women feel okay after birth, the inhibition of their pelvic health during pregnancy can cause (expensive and timely) issues down the road. So, it’s better for the overall healthcare system to preventatively invest in helping women heal properly postpartum than it is to wait until they are in their 40s, 50s, and 60s when gravity + pelvic floor sleepiness has already taken its toll and it’s much harder to fix.

I would take it a step further when it comes to preventative healthcare, and say that all women should have the opportunity for their body to be assessed for potential risk factors for ANY musculoskeletal condition from an early age…(but, that’s another blog topic).

Improving Pelvic Health During Pregnancy

Pregnancy is a sweet spot in women’s’ healthcare journey. It’s a time where women are often extra motivated to create healthy lifestyle habits and change. It can also feel really empowering to care for yourself while pregnant.  All expectant mothers should work on improving their pelvic health during pregnancy.

This is exactly why Train4Birth, the deep core exercises + education+ accountability/support program was born. It’s essentially the equivalent of having a PT (virtually) by your side throughout your entire pregnancy for $188 dollars. That’s a tremendous value –when the average cost of incontinence in the US is approximately $900 per person annually.

Plus, when it comes to resource management:
1) It can be easier to afford pelvic health care before you take (usually un-paid) maternity leave.

2) The cost of Train4Birth, which includes the information usually covered in about four in-person PT sessions, which would be about $600, is 1/3 of that cost.

3) It’s VERY hard to find time for self-care with a newborn. With the ability you start Train4Birth starting at any stage of your pregnancy gives you a jump start.

4) Plus, if you are all “tuned up” and the healthiest version of yourself going into labor, you’re less likely to experience instrument assisted birth or complications you have to deal with down the road.

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There are a lot of premade pregnancy recovery programs out there, but, because all of our bodies are unique and what helps us truly recover will depend on a deep understanding of your individual movement history, your anatomy, and your specific connective tissue I’m a bit leery of any program that doesn’t also include a listening ear.

Regardless of how you decide to care for your body, mind, and soul, I just want to encourage all women that the pelvic floor and deep core is an essential part of our health. To care for your pelvic floor is to care for both your present day and future self.


Author Bio

Dr. Monika Patel is a mom + DPT + fitness pro + environmentalist + lover of all things peanut butter. I love making people’s Birth-Days extra special and have to reign in my tendency to dream about RV life. I love to hear people’s stories. I don’t love to cook. My car usually has crumbs on the bottom of the floor. And I hope to make even just a tiny dent in improving the world.  

Feel free to reach out with questions or thoughts at connect@train4birth.com

7 Signs You Need to Strengthen Your Pelvic Floor Muscles (and the best way to do it!)

It’s normal for moms to experience weakened pelvic floor muscles.

Pregnancy, labor and delivery weaken our pelvic floor muscles and so it’s especially important to work at strengthening them during the postpartum period and afterwards.  The added weight of pregnancy wears down our pelvic floor muscles and the pressure of labor contractions overworks them.  And then there’s the big deal of pushing a human being right through them.  Women who experience a c-section are not exempt either, as we tend to tense our pelvic floor muscles whenever we feel pain or strain to move after surgery.

How do you know if you have weak pelvic floor muscles?  Check out some of these signs and find out how to strengthen them.
Strengthen Your Pelvic Floor Muscles with Perifit
*This is a sponsored post for which I received compensation. As always, the opinions in this post are my own. This post may also contain affiliate links which means that if you click on one of these links and buy a product, I may earn a small commission at no additional cost to you. Rest assured that I only recommend products that I love from companies that I trust. Furthermore, I am not a medical professional and nothing in this post should be taken as medical advice. I am simply a mother who has been there and lived to tell the tale.

You pee when you sneeze.

Or cough or squat or bend over to put on your shoes.  Leaking pee (a.k.a. urinary incontinence) is one of the most common signs of weak pelvic floor muscles.  It’s almost become a right of passage for moms, but it doesn’t have to be that way. 

You need to pee all the time.

Another common sign is the urge to pee more frequently.  If you’re feeling the urge to pee and just can’t hold it in, it could be due to the weakened muscles supporting your bladder.  During pregnancy there is added weight on the bladder combined with additional fluid intake so it makes sense that you need to pee more often.  But in the postpartum period, you should be able to go longer periods between bathroom breaks, or at least hold it in until you can get to a bathroom.

When you can’t control your bladder, consider using incontinence protection pads or underpants to lessen your worries. This way, you don’t have to be afraid about urinary leakage when you laugh, cough, sneeze, or just move. Having incontinence pads on will make you feel generally more secure and confident; not to mention, it will save you from cleanup after a leak.

You have trouble emptying your bladder or bowels completely.

The inability to empty your bladder or bowels completely is another warning sign to watch out for.  The muscles in your pelvic floor are used for pushing out pee or poop.  They might need strengthening if you really need to strain on the toilet.  If you’ve been using a stool softener but you’re still having trouble pooping, this could be the reason.

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Can’t control your farts.

(Oh this just keeps getting better and better, doesn’t it?)  Do you avoid yoga class because you’re worried about farting during downward dog?  Afraid to bend over in public or get up too quickly?  The uncontrollable passing of wind is yet another sign that your pelvic floor muscles are weak, as they should be tight enough to keep those in until you can release them privately. 

Tampons or menstrual cups don’t stay in place.

Inserting tampons or menstrual cups might be easy enough, but if you find that they slip out of place or feel uncomfortable when they’re in, it could be due to your pelvic floor muscles.  You shouldn’t need to try too hard to hold your menstrual products in, as your pelvic floor muscles should automatically keep them in place.  But when they’re weak, they don’t do a great job at that.  

Sex isn’t as enjoyable.

And finally let’s talk about the ways that weak pelvic floor muscles can affect sexual intercourse.  Many moms report that sex isn’t as enjoyable after giving birth and a lot of the time, it’s due to those weakened muscles.  Since these muscles control the vaginal opening, if they are weak then both partners will feel less sensation.  In addition to the uncontrollable peeing and farting, the entire experience may cause a woman to feel stressed out and not be able to enjoy it all.

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There’s a bulge in your pelvic area.

This can be a sign of a pelvic organ prolapse.  Basically, it means that one or more of the organs located within your pelvis falls through the pelvic floor.  It can cause a whole bunch of uncomfortable symptoms, depending on which organs it is.  The most common sign is that you will notice a bulge near the vaginal opening.


How to Strengthen Your Pelvic Floor Muscles

There are specific exercises we can do that target the pelvic floor muscles, including pelvic lifts, squats and perhaps the most famous… Kegels.  But similar to working out our other muscles, it’s hard to remember and/or find time to do them.  And the results are often less impressive than working out a bicep. 

Pelvic floor physiotherapy is helpful in that you get targeted exercises to work the right muscles.   Plus, there are ways for physiotherapists to test your pelvic floor strength and monitor your progress.  But it does have it’s downsides as well.  Besides the costs and time associated with seeing a professional, many women also feel embarrassed talking about it and would prefer a more private solution. 

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Thankfully, there’s a third option. 

It’s called Perifit and it combines the power of pelvic floor exercises with the benefits of professional guidance. Perifit is a small, medical grade silicone device that connects to an app via Bluetooth.  Once inserted, you use your pelvic floor muscles to play games on your smartphone which actually help to strengthen them over time. 

Perifit device in box
Perifit – Strengthen your pelvic floor muscles at home
Yes, you heard me right… you get to play video games with your vagina. 

It sounds a little strange to stick a game controller up your hoo-hah but it’s the only way to test your pelvic floor strength.  Inserting it is similar to inserting a tampon and once it’s in, you don’t even really feel it.


All you do next is get comfy, grab your phone, download the Perifit app and follow the on-screen instructions.  Basically, all you need to do in each game is squeeze and release your pelvic floor muscles.  It feels similar to doing Kegels, but having a purpose for each one keeps you from getting bored and giving up.  Like other games, the levels get harder and harder, so they work to strengthen your pelvic floor muscles over time. 

Perifit app games
Perifit – play games in the app using your pelvic floor muscles

At the end of each session, you get to see how strong your muscles are and track how they have improved.  Perifit also keeps track of how often you are performing the exercises as it should become a regular habit.  Try to incorporate a few minutes into your daily self care routine and you can see results within as little as 2 weeks.  

Perifit app stats
Perifit – track your progress

The thing that surprised me the most while using Perifit was how hard I had to squeeze my pelvic floor muscles to complete some of the levels.  While doing Kegels, I never would have squeezed that hard, which is probably why they didn’t work well enough.  Having a real guideline for how hard to squeeze, and for how long, makes such a difference compared to winging it with Kegels. 


If you are struggling with symptoms of a weak pelvic floor,  Perifit is the best way to strengthen them.  You get the professional guidance of a physical therapist within the convenience and privacy of your own home.  Having weak pelvic floor muscles following pregnancy and childbirth is totally normal and never something you should be embarrassed about.  But that doesn’t mean that you have to live with it forever.

For more information about the benefits of Perifit, visit https://perifit.co/.


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Strengthen Your Pelvic Floor Muscles with Perifit Strengthen Your Pelvic Floor Muscles with Perifit

Strengthen Your Pelvic Floor Muscles with Perifit

Strengthen Your Pelvic Floor Muscles with Perifit