9.18.2013

Pelviconscious


I want to talk about butts. Not just butts in general – but the laboring woman’s butt. In pregnancy, the
pelvic inlet is strong and sinewy, protecting baby and holding everything in place. The bones are hard, providing a shielding bowl, and the uterus is protected well.

While in labor, though, the pelvis changes. It becomes soft and pliable, jointed and open. A woman who keeps her posterior open and moving tends to have a shortened laboring time, more efficient dilation, and better pelvic relaxation. Let’s talk about why.

Anatomy, the hard stuff – We women are built with this beautiful basin that protects and holds our
inner stuff, including our growing babies, in and up where they are supposed to be. During late pregnancy and labor, it is our bodies’ jobs to provide a space that can let baby come down into this basin.

Later in pregnancy, our bodies release hormones to help the pelvis to become this ‘more open’ and jointed, mobile basin; these hormones are relaxin and hyaluronidase. Both of these hormones help to soften the cartilage, joints, and ligaments in your body. The result is that your pelvis is no longer a firm bony structure, but a moldable, open, hinged structure that accommodates babies descent.

- Finding that open basin -

Stand up.

Yes you.

Stand up.

Now, reach behind you to grasp your behind. Don't cheat by bending your legs or bending at the waist. Standing up, with your legs at a natural distance together or apart, feel for your sit bones (aka sitz bones or, more accurately, ischial tuberosity) you know, those bony prominences of your tush. Now take note of where they are at, how far apart or close together your hands are.

Now keeping your hands on your sit bones, bend at the waist (keep your knees locked). Feel the difference this simple change in posture made on the space in your sit bones/pelvis? Now we are going to go a step further. Keeping your hands on your sit bones and bent at the waist, now add in bending your knees. How did that change things?

Now take note of what you look like. Beyond 'silly', you should be able to note that you are bending at the waist with your knees unlocked and bent slightly. This is a positive laboring posture, one that will encourage your pelvis to be nice and open.

Labor positions that reflect this openness include:

  • hands and knees
  • forward leaning
  • slow dancing
  • belly dancing
  • crawling
  • walking (to a degree)
  • toilet sitting
  • kneeling
Anatomy, the soft stuff – Running through the basin of the pelvis is a whole bunch of muscles,
ligaments, tendons, veins, and nerves. As baby grows and your body gets more relaxed and open, your soft tissues automatically begin to stretch and soften. Sometimes, though, just like with a muscle spasm or other tensing of soft tissue, there can be some resistance to this body change.
The “pelvic floor” is actually not one muscle, but several layers of muscles that help to support our internal organs. The first layer of muscle can be thought of as a “compass rose” that runs front to back from the pubic bone to the coccyx (the bulbocavernosis), and from side to side from the perineum to the sit bones (the transverse perineals. (For a detailed, three dimensional video that shows all the major structures of the pelvic floor much better than I could explain, click here. It’s well worth the view.) 
There are three openings along the length of the bulbocavernosis, the urethra, the vagina, and the anus, and the bulbocavernosis snakes around them like a figure eight. The perineum is the area between the vagina and the anus, and it is this area that gets a lot of attention during the birth process. 
The next innermost layer of muscle is known as the levator ani. These have almost a bowl-like shape at the bottom of the pelvis, with a U-shaped an opening for the urethra and vagina, and are the muscles that do most of the heavy lifting of the abdominal organs. When we take a breath in, the thoracic diaphragm balloons downward, pushing the abdominal organs toward the pelvic floor, which in turn moves downward and stretches slightly. When we exhale, the thoracic diaphragm moves upward, followed by the abdominal organs, and finally the pelvic floor. We can accentuate this natural stretching and toning by bringing conscious awareness to our PF’s. But more on this later. - OmMama
- Contraction, aka, getting strong -

Kegels. Yes, everyone should be doing them to make sure that their pubococcygeous muscle is strong, but they shouldn't be doing them to the extent t3hat you can move a small vehicle simply with a contraction of your PC muscle.

Pelvic Clocks. These are awesome for labor, and a great way to tone the pelvic floor more thoroughly. I will let this link tell you a little more on how to accomplish them, this one that has a step by step walk through, and watch the video below for more information.


- Relaxation –

Learning to relax your pelvic floor is equally as important as learning to control/tighten it. One way in which to accomplish this is to learn to breath down into your pelvic floor. Attempt to inhale by expanding your ribcage, not lift your shoulders. Tune into what it feels like in your pelvic floor. Now exhale, again, note the change in your pelvis. And if you are a more visual learner see here.

- Stretching -


Inner Pelvic Stretching will help to loosen any taut or restricted soft tissue. Be sure do both sides evenly and slowly :)... once you have achieved full STRETCH, hold a few seconds, breathing deeply, and waiting for your tendons and ligaments to completely release (they will fight you a little).


The Piriformis Stretch be sure to do both sides evenly and slowly. Once you have achieved full STRETCH, hold a few seconds, breathing deeply, and waiting for your tendons and ligaments to completely release (they will fight you a little)


Your pelvis is an amazing thing! Opening, bending, compressing, expanding - allowing you to protect your baby during pregnancy and bring your baby out of your body during birth. Hopefully, these exercises will help you to become more pelviconscious.  

2 comments:

Mary H said...

I was wondering about pelvic separation. I experienced a crushing sort of pelvic pain during my 3rd and 4th pregnancies. I first noticed it around 6 months while doing prenatal exercises on my hands and knees. That child was 9lb 6oz. The next pregnancy, I had a lot of issues with contractions, racing heart (120-140) and generally feeling crummy, so I didn't do any official exercises other than some prenatal stretches, squats throughout the day and sitting cross legged. I didn't feel the pelvic pain until my last month, but it was severe, can't hardly walk sort of pain. This baby was 9lb 3oz. I'm 18 weeks with number 5 and wondering what I can do to prevent this separation. Are exercises, squats and open leg sitting helpful or harmful in this sort of situation?

emily wannenburg said...

I am a nurse-midwife (no longer working as a midiwfe, however) whose main work is now in the field of women's fitness and as a birth doula. I could not have written this any better! Thank you.

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