Working with a pelvic floor physiotherapist before and during pregnancy is one of the most proactive steps you can take to support your body through this incredible journey. The journey into motherhood affects your body in many ways, and while most people focus on the visible changes, the most significant transformations happen beneath the surface—including the pelvic floor.
If you are pregnant, planning to become pregnant, or have recently given birth, consult with your healthcare team before beginning any new exercise program, including pelvic floor muscle training. If you experience symptoms such as urinary or fecal incontinence, pelvic pain, vaginal heaviness, or pain during intercourse, please seek assessment from a qualified healthcare professional.
Remember that every woman’s recovery journey is unique. What works for your friend or sister might not be right for you. Listen to your body, be patient with yourself, and don’t hesitate to seek professional guidance when needed.
What Is the Pelvic Floor?
Your pelvic floor consists of layers of muscles that stretch like a hammock from your tailbone to your pubic bone, supporting your bladder, uterus, and bowel. During pregnancy, these muscles work overtime, supporting your growing baby while stretching to accommodate the increasing weight. The hormones that help your body prepare for childbirth also soften these muscles, making them more vulnerable to strain.
Research indicates that pelvic floor dysfunction is a prevalent health concern, affecting approximately 50% of women within 10 years of giving birth (Díaz-Bueno et al., 2025). Studies have shown that up to 73.6% of postpartum women report symptoms of pelvic floor disorders, with urinary symptoms being the most common (Takahashi et al., 2023). Yet many women suffer in silence, assuming their symptoms are just “part of being a mom.” This doesn’t have to be your story.
What Is Pelvic Floor Physiotherapy (PFPT)?
Pelvic floor physiotherapy is a specialized form of treatment that focuses on the muscles, ligaments, and connective tissues in your pelvic region. These structures form a supportive hammock at the base of your pelvis, providing essential support for your bladder, uterus, and bowel.
During pregnancy, hormonal changes and the increased weight of your growing baby place additional strain on these muscles. This can lead to issues like incontinence, pelvic pain, and even prolapse. A qualified pelvic floor physiotherapist can assess your unique situation and develop a personalized treatment plan to strengthen, relax, and coordinate these vital muscles.
When Should You Start Pelvic Floor Physiotherapy?
Many pelvic floor physiotherapy clinics recommend booking your first appointment around 12–14 weeks of pregnancy, though it’s truly never too late to begin. Starting early allows enough time to address any issues identified and properly prepare for delivery.
Even if you’re not experiencing any symptoms or concerns, a pelvic floor assessment during pregnancy can be incredibly valuable. Many practitioners believe pelvic physiotherapy should be a standard part of antenatal care for all pregnant individuals, regardless of whether issues have developed.
A second key appointment to consider is around 34–36 weeks, focused specifically on labour preparation, including perineal massage instruction and pushing technique optimization.
Benefits of PFPT Before Pregnancy
Starting pelvic floor physiotherapy before you conceive gives you a significant head start. Building a strong connection to your deep core and pelvic floor before pregnancy makes it much easier to maintain that awareness throughout your pregnancy and retrain these muscles postpartum.
Pre-conception pelvic floor work can help you:
- Understand your baseline pelvic floor function
- Identify and address any existing issues before they’re compounded by pregnancy
- Establish good habits around posture, breathing, and pelvic floor activation
- Create a foundation for faster postpartum recovery
Benefits of Pelvic Floor Physiotherapy During Pregnancy
Reducing and Preventing Incontinence
Cochrane systematic reviews demonstrate that women who perform supervised pelvic floor muscle training during pregnancy are significantly less likely to develop urinary incontinence. Continent pregnant women performing antenatal PFMT have a 62% lower risk of reporting urinary incontinence in late pregnancy and a 29% lower risk up to six months postpartum compared to those receiving usual care (Woodley et al., 2020). Pelvic floor muscle training is most effective when supervised by a physiotherapist, as every person’s pelvic floor is unique and requires individualized attention.
Managing Pregnancy-Related Pain
Many pregnant women experience discomfort in their lower back, pelvis, or hips as their pregnancy progresses. Pelvic girdle pain is the most common musculoskeletal disorder reported during pregnancy, affecting an estimated 20% of pregnant women who seek medical help, with worldwide prevalence ranging from 7% to 84% depending on diagnostic criteria used (Casagrande et al., 2023; Wu et al., 2004). While common, this pain shouldn’t simply be accepted as something you have to endure.
A pelvic floor physiotherapist can assess your postural alignment and guide you through corrections that ease pain. As your belly grows, your centre of gravity shifts forward, and your body naturally compensates by shifting backward. While this posture is common, it can cause significant discomfort when muscles aren’t properly supported.
Preparing for Labour and Delivery
Here’s something remarkable: your pelvic floor muscles can stretch to more than three times their normal resting length during the second stage of labour. Computer models have shown that the pubococcygeus muscle, the most medial component of the levator ani, reaches a stretch ratio of up to 3.26 during vaginal delivery—an extraordinary feat unmatched by any other muscle in the body (Lien et al., 2004; Ashton-Miller & DeLancey, 2024).
Pelvic floor physiotherapy for labour preparation includes:
- Learning relaxation and breathing techniques that help you become more attuned to your body during contractions
- Understanding optimal pushing techniques (your pelvic floor muscles need to relax to allow your baby to descend through the pelvis)
- Practicing perineal massage, which evidence shows may reduce the risk of episiotomy when done regularly from 34 weeks onward, particularly for first-time mothers (Beckmann & Stock, 2013; Yang et al., 2022)
- Exploring different birthing positions and understanding what might work best for your body
Promoting Optimal Baby Positioning
Proper alignment of the pelvis is crucial for your baby’s positioning in the womb. Pelvic floor physiotherapy can help ensure your pelvis is balanced and provides exercises that encourage your baby to adopt the optimal position for labour and delivery.
Influence on Labour Duration
Evidence from randomized controlled trials suggests that pelvic floor muscle training during pregnancy may influence labour outcomes. One landmark RCT found that women who completed structured PFMT had a lower rate of prolonged second stage labour (24% vs. 38% in controls), with the number needed to treat to benefit being 8 (Salvesen & Mørkved, 2004). A systematic review and meta-analysis concluded that antenatal PFMT might be effective at shortening the first and second stage of labour in first-time mothers, though the evidence shows moderate heterogeneity (Du et al., 2015). It’s worth noting that some studies have found no significant difference, so more research is needed in this area.
Common Postpartum Pelvic Floor Concerns
After delivery, whether vaginal or cesarean, your pelvic floor needs time and attention to recover. The most common issues new mothers face include urinary incontinence—those unexpected leaks when you cough, sneeze, or laugh. You might also experience pelvic organ prolapse, which can feel like heaviness or pressure in your vagina. Some women struggle with difficulty controlling gas or bowel movements, while others experience pain during intercourse or persistent lower back and pelvic pain.
These symptoms might seem overwhelming, but they’re treatable. Research demonstrates that pelvic floor muscle training in the first year postpartum reduces the odds of urinary incontinence by 37% and pelvic organ prolapse by 56% compared to control groups (Davenport et al., 2025). Additionally, antenatal PFMT for prevention shows a 62% reduction in urinary incontinence risk in late pregnancy among previously continent women (Woodley et al., 2020).
Finding the Right Pelvic Floor Physiotherapist
Investing in your pelvic floor health now benefits you for years to come. Women who address pelvic floor issues early postpartum report better outcomes and fewer symptoms later in life. This isn’t just about recovering from childbirth—it’s about setting the foundation for lifelong pelvic health.
Looking for pelvic floor physiotherapy in Burnaby? Our clinic offers personalized prenatal and postpartum pelvic health services to support you through every stage of your pregnancy journey. Contact us today to book your assessment.
Understanding and caring for your pelvic floor health is crucial for your recovery and long-term wellbeing as a new mother.
Whether you’re just starting to think about pregnancy, are already expecting, or have recently given birth, working with a pelvic floor physiotherapist can make a meaningful difference in your experience. Your pelvic floor supports you through every stage of life—and it deserves the same care and attention you give to every other aspect of your prenatal journey.
What to Expect at Your First Appointment
When you visit a pelvic floor physiotherapy clinic, your initial assessment will typically include a detailed discussion of your symptoms, medical history, and lifestyle factors, along with a postural and movement assessment to identify any contributing imbalances. Many physiotherapists also offer a pelvic muscle examination to assess tone, strength, and coordination, as well as an evaluation of bladder and bowel habits to determine functional patterns.
Internal pelvic examinations are never mandatory. If you’re not comfortable proceeding with one, a skilled physiotherapist can explore alternative assessment methods. Your comfort and consent are always the priority.
References
Ashton-Miller, J. A., & DeLancey, J. O. L. (2024). Pelvic floor injury during vaginal birth is life-altering and preventable: What can we do about it? American Journal of Obstetrics & Gynecology, 230(1), 1-13. https://doi.org/10.1016/j.ajog.2023.12.004
Beckmann, M. M., & Stock, O. M. (2013). Antenatal perineal massage for reducing perineal trauma. Cochrane Database of Systematic Reviews, (4), CD005123. https://doi.org/10.1002/14651858.CD005123.pub3
Casagrande, D., et al. (2023). Pelvic girdle pain in pregnancy: A review. Obstetrical & Gynecological Survey, 78(6), 368-379.
Davenport, M. H., et al. (2025). Impact of postpartum exercise on pelvic floor disorders and diastasis recti abdominis: A systematic review and meta-analysis. British Journal of Sports Medicine. Advance online publication. https://doi.org/10.1136/bjsports-2024-108984
Díaz-Bueno, I., et al. (2025). Prevalence and impact of pelvic floor dysfunctions on quality of life in women 5–10 years after their first vaginal or caesarian delivery. Heliyon, 11(2), e41598. https://doi.org/10.1016/j.heliyon.2025.e41598
Du, Y., Xu, L., Ding, L., Wang, Y., & Wang, Z. (2015). The effect of antenatal pelvic floor muscle training on labor and delivery outcomes: A systematic review with meta-analysis. International Urogynecology Journal, 26(10), 1415-1427. https://doi.org/10.1007/s00192-015-2654-4
Lien, K. C., Mooney, B., DeLancey, J. O. L., & Ashton-Miller, J. A. (2004). Levator ani muscle stretch induced by simulated vaginal birth. Obstetrics & Gynecology, 103(1), 31-40. https://doi.org/10.1097/01.AOG.0000109207.22354.65
Salvesen, K. Å., & Mørkved, S. (2004). Randomised controlled trial of pelvic floor muscle training during pregnancy. BMJ, 329(7462), 378-380. https://doi.org/10.1136/bmj.38086.701215.E0
Takahashi, S., et al. (2023). Prevalence and risk factors of pelvic floor disorders after delivery in Japanese women using the Pelvic Floor Distress Inventory: A retrospective cohort study. Cureus, 15(5), e39287. https://doi.org/10.7759/cureus.39287
Woodley, S. J., Lawrenson, P., Boyle, R., Cody, J. D., Mørkved, S., Kerkhoff, A., & Hay-Smith, E. J. C. (2020). Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews, (5), CD007471. https://doi.org/10.1002/14651858.CD007471.pub4
Wu, W. H., Meijer, O. G., Uegaki, K., Mens, J. M. A., van Dieën, J. H., Wuisman, P. I. J. M., & Östgaard, H. C. (2004). Pregnancy-related pelvic girdle pain (PPP), I: Terminology, clinical presentation, and prevalence. European Spine Journal, 13(7), 575-589. https://doi.org/10.1007/s00586-003-0615-y
Yang, J., et al. (2022). Effect of prenatal perineal massage on postpartum perineal injury and postpartum complications: A meta-analysis. Computational and Mathematical Methods in Medicine, 2022, 3291736. https://doi.org/10.1155/2022/3291736