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​​What are Pelvic Floor Muscles? 

The pelvic floor muscles form the support of the organs in the pelvis like intestines, urinary bladder (“urine bag”), urethra (“urine tube”) and uterus (womb). 

They also assist the tight closure of the sphincters of the urethra and anus, so that there will be no leakage of urine or faeces (Figure 18.1). 

​In the absence or weakening of these supports, there would be prolapse (sagging) of the womb, bladder and rectum. 

There may also be incontinence (leakage) of urine when laughing, sneezing or even during brisk walking or exercise.​ 

 

Important!

  • Do not breathe in or squeeze your abdominals. 

  • Do not hold your breath. 

  • Do not squeeze your thigh or buttock muscles. ​

​​​Pregnancy and its Effect on the Pelvic Floor Muscles 

The pelvic floor muscle stretches during pregnancy as a result of hormonal changes and increase weight in the womb. Furthermore, these muscles stretch further during vaginal delivery as the baby passes through the natural birth passage. 

All these forces result in weakening of the pelvic floor muscles which compromises its support and sphincter function. This may lead to symptoms of urinary incontinence (leakage) or prolapse of the pelvic organs as described above.​​

Pelvic Floor Exercises  

Pelvic floor exercises (PFE) are a set of exercises which aim to strengthen the pelvic floor muscles. PFE has been shown to reduce the incidence of prolapse and urinary leakage, especially after the delivery of your baby.​​​ 


Important!​

​A valsalva maneuver could be wrongly performed instead of pelvic floor muscle tightening. This will further stretch and weaken the muscle. Please check with your doctor ​or physiotherapist for the correct technique.​

When to Start PFE in Pregnancy? 

You should initiate these exercies from the start of your pregnancy and they must be continued daily throughout the entire pregnancy. 

How to Perform Pelvic Floor Exercises? 

Imagine that your urinary bladder feels full and you are unable to locate the toilet. Gently squeeze your pelvic floor muscles together right from the anus to the urethra to prevent the urine from leaking. You should feel the whole pelvic floor tightening up.​ 

Do both exercises together each time. Repeat these exercises regularly throughout the day. It can be done in any position — lying, sitting, standing or even walking. 

Never practise while passing urine. Stopping the stream of urine intermittently may result in incomplete voiding. 


Pelvic Floor Exercises After Delivery 

When continued into the postnatal period after your delivery, PFE help to reduce perineal swelling by improving circulation through the muscle pump action. They also reduce pain in the perineal area by preventing muscle spasm and tension. 

PFE strengthens the weakened muscles to regain its original suppor​t and sphincter function as soon as possible. The weakened muscles would not “build” back its strength on its own if these exercises are not done. 

The Ultimate Pelvic Floor Test 

This test can be performed after six weeks post delivery. On a full bladder, jump up and down for ten times. Also, cough strongly for ten times. 

If there is no urine leakage, your pelvic floor muscles are considered strong! ​

Did you know?

  • At 24 weeks gestation, baby weighs an average of 500 grams and is about 30cm long.
  • Your baby's lungs start branching into air sacs and producing surfactant, a substance that prevents the lungs from collapsing during exhalation and allows your baby to breathe properly when born. 


Acknowledgement

Source: Dr TAN Thiam Chye, Dr TAN Kim Teng, Dr TAN Heng Hao, Dr TEE Chee Seng John, The New Art and Science of Pregnancy and Childbirth, World Scientific 2008.