Continence and Pelvic Floor in First Time Mums

There are so many beautiful things about your first pregnancy – you’re about to become a mum for the first time and soon you’ll be holding your little bundle of joy (and indulging in a mums and bubs class or two with us!). However, there are also a thousand questions that go with the territory of being pregnant for the first time and because every person from your mum to your local florist is going to offer their two cents of advice it can be hard to find out the information that you really want need.

pregnant query


One thing that a lot of women feel uncomfortable asking even their closest friend about is any pelvic floor and continence issues. There are a lot of changes happening “down there” in the first half of your pregnancy least of all being that you need to pee – a lot! Due to the large amount of pregnancy hormones circulating the body there is a softening of all the ligaments in the pelvis which can lead to some pelvic and low back pain for some women and there is a lot of Relaxin hormone circulating the body which can soften muscles and sometimes lead to continence issues during pregnancy. Below are some of the typically asked questions answered by our women’s health physiotherapists.

Question: I’ve just found out I’m pregnant! How important is it to make sure my pelvic floor is working? Or can exercising it wait until after the baby?

THe additional weight ofpregnancy combined with hormonal effects will place much more load on your pelvic floor muscles and other tissues
The additional weight ofpregnancy combined with hormonal effects will place much more load on your pelvic floor muscles and other tissues

Answer: SUPER important! Your pelvic floor muscles span from the back at your coccyx (very tip of your spine) to your pubic bone on the front of your pelvis and from side to side – between your two sit bones. Collectively they are quite a big muscle that works to support your pelvic organs (bladder, vagina and rectum) from below – and now you’re growing a baby in your uterus on top of your bladder so it has to work even harder to support your growing baby and your bladder which is constantly being pushed on – hence the need to pee all the time!

Whilst great benefits have been shown for pelvic floor muscle training post-natally, it is also equally important to try to maintain strong pelvic floor muscles throughout your pregnancy to help support your bladder, reduce the risk of incontinence (very common during pregnancy) and to provide support for your baby! Training them now will also mean it may be easier to train them after delivering your baby as you will be more aware of the muscles, how to activate them and how to train them – perhaps one less thing to worry about as a new mum!

Question: I’m 4½ months pregnant and I have noticed that sometimes when I laugh or sneeze or cough a little bit of wee comes out – it’s so embarrassing but I asked my mother in law about it and she said it’s normal during pregnancy – is this true? It doesn’t happen at other times – only during those activities!

Answer: It’s not “normal” to leak urine at any time but it is common during pregnancy because of the increased pressure on our bladders and increased weight in our tummies which pushes on the pelvic floor. Our pelvic floor might be strong enough to hold against these pressures during normal or light activities but when you add more intra-abdominal pressure – such as that involved when we laugh, sneeze or cough – our pelvic floor may not be strong enough to resist this! When we cough, we expand our belly immediately prior to coughing and this increases the pressure inside our abdominal cavity (purple arrows) and temporarily pushes the organs inside it downwards. To counteract this, the pelvic floor (in blue) contracts upwards and keeps everything supported. If our pelvic floor is not strong enough to resist the pressure, urine can leak out as we are unable to maintain enough closure of the bladder.

Question: How can Physiotherapy help? Are all physiotherapists qualified to manage pelvic floor issues or does it have to be a specialist?

All physiotherapists are introduced to the pelvic floor muscles and associated disorders when they study their degree in South Australia. However, given all the things they have to learn in 4 short years it is not a very in-depth look. Tory and Beck have done extensive training in the women’s health and continence area and Kate has done further studies also (and will do more and more over the coming months/years). They are qualified to assess your  ability to contract the pelvic floor muscles through instruction and diagrams as well as through the use of biofeedback and manual techniques.  They can also identify and treat many potential dysfunctions found.  35% of women do not contract their pelvic floor muscles correctly, and we know that doing regular pelvic floor muscle training in pregnancy can dramatically reduce your risks of incontinence both in pregnancy and in later life.  Call Vital Core Physiotherapy today on 8331 0552 to make a time to discuss your needs today!