The role of the pelvic floor during the pushing stage of Labor

The average second stage of labor “pushing stage” in first time moms is:

· 2 hours without an epidural

· 3 hours with an epidural

 Heavy Lifters focus on their breathing and muscle performance to achieve incredible power and strength, the same is true for pushing a baby out. The combination of your pushing strategy with coordination of core compression and pelvic floor relaxation is key for effective pushes!

 We can work to promote pelvic floor relaxation to help reduce increased muscle resistance to vaginal delivery and improve the ability of the perineum and vaginal muscles to stretch during vaginal birth.

As pelvic physical therapists, we can use pelvic floor relaxation strategies to help increase the tissue flexibility at the vaginal opening, reduce the risk or amount of possible vaginal or perineal tissue tearing during delivery and help a birthing individual recognize and better tolerate the normal stretching of these tissue that occurs during birth.

Signs you may benefit from learning how to relax your pelvic floor muscles:

·  You have a history of pain with any form of penetration: penis, toy, speculum, tampon/menstrual products

·  History of chronic or intermittent constipation

·  Urinary incontinence (often caused by constipation, or poor functioning pelvic floor)

·  Low back, SIJ, hip or pelvic girdle pain (often a sign of poor coordination and strength of the pelvic floor muscles)

·  You are worried about how to push a baby out

 During the second stage of labor the pelvic floor muscles undergo a high level of repetitive stretch and loading as the uterus contracts and as strenuous maternal pushes are combined to help expel the fetus out of the vaginal opening.4 Incomplete or absent relaxation of the Levator Ani muscle may make this active stage of labor longer and could potentially lead to higher risk of cesarean or operative deliveries, so teaching pregnant clients awareness of how to relax their pelvic floor muscles and proper strategies to do so is of great benefit regardless of use of open or closed glottis strategy during vaginal delivery. 

Want to learn more?

Check out our Pregnancy Prep class, trusted by over 1,000 families nationwide!

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We always recommend a perinatal visit! Our clinic offers in person and virtual push prep sessions.