Advices and exercises
When I listen to my pregnant patients, I hear “I did my kegel exercises, I’m ready to give birth’
Hmmmm well…. Yes and no…
It is very good to learn how to squeeze your pelvic floor before to give birth BUT if you think about what will happen, you will understand why you also need to know how relax it.
The D day, having a relaxed, stretched pelvic floor will protect you from a tear or an episiotomy.
I won’t say “it can’t happen” but it definitely helps to prevent and reduce damaged.
#1 Let’s start with the Pelvic floor massage
You can start from the 34th week of pregnancy (if you don’t have any pregnancy issues like vaginal infection, pre-eclampsia…).
- Choose a comfortable position: Try sitting or lying down, but you also can do it standing with one foot on a chair.
- Do it right after shower or wash your hands before to do it. Be careful with your nails!
- You can use perineum oil or just almond oil.
- Put oil on your thumb and on your pelvic floor (from your vagina to your anus)
- Put your thumb inside your vagina.
Describe half circles, pressing down with your thumb 5 times.
And then stretch with your thumb from the deep part to superficial part of the vagina.
It will stretch your perineum and will help you to avoid tear or episiotomy.
Do it every day (at least 3 times a week), for 2-3mns. Start by doing it 1 minute and with practice you may be able to continue the massage for up to 3 minutes.
Perineum massage shouldn’t hurt, it could be a bit uncomfortable at the beginning but you need to find the right pressure for you.
If you feel the position uncomfortable, and if your partner is enthusiastic, he can do it for you (same techniques but he will find easier to use his fingers rather then his thumb).
After doing your massage for few weeks, you may feel the skin and muscles around your vaginal opening are becoming looser, it is normal and a good sign. It means your perineum is ready for the delivery!
If you are unsure how to do it, do not hesitate to ask to your women health (obstetric) physiotherapist to teach you.
#2 Epi-No:
If you are not keen on doing massage, you can use this balloon , which will stretch your perineum.
Even if you do your massage, it is a good item to prepare the perineum with gentle stretching exercises after Week 36.
- How to use it?
- Slowly inflate the EPI-NO balloon to the point of stretching and comfort.
- Each day you will inflate and stretch a bit more.
- After the stretching phase (around 5 minutes), relax your pelvic floor muscles and allow the inflated EPI·NO balloon to gently expel itself from the vagina. This will familiarise you with the sensation of delivering the baby’s head.
- Do 4 cycles per session (20 min training)
- Optimum training is achieved when the balloon size has reached a diameter of 8.5 -10 cm (3-4 inches) and can be pushed out while inflated (usually after 3 weeks of training)
- There is no risk for your baby.
A women’s health (obstetric) physiotherapist would be able to show you how to use it.
#3 Don’t squeeze your pelvic floor too often or too many times after 8 months of pregnancy.
It is good to know how to squeeze it and to have corrects automatisms (habits when coughing, laughing…) but if your pelvis muscles are too tight, you won’t be able to relax it properly during the delivery.
Do your pelvic floor contraction at the beginning of pregnancy.
- Fast contractions:
- 10 times as if you want to stop urinary stream
- 10 times as if you want to close pelvic floor
- 10 times as if you want to hold a gas
- Slow contractions:
- 5 times closing and pulling pelvic floor, hold it for 12sec. Have a long break (around 30sec) between each contractions. Do it twice.
You can also associate this pelvic floor exercises with gentle abdominal exercises:
Don’t hesitate to consult a women’s health (obstetric) physiotherapist for more information. She will help you to understand how to squeeze the right muscles, will show you how to do pelvic floor massage and how to use Epi-no. Get ready for the delivery!
