Too Tight for Birth?

Can a knotted up Pelvic Floor affect your chances of birthing vaginally?

tight pelvic floor

The Pelvic Floor is like any other muscle group in that, to work well it must have good strength and good flexibility (besides other factors like hydration and good nutrition). When one or both of these conditions are not met, the muscle in question acts sub-par.

During the second stage or pushing stage of labor, most active pushing is performed by the Uterus (a wonder organ, more on that later!), with the abdominal muscles assisting in most cases. While a woman pushes, her pelvic floor must primarily relax or lengthen effectively, to allow for more room, and decreased resistance for baby’s descent through the birth canal.
Therefore, in theory, if the Pelvic Floor is tight and lacks flexibility, the pushing stage can be prolonged which often has implication for the mother’s postpartum pelvic health and her ability to birth vaginally.


Bo et al (2013) found that women with tighter pelvic floors had prolonged pushing stages, compared to those who’s pelvic floors were more relaxed. The study also found that a stronger pelvic floor was not a disadvantage for vaginal childbirth, but a tighter one may be.

So how can one know if her pelvic floor is tight? If you answer “yes” to any of the following questions, you may have higher than average resting pelvic floor tension :

– Are you a pro-athlete or engage in a high-impact activity (crossfit, weightlifting, running, gymnastics) on a regular basis?

– Do you participate in a moderate to high intensity physical activity for >7 hours every week, with little-no alternation with stretching/lengthening activities (yoga, pilates, functional stretching)?

– Do you have a pelvic pain condition?

– Do you “carry stress” in your shoulders or jaw? Spend a good part of your day sitting with one leg crossed over the other?

– Do you have a Type A personality, or experience anxiety or OCD symptoms?

– Do you have a history of non-consensual/unwanted sexual experiences?

Here are a few strategies to decrease Pelvic Floor tightness; though treating the root cause will lend the best results.
✔️ Conscious relaxation exercises of the Pelvic Floor, aka, Reverse Kegels. These are the opposite of the tightening Kegels, and are best learned from a trained professional.
✔️ Including regular flexibility training like yoga or pilates into your fitness routine.
✔️ Mindfulness and relaxation exercises to decrease tension carrying patterns throughout your body -jaw, neck & shoulders, low back & pelvis are common spots of increased muscle tension.
✔️ Manual therapy (external, and internal when necessary) by a Pelvic Floor Therapist, followed by self treatment has shown excellent results, especially for those experiencing pelvic pain.

One of the advantages of working with a Pelvic Floor Occupational Therapist is the training in treating both the physical and emotional aspects of Pelvic Floor conditions. If you want to know how we can help you improve your Pelvic Health, contact us here.

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