Physical preparation for childbirth

The miracle of childbirth. One of the most natural and incredible events that can occur in our lifetime. Yet so complex, with the potential for women to experience many different outcomes.

Pelvic Health Physio Jenni Davies and Personal Trainer Emily Bennet share their experience on pre and post natal anatomy and exercise to help pregnant ladies before the big day (and nights) arrive.

1. Have a birth plan covering all scenarios

Jenni: As much as we’d love everything to go perfectly when we give birth, the honest reality is that it often doesn’t. The more informed women are pre-natally, the more empowered they are to make decisions they’re comfortable with.

This keeps a sense of being in control and in good health through all stages and possible outcomes pre-natally, during delivery and post-natally.

Women who are well informed and feel like they’ve been an active participant in their birthing process are the least affected by any negative outcomes post-natally. And women who have very definite ideas about how their birth is going to go who have not considered any alternatives, tend to really struggle post-natally.

It’s important to get good support and relevant information to help prepare you, and not frighten you.

Women deserve to be empowered, even if it means finding out the uncomfortable reality of giving birth before they do actually go through the process. I’ve seen too many women devastated after birth once they have issues who are so angry they weren’t told what could happen beforehand, so that they could have made better decisions.

2. Reduce the discomfort of some common pregnancy aches and pains

Jenni: Pelvic girdle pain is common. This is felt either in the back around the sacroiliac joints or at the front in the pubic symphysis.

Also many women experience lower back pain, aching through the hips and abdominal/round ligament discomfort or pain. The less common aches and pains come from variscosities occurring in the labia.

Overcoming these pains is a really individual thing for each woman but a global rule of thumb would be to:

a. Try to weight bear symmetrically (ie 50:50 between each leg) when standing and lifting, but also sitting symmetrically, so avoid sitting with both legs to the side, or with one tucked underneath you.

b. Keep active and stretch regularly

c. Seek help from a pelvic physio if pains are not settling, or are starting to limit activity or interfere with sleep and usual daily routines.

3. Get assessed and focus on your pelvic floor

Jenni: Ideally we’d see all women at approximately 20 weeks during pregnancy to check their pelvic floor and discuss any concerns they have. We also go through birthing options and positions with them at that time. These are things your doctor generally wouldn’t cover with you.

Being able to fully relax the pelvic floor muscles is really important for birthing. This is particularly relevant for women who have a history of painful sex, endometriosis, pelvic pain or tightness in their pelvic floor muscles (vaginismus).

The final stand out recommendation is performing a pelvic floor program during pregnancy. This decreases the risk of urinary incontinence post-natally (statistics show that 1 in 3 women leak post-partum).

4. Keep an open mind about delivery

Jenni: Don’t have any expectations. Keep an open mind and be aware of all your options so you can make an informed decision and make sure your birthing partner knows what your wishes are so that they can advocate for you in the moment if needed.

Discuss any concerns you have with your Obstetrician/Midwife during your pre-natal checks.

5. Make sure you exercise – safely – during pregnancy

Jenni: Starting or maintaining a general exercise program is important and decreases the risk of interventions including caesarian sections, reduces the risk of high blood pressure and gestational diabetes. This in turn decreases the risk of post-partum issues for mum.

Emily: Strength training & cardio during pregnancy is both safe and incredibly beneficial, regardless of your experience level with it. That means even absolute beginners can get started with training during pregnancy!

There are just a handful of activities and exercises pregnant women should avoid completely, and some specific symptoms to watch out for while you train.

Whilst you’re pregnant it’s best to avoid any exercises that are a high risk for the mother or baby (eg contact sports, a high risk of falling, activities done in high temperatures), prolonged exercises on your back in the later stages of pregnancy, exercises that aggravate existing pain, exercises that cause you to use the valsalva maneuver & exercises performed at such a high intensity that you can’t speak comfortably.

If any particular exercise causes pain or discomfort, leaking, or sensations where you feel like your belly bulges out, or bulging/heaviness in the perineum, you should stop and either modify or avoid these exercises.

The best thing is to tune in to what your body is telling you, and if you’re getting hints that your body needs to back off, do so.

If you don’t experience any of the sensations mentioned above and with guidance of a trainer, you can keep going.

The bottom line is that as long as your doctor or pelvic floor physio says you can exercise, you can go ahead and exercise! Of course, you may need to modify some exercises, especially later on in pregnancy which is why it is important to work with a pre & postnatal qualified coach.

If you’re just getting started with training during pregnancy, my advice is to ease yourself into it.

Start slow and gradually build yourself up. I recommend using the perceived effort scale which is a way to measure how intensely you’re working based on how you feel.

Start at a 3-4/10 intensity and as you get more practice you can build to a 5-6/10. I don’t recommend going above an 8.5/10 intensity when you are training whilst pregnant (so this rules out HIIT training).

Every woman’s pregnancy experience is unique – your body is performing an incredible feat in pregnancy! Keep the focus of your exercise routine on helping your body feel comfortable and supported, right now and for the long term.

Exercising during pregnancy has a ton of benefits, and we believe it is important to work with a qualified pre-natal coach so you have a safe, healthy & strong pregnancy & postpartum experience.

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