10.07.2024

Pregnancy and birth: why you should strengthen your pelvic floor

A well-trained pelvic floor is important for both women and men. However, pregnancy in particular poses an increased demand on the pelvic floor and can cause unpleasant side effects. This can be counteracted with ted pelvic floor training, ideally starting before the pregnancy and birth itself.

Our pelvic floor

The pelvic floor consists of muscles, tissue and nerves and is the base of our inferior pelvic aperture. Its muscles belong to the lower part of our skeletal muscle system and are connected to the deep abdominal and back muscles as well as the midriff.

Purpose of the pelvic floor muscles

The pelvic floor has these functions

It stabilises our internal organs (bladder, bowel, uterus/ovaries, prostate).
It enables controlled emptying of the bladder and bowel.
It stabilises our body, especially when pressure increases, such as when coughing, sneezing or lifting heavy loads.
Ensures good posture and prevents back pain.

Like every muscle, the pelvic floor muscles should be trained regularly, as otherwise they lose strength, which can cause various complaints. "Pelvic floor training is important for everyone, regardless of gender and age," explains trained pelvic physiotherapist Mirande Zwanenburg, who offers pelvic floor rehabilitation at the Rosenklinik Physiotherapie together with her colleague Martina Jung. "However, it cannot be denied that pregnancy in particular is a real stress test for the pelvic floor."

Risks and consequences of pelvic floor weakness

Pregnancy is actually considered a high risk for the pelvic floor: The growing belly and the weight of the child put direct pressure on the muscles and place them under great strain. "The pelvic floor is particularly strained in the second half of pregnancy, firstly because of the growing baby and secondly because pregnancy hormones soften the pelvic floor to prepare it for the birth. During a vaginal delivery, the pelvic floor stretches three times its original length," says Zwanenburg. An untrained pelvic floor can quickly become overstretched with so much strain, which can lead to problems such as urinary and faecal incontinence, pressure or prolapse problems or pain during intercourse. Studies show that around one in four expectant mothers suffers from pelvic dysfunction.

Individual anatomy and certain risk factors can increase the likelihood of pelvic floor problems, such as weak connective tissue, hypermobility syndrome (HMS), obesity and previous births. Exercising too much or lifting heavy loads in everyday life can also weaken the pelvic floor.

Pelvic floor training: not only physically, but also mentally important

"Ideally, pelvic floor training should be part of regular workouts for both women and men. Especially for women who want to have children, it is advisable to get to grips with it at an early stage," says Zwanenburg. A well-functioning pelvic floor cannot eliminate all the risks of pregnancy, but it can reduce them. After the birth, training can help to counteract existing problems.

After giving birth, targeted pelvic floor training is particularly recommended in order to rebuild the weakened muscles. Women who start training before or during pregnancy usually have a better awareness of their pelvic floor and can therefore react more quickly to negative changes. "Pelvic floor training is not only an enormous support physically, but also psychologically, as pelvic dysfunction is often associated with a great deal of suffering and shame. Regular and targeted training can significantly improve quality of life. It gives women more confidence and security in their own bodies," emphasises Zwanenburg.

When can I start pelvic floor training after the birth?

Giving birth is a major challenge for the body. Pelvic floor physiotherapy is therefore recommended in any case after the birth. Rehabilitation can begin approximately four to twelve weeks after the birth. The exact time depends on the course of labour, the type of delivery and wound healing. Training should therefore always be carried out in consultation with your gynaecologist.

How to train the pelvic floor depends on the individual circumstances of the person concerned. For this reason, training should be carried out under the guidance of a specialist in pelvic floor rehabilitation. In Switzerland, pelvic floor therapy is recognised by health insurance companies and can be prescribed with a physiotherapy prescription. Some health insurance companies also cover preventive therapies.

How can I strengthen my pelvic floor in everyday life?

First and foremost, we recommend maintaining an upright posture, paying attention to your weight and regularly doing targeted pelvic floor training: "This promotes the activity of the pelvic floor and reduces the pressure on the organs and muscles."

Our experts

Mirande Zwanenburg

Mirande Zwanenburg has been working as a physiotherapist since 1992 and has specialised in pelvic floor rehabilitation for men and women since 2002. She is a member of Pelvisuisse, the Swiss Association for Pelvic Floor Physiotherapy. She welcomes her patients at Rosenklinik Physiotherapie, which she founded together with her husband Hajo Zwanenburg.

Martina Jung

Martina Jung works as a physiotherapist at Rosenklinik Physiotherapie and completed her training as a certified pelvic floor physiotherapist (Pelvisuisse) in 2023. In addition to pelvic floor physiotherapy, she also offers postnatal courses and "Back to sport" programmes for mothers.

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