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5 Tips for Pregnancy

Hi friends! May is National Pre-eclampsia Awareness Month. Preeclampsia falls under a broad category of pregnancy blood pressure problems, and is the new onset of high blood pressure that often occurs AFTER week 20 of the pregnancy and frequently near the delivery date (ACOG, 2019).


To learn more about pre-eclampsia, check out our blog here. Since we already have a blog on pre-eclampsia, let’s observe the month by talking about 5 tips for pregnancy.


#1: Get Some Exercise

For most women, exercising while pregnant is safe. Be sure you talk with your physician before starting any exercise program (whether you are pregnant or not).


Exercise has several benefits including regulating blood pressure and blood sugar. Researchers have found that exercise can reduce the risk of gestational hypertension (high blood pressure), preeclampsia, and diabetes. Exercise can be started in early pregnancy or even before becoming pregnant! Aerobic exercise can include activities like swimming, walking, running, and spinning.

While you are exercising, it can help to lie on your left side to help maximize blood flow to the uterus and placenta. It is important to avoid holding your breath while exercising, too. You can count sets and repetitions out loud to prevent breath holding.


#2: Don’t Accept Urine Leakage As Normal

Even if it’s just a drop or two, any amount of leakage is a sign that something is not working properly and the pelvic floor muscles are often the culprit. Yes, this means that being pregnant is not an excuse for having urinary leakage! In fact, having urinary leakage during pregnancy significant increases the risk of having urinary leakage at 12 years postpartum (Moossdorff-Steinhauser, 2021).


But there is hope, pelvic floor muscle training, bladder retraining, and/or pelvic floor therapy can all help treat any amount of leakage.


#3: Learn How to Contract Your Pelvic Floor

Pelvic floor muscle training can have so many benefits in the perinatal period. It can prevent or improve urinary incontinence and help reduce the risk of developing back and pelvic pain during the 3rd trimester and up to 3 months after birth (Bo, 2015; Woodley, 2017).


One of the difficulties with pelvic floor muscle training is being unable to isolate and control those muscles. Many times, individuals cannot isolate and squeeze the pelvic floor muscles and instead use other muscles like the inner thighs, abdominals, and glutes. We want to train these muscles to work WITH other muscles, but we also want to have good coordination and a good mind-body connection to use these muscles properly.


Studies have shown that performing PFMT during first time pregnancies has been shown to shorten the first and second stages of labor (from the start of contractions to pushing). (Du, 2015) Why does this happen? PFMT can help you become more aware of your pelvic floor muscles and help you to relax AND strengthen them.


Tip: If you’re having trouble isolating or contracting the pelvic floor muscles, see a pelvic floor therapist! Ask your provider for a referral to one near you, or find one at www.mypfm.com/find-a-pt


#4: Learn How to Relax Your Pelvic Floor

Knowing how to relax the pelvic floor muscles is just as important as knowing how to squeeze. This is especially true when talking about delivering a baby vaginally. There is a common myth that we need strong pelvic floor muscles to help push the baby out. The opposite is true: the pelvic floor muscles need to be able to stretch and relax during delivery to allow the baby to exit the vaginal canal. Keep in mind everyone’s birth is a unique experience and it involves so many different factors. PFMT alone won’t ensure a safe and smooth delivery process.


#5: Perform Perineal Massage

Perineal massage is a technique used to help decreased the risk of perineal tearing during delivery and postpartum pain. This technique is typically performed starting around 36-37 weeks, and it’s important to get clearance from your birth provider before performing. Perineal massage has been shown to reduce the risk of tearing or having an episitomy by 9% (Beckmann, 2013).


To learn more about performing perineal massage, read about it here.

Labor and delivery can be an overwhelming time, but information is power! myPFM has many resources to help. You can find many free resources at www.mypfm.com as well as several courses:


To learn more about your pelvic floor muscles, check out these great resources:

For providers, check out our online courses to help your clients. Consider joining our Ambassador Program and most of our courses are included with your membership!


Written by Emily Reul, PT, DPT


References

  1. The ACOG. Practice Bulletin. Clinical management guidelines for obstetricians-gynecologists: gestational hypertension and preeclampsia. Obstet Gynecol. 2019;133(1):e1-e25.

  2. Beckmann MM, Stock OM. Anternatal perineal massage for reducting perineal trauma. Cochrane Database of Systematic Reviews 2013, Issue 4. Art No.: CD005123.

  3. Bo K, Berghmans B, Morkved S, Van Kampen M. Evidence-based physical therapy for the pelvic floor bridging science and clinical practice: 2nd edition. 2015.

  4. Du Y, Xu L, Ding L, Wang Y, Wang Z. The effect of antenatal pelvic floor muscle training on labor and delivery outcomes: a systematic review and meta-anaylsis. Int Urogynecol J 26, 1415–1427 (2015). https://doi.org/10.1007/s00192-015-2654-4

  5. Moossdorff-Steinhauser FA, Berhmans BCM, Spaanderman MEA, Bols EMJ. Prevalence, incidence and bothersomeness of urinary incontinence in pregnancy: a systematic review and meta-analysis. Int Urogynecol J. 2021;32(7):1633-1652.

  6. Woodley SJ, Boyle R, Cody JD, Morkved S, Hay-Smith EJC. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2017 Dec 22;12(12):CD007471. doi: 10.1002/14651858.CD007471.pub3.

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