Why you should see a pelvic floor therapist before getting pregnant
Pelvic floor therapy has been gaining a lot of attention over the last few years, but many people still think pelvic floor therapy is only for pregnant and newly postpartum women. As a pelvic floor therapist, I certainly believe that every pregnant and postpartum woman can benefit from seeing a pelvic floor therapist. If you’d like to learn more about why I think a pelvic floor therapist should be a member of your prenatal and postpartum care team, you can check out this blog post.
Pregnancy, labor, and delivery are a major physical event. Just like we encourage patients to “prehab” before a major surgery, pelvic floor therapy can be incredibly helpful prior to conceiving. In this post, I’m going to talk about some of the major things pelvic floor therapy can help address before pregnancy, including:
Existing pain
Symptoms that indicate your pelvic floor isn’t working optimally
Education on your core and pelvic floor
Improving organ mobility prior to pregnancy
Addressing Existing Pain Before Pregnancy
During pregnancy, your body is placed under increasing strain due to changes in posture, load, and movement patterns. This happens gradually, and some women have no problem adjusting to these changes. However, if you have existing low back, pelvic, or hip pain, these symptoms can become exacerbated during pregnancy.
A pelvic floor therapist can complete a full-body assessment to determine any factors contributing to your pain and treat those issues to help you find relief before undergoing the physical changes that pregnancy brings.
Even if you don’t currently have pain but have concerns about pregnancy-related aches and pains, a wellness and preventative assessment can be incredibly helpful. During this type of visit, we can:
Discuss your past medical and injury history
Assess your current strength and mobility
Identify ways to improve your physical health prior to pregnancy
We can also discuss what changes to expect when it comes to your core and pelvic floor during pregnancy and when it may be beneficial to see a pelvic floor therapist during pregnancy itself.
Resolving Pelvic Floor Symptoms Before They Escalate
Even if you have never been pregnant, you could still have pelvic floor muscle dysfunction. The Cozean Pelvic Dysfunction Screening Protocol states that pelvic floor dysfunction is likely if you have three or more of the following:
Pelvic pain (in the genitals, perineum, pubic or bladder area, or pain with urination) that exceeds a 3/10
A history of a fall onto your tailbone, lower back, or buttock (even in childhood)
One or more urinary symptoms, including:
Accidental loss of urine
Feeling unable to completely empty your bladder
Needing to void again shortly after urinating
Pain or burning with urination
Difficulty starting or stopping your urine stream
Getting up two or more times per night to urinate
A feeling of pelvic pressure or the sensation of pelvic organs slipping down
Pain or discomfort with sexual activity or intercourse
Sexual activity that increases other symptoms
Symptoms that worsen with prolonged sitting
If you answered “yes” to three or more of these, pelvic floor therapy can help.
Pregnancy causes a significant increase in pressure within the abdomen and down onto the pelvic floor muscles. Hormones also affect the ligaments and muscles of the pelvis. Addressing pelvic floor symptoms before pregnancy can reduce the risk of those symptoms worsening during pregnancy and postpartum.
Pelvic floor therapy helps address these symptoms in several ways. First, we assess posture, breathing, and movement patterns, including how your pelvic floor coordinates with breathing, abdominal muscles, and functional movement. We then prescribe individualized exercises based on what we observe.
We can also assess the pelvic floor muscles themselves to determine whether they are holding excess tension, weak, or uncoordinated, and apply appropriate treatment techniques to improve muscle function. This often includes an internal pelvic floor muscle assessment. You can learn more about internal assessments in this blog post.
In addition, we teach healthy, individualized bowel and bladder habits. If you’re experiencing leaking, urgency, bladder pain, or constipation, there are often many simple strategies that can significantly improve symptoms - and support better pelvic floor function overall.
Addressing pain with intimacy before pregnancy is also incredibly important. Pain with intercourse is not something you should just “deal with.” It can be a sign of pelvic floor muscle tension. You deserve comfortable, enjoyable sex, and reducing pelvic floor tension can also help decrease pain during pregnancy and prepare your body for labor and delivery.
Your pelvic floor muscles need to lengthen significantly during a vaginal delivery. This can be much more difficult if those muscles are already holding a lot of tension.
Education: Understanding Your Core & Pelvic Floor Before You’re Pregnant
Many of my patients head into pregnancy unsure about what exercises are “safe,” when they should stop certain activities, or how to modify exercises as their body changes. I also work with many patients who are unable to exercise during their first trimester due to nausea and want to return to movement in the second trimester but aren’t sure where to start.
Education prior to pregnancy helps you feel confident and stay active throughout pregnancy.
Topics we commonly cover during preconception education include:
What the pelvic floor is and how it functions
How the diaphragm, abdominals, and pelvic floor work together
Normal changes that occur during pregnancy
How to safely stay active throughout pregnancy
Creating Space for Pregnancy: The Role of Visceral Manipulation
Visceral Manipulation is a gentle manual therapy technique that aims to optimize movement of the abdominal and pelvic organs. Prior to pregnancy, it can be especially helpful for addressing restrictions in the uterus, bladder, rectum, digestive system, and surrounding tissues.
During pregnancy, the uterus grows along with the baby, pushing abdominal contents out of the way to make space. Visceral Manipulation can help promote mobility, adaptability, and space within the abdomen and pelvis to better accommodate these changes.
You can read more about how organ mobility supports pelvic floor health in this blog post.
Preventative Care for Pregnancy & Beyond
Pelvic floor therapy is not just a tool to be used after problems arise postpartum. It’s also a powerful form of preventative care. Pelvic floor therapy can help you prepare for pregnancy, provide education for a confident and active pregnancy, and reduce the risk of significant pain, injury, and pelvic floor dysfunction postpartum.
If you’re hoping to conceive in 2026, I encourage you to reach out and schedule a preconception pelvic floor appointment. You can schedule an in-person visit at my offices in the Memphis, TN area or a virtual visit here.
Blog post written by Dr. Alexis Hutchison, PT, DPT, OCS, PCES