How’s Your Pelvic Floor? 5 Things You Need to Know

Written by Moorea on September 7th, 2012

Birth, Holistic Health, Pregnancy, Preparing for Parenting

Poop and pee—those things we are fine talking about as long as it comes to diapering and potty training your child. But what about you?

I thought I knew how to do Kegels and I thought my pelvic floor was strong. We also did perineal massage during my pregnancy. Still, how many of us mamas are peeing our pants just a little after birthing a child or three? Learning even more about my pelvic floor was not a feminist act but more of an…accident!

Starting as early as during my pregnancy, I would either spend all day on the toilet or having to manually help my bowels out with a gloved hand and I didn’t really understand what was wrong. I lived with what I called my “pocket” until I could live with it no longer and I sought help. From my midwife to a proctologist to the gynecologist and the physical therapist I went.  I have been fortunate enough to learn a lot from my personal pelvic floor physical therapist and dispense some info to you.

Whether you have had children or not, your pelvic floor may be lazy or stretched out. The pelvic floor can weaken with age or with C-sections and vaginal births alike—even natural squatting water births. (Though certain kinds of births—say mine with the yucky pitocin and epidural—can cause more intense problems as you shall see!)

What you didn’t know about Pelvic Floor Exercise:

  1. Don’t just clench your vagina. The pelvic floor sling of muscles includes those around your vagina, urethra/bladder, rectum/anus, the muscles on both sides of your spine in your lower back, your lower abdominals/psoas muscle, and the rectus abdominus and obliques.
    1. Your daily postures are essential. It has been found that the the best posture for pelvic floor health and for doing the exercises is a neutral spine, not a tushy pushed outward or the yoga pelvic tuck under. While evacuating on the toilet, it has been found that a squatting position with feet on the floor and leaning forward is the most healthy.When you sit in a chair or on the floor, your sitz bones (bottom of your pelvis) should attempt to make contact. Both of them. This means no crossing your legs! And don’t forget to lift in your pelvic muscles when you are about to lift things from the floor, including children.
    2. Standing, Sitting, Squatting, On the toilet, laying down. These are all of the places to practice working our your pelvic floor. Most people just do it in line at the grocery store or on the toilet. Try them all! It feels different to contract the muscles in every position. Oh, there is one more: during sex (with a partner or alone, toys can be extremely helpful as something to clench muscles around—yes, I just said that!).
    3. Do not do PC exercises to stop the flow of urine as you may have heard. This can cause a urinary tract infection. After your pee has evacuated fully, then it is time to try and engage your muscles on the toilet.
    4. Simply spending too much time on the toilet can strain your rectal muscles and bladder, so take all dietary precautions to avoid constipation and resist the urge to delve into a long book or a crappy (no pun intended) magazine. You can read in the bath. Lets just say that with my irritable bowel, I have caused myself hemorrhoids and stretched out my pelvic floor muscles before just from the gravity of the long-term-toilet position.

    My pelvic floor therapist is a miracle worker with the sort of mystical well-kept feminine knowledge a midwife has. Pelvic floor therapists are hard to come by, as training is hard to find.

    Visit the APTA for a list of great pelvic floor articles and to search for a therapist in your area! Or simply do a google search “pelvic floor therapist, Seattle WA” etc.  Or call a local female physical therapist and ask if she knows of anyone in the speciality.

    Here is what a cystocele looks like with bladder protrusion into vagina:

    Here is what a recocele looks like with rectal protrusion toward the vagina:


    Statements on this website have not been evaluated by the Food and Drug Administration. Products and/or information are not intended to diagnose, cure, treat, or prevent any disease. Readers are advised to do their own research and make decisions in partnership with your health care provider. If you are pregnant, nursing, have a medical condition or are taking any medication, please consult your physician. Nothing you read here should be relied upon to determine dietary changes, a medical diagnosis or courses of treatment.

About The Author: Moorea

@mooreamalatt My NPN Posts

Moorea Malatt is the founder of Savvy Parenting Support (and MamaLady blog), an online resource for gentle and naturally-minded early parenting challenges. Moorea is an expert and Parent Educator in gentle (and early) potty learning, gentle sleep learning and gentle discipline. She authors online learning programs, books and blogs, leads sold-out workshops and provides private phone consults. Moorea has 20 years of experience with parents and young children as a preschool teacher, certified postpartum doula, infant nanny and mom. Moorea also wrote an album of songs called, “Whip It Out: Songs for Breastfeeding.” Moorea continues to study the behavioral sciences and anthropology. She is a bit of a flop as a dinner chef loves a good sugar-free “paleo” baking experiment!

4 Responses to How’s Your Pelvic Floor? 5 Things You Need to Know

  1. Amy Phoenix  

    Moorea, thank you! Helpful tips on a not too talked about, but really important subject. I have also been finding this physical therapy DVD beneficial: 🙂

  2. Laura  

    Chelsea Athing at Experience Momentum in Lynnwood (north of seattle) just did a talk for my mom’s group on this topic and I was really impressed with her.

  3. Amy

    Love the article! May I ask with which pelvic floor therapist you worked?