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3rd Trimester & Your Pelvic Floor

Written by Elizabeth Willison of El Paso Pelvic Health

It’s the third trimester and you’re finally on the home stretch. You decorated the nursery, you stocked the diaper drawer, and you developed your birth plan.

But have you prepared your pelvic floor?

The pelvic floor muscles sit at the bottom of your pelvis and support your abdomen. Because the belly is growing bigger and getting heavier each week, the support system needs to adapt and strengthen to accommodate it. Hence, many women that come to physical therapy during pregnancy report they perform “Kegel” exercises. (Kegels are one type of strengthening exercise that some women may benefit from that involves squeezing as if you are holding back gas or stopping the flow of urine.) It should be noted that not every woman should be doing Kegels and it’s best to be evaluated by a physical therapist that specializes in the pelvic floor first.

However, when you come to the end of your third trimester, your pelvic floor needs more than strength. These are the same muscles that the baby passes through in a vaginal delivery. If you only know how to tighten these muscles, they can create a roadblock for the baby. I’ve worked with many women over the years who were not able to connect to the pelvic floor with relaxation and tried pushing through a partially closed door. If you do this, you will be much more likely to tear these muscles.

So how do you prepare the pelvic floor muscles in the third trimester? Practice feeling your pelvic floor muscles contract and relax. I often tell women to do this on the toilet after you finish voiding because the muscles are great at relaxing on the toilet.

Imagine an elevator. As you squeeze, the muscles should be able to come up to third or fifth

floor. Then let the elevator come back to the lobby. Next, and this is the most important part, take the elevator into the basement. You should be breathing as you do this. As it gets easier, try it in different positions, such as on your back, on your side, and on hands and knees.

Getting the pelvic floor into the basement will be your focus during the pushing stage of labor. If you have any trouble connecting to the pelvic floor or you want to make sure you’re doing it correctly, contact our clinic for a video consultation or search for a pelvic floor physical therapist in your area.

Dr. Elizabeth Willison is a physical therapist and certified pelvic rehabilitation specialist in El Paso, Texas. She owns El Paso Pelvic Health, where she provides in-person and telehealth treatment to help those with pelvic dysfunction. You can check out her website at or search @eppelvichealth on Instagram.

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