Healing & Protecting Your Pelvic Bowl
Pelvic health is so important, but often it is something that is ignored. Many women are not educated about their pelvic muscles, deep core muscles, and the connection between the two. When a woman goes to a doctor with common symptoms of pelvic dysfunction, they are rarely given any useful information. In the medical system women are brushed off and sometimes even told the only treatment is to have their uterus removed(hysterectomy) or other invasive and possibly dangerous surgeries, like a transvaginal mesh or bladder slings. There have been class action lawsuits as a result of these surgeries because of the horrific side effects many women endured after the procedure. Pelvic health is one issue in a long history of allopathic doctors not knowing much about female physiology, failing to address the root cause, and causing more harm than good with their treatments.
There is a common misconception that after a woman has children it is normal for her to pee her pants when she jumps, sneezes, or coughs. Urgency incontinence is definitely to be expected after kids. This is when a person cannot hold their bladder for very long and must make frequent trips to the bathroom. These things are common, especially amongst older women, but not normal and a sign of pelvic dysfunction. Painful sex, chronic constipation, diastasis recti(abdominal muscle separation), bladder or uterine prolapse are also signs of pelvic dysfunction.
Women can heal their bodies and prevent pelvic dysfunction in the first place!
Anatomy of The Female Pelvis
To start, I think it is helpful to understand some basic anatomy of the female pelvis and pelvic floor muscles. I am specifically talking about the female anatomy because it differs from the male pelvis greatly. Women have wider angles in their pelvic bones, more cartilage, and a posterior tilt. This is all part of the perfect design for women’s physiological functions of pregnancy and birth.
Women naturally have a posterior tilt to their pelvis, meaning we arch our lower back slightly when we stand in a relaxed posture. Unfortunately, many women were taught to tuck their hips in. This posture mimics the natural male posture but will create dysfunction in the female body if done frequently overtime. Mimicking an unnatural anterior tilt(male posture) will tighten the glutes and pelvic muscles - creating excessive downward pressure and strain on the pelvic floor.
This is why many dancers, gymnasts, and yoga teachers develop pelvic floor dysfunction. In these practices it is common that women are instructed to tuck their hips in. After years of mimicking this unnatural posture, the pelvic floor muscles will be hypertonic - chronically tight and over-contracted.
I refer to the entire pelvic region as the pelvic bowl, which comprises the bony structures of the pelvis, ligaments, tendons, and a matrix of muscles.
The pelvic lattice is the layering matrix of muscles within the pelvic bowl. This is commonly referred to as the pelvic floor. When you get to know this area, it is clear that the term “floor” does not accurately describe it. I still use the term “pelvic floor”, like in the title of this resource, because that is the common term that most people will understand. There are times where comprehension trumps using accurate language.
These muscles hold up the pelvic organs - bladder, uterus, rectum. Sometimes prolapse of these organs occurs when there is dysfunction in the pelvic muscles. Pelvic health relies on these muscles’ ability to contract and relax. Like any skeletal muscle, the pelvic lattice must be not only strong but also flexible.
The pelvic lattice acts as a diaphragm. Just like the diaphragm that separates the lungs from the lower internal organs, the pelvic lattice lifts up and down as we breathe. Often, when people think of core muscles, they think of the outer core muscles. There is a whole network of muscles under the superficial muscles that can be seen from the outside. These deep core muscles play an important role in the functionality of the pelvic lattice of muscles.
Pregnancy
It is wise to create awareness about your pelvic floor BEFORE issues arise! Prevention is key! Of course this isn’t always possible but it is never too late to heal your body. Pregnancy is a great time to connect with your body in all ways, especially your pelvic bowl! Simple exercises can help build functionality in your body, which will not only prevent issues down the road but also help you birth your baby with more ease!
During pregnancy, a woman’s body experiences an increase in weight pressing down on her pelvic lattice and out against her abdominal muscles. A healthy pelvic lattice will be able to hold this extra weight, but if there was dysfunction in this area before pregnancy, it could lead to further dysfunction and issues that can linger after birth.
Using proper body mechanics is always a good idea but it becomes a necessity during pregnancy. At some point during pregnancy, women will notice that their center of gravity, balance, and how they move are changing. This is all normal and women must make adjustments to how they move and live to accommodate a growing belly and protect their abdominal muscles and pelvic lattice.
General proper body mechanics:
Exhale when lifting, straining, or pushing. ex: when doing a squat exhale when bending knees and pressing down, inhale when straightening legs and lifting up.
Lift with your core and legs, not your back. This means as pregnancy progresses the weight you can safely lift will decrease.
When lifting keep the object as close to your body(center of gravity) as possible.
You can also incorporate certain breathing techniques(like 360 breathing mentioned later in this resource) and physical exercises into your prenatal care routine to protect the pelvic bowl during this time of physical growth and expansion.
Learn more about mindful prenatal practices in the Knowledge is Power Birth Prep Course.
Book a prenatal support coaching session with me.
Birth
Every woman has the power to choose her prenatal care, birth setting, birth team, and how she prepares for birth. These decisions can greatly affect her birth experience and healing postpartum. Women who have a physiological and undisturbed birth are less likely to experience pelvic dysfunction. Learn more.
Things that put women at greater risk for pelvic dysfunction:
Birth in the hospital
Birthing on her back with feet in stirrups
Coached pushing or “purple pushing”
Surgical birth (cesarean section)
Episiotomy, vacuum or forceps “extraction”
Healing Postpartum
Resting immediately postpartum is so important to facilitate healing after pregnancy and birth. Staying in bed/around bed for the first 2 weeks is very important to help regulate hormones, establish breastfeeding, and allow internal organs to settle back into a non-pregnant state. It is important to have a solid care and support plan for postpartum to ensure that your usual responsibilities are taken care of so you can rest and heal. This typically means someone other than your partner will need to pitch it to help with cooking, cleaning, and care of older children. It can be great to have a friend or family member stay in your home to help during this immediate postpartum period. I can help you create a game plan for postpartum support and healing in prenatal coaching sessions.
I have an entire section on healing postpartum in the Knowledge is Power Birth Prep Course. I highly recommend this course for any woman preparing for birth, postpartum, and mothering!
Book me for Postpartum Care to help you heal and thrive after birth!
360 Breathing
360 breathing is a gentle practice that can be done in any season of life. This practice can help to prevent pelvic dysfunction and possibly heal present pelvic dysfunction. This practice helps the pelvic muscles to lift up and down with the breath, which can be beneficial for women with hypertonic (tight) or hypotonic (weak) muscles. This practice creates awareness in the body that is especially beneficial in pregnancy to prepare for birth.
360 breathing is a deep breathing technique that involves expanding the rib cage and abdomen in all directions. It is also known as diaphragmatic breathing or canister breathing. This breathing technique improves core strength and stability, reduces stress and anxiety, increases oxygen intake, improves posture, and promotes relaxation.
During inhalation, the diaphragm contracts and descends into the abdomen, pulling the lungs downward, which in turn, creates negative pressure in the thorax (rib cage) drawing more air into the lungs through the glottis/ throat. This then pushes the visceral organs downward, massaging the digestive system, aiding in digestive activity. As this happens, the pelvic floor lengthens to accommodate changes in pressure from above.
During exhalation, the diaphragm recoils up, drawing the organs back up, and the pelvic floor and transverse abdominis (deepest abdominal wall muscles, part of the core) reflexively contract to assist the emptying of the breath and upward direction of depressurization.
Ideally diaphragmatic expansion should occur in a multi-planar direction, moving front, back, sideways, and upward. Imagine your bottom 5 ribs (to which the diaphragm attaches) like bucket handles each side coming up and out on the inhale to allow for more optimal excursion of the diaphragm. This not only draws more air into all lobes of the lungs, but also massages the organs to a greater degree, as well as balances abdominal and pelvic pressures throughout the abdominopelvic canister. This in turn allows for more optimal reflexive activation of the deep stability system.
How to Do 360 Breathing:
Sit or lie down in a comfortable position.
Place your hands on your ribs, just below your chest.
Inhale deeply through your nose, allowing your ribs to expand in all directions: front, back, and sides.
Feel your diaphragm pushing down and your abdomen expanding.
Exhale slowly through your mouth, allowing your ribs to return to their original position.
Repeat for several breaths.
Watch my video here
Yoga
I mentioned at the beginning of this resource that women who have been doing yoga for a long time often have hypertonic pelvic muscles and pelvic dysfunction. This is because all classical styles of yoga were created for male physiology and are still taught that way hundreds of years later. Most yoga teachers were not taught how to teach yoga safely to women. In many styles of yoga, women are instructed to do things like tuck their hips in to do the poses correctly. This is very harmful to women as it can cause serious dysfunction if done regularly over a long period of time.
In 2023, I had the pleasure of taking a yoga teacher training with Adelaide Meadow on how to cue yoga for female physiology. This training was extremely transformational in how I teach yoga, especially prenatal yoga. This is when I learned that most mainstream prenatal yoga is just the same male-oriented poses but modified for a large belly. There are so many beneficial movements and modifications to support women through pregnancy. I love incorporating strengthening practices, walking/hiking, and gentle stretching into my movement routine during pregnancy.
Below is one of my yoga classes that is specifically on connecting to the pelvic bowl.
Watch my video here.