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Sunday, December 9, 2012

Ease Labor with Pelvic Exercises


No one — not your doctor, midwife, or even your mother — can reliably predict how your labor will progress. Fortunately, there are a few exercises you can do now to help prepare your body for what's to come.

Kegels: Kegel exercises are small internal contractions of the pelvic floor muscles that support your urethra, bladder, uterus, and rectum. Strengthening your pelvic floor muscles improves circulation to your rectal and vaginal area, helping to keep hemorrhoids at bay and speeding healing after an episiotomy or tear, if you have one during childbirth. There's even some evidence suggesting that strong pelvic floor muscles may shorten the pushing stage of labor.

You can do Kegels anywhere — sitting at your computer, watching TV, even standing in line at the supermarket.

Here's how:
• Tighten the muscles around your vagina as if trying to interrupt the flow of urine when going to the bathroom.
• Hold for a count of four, then release. Repeat ten times. Try to work up to three or four sets about three times a day.

Pelvic tilt :
This variation of the pelvic tilt, done on all fours, strengthens the abdominal muscles and eases back pain during pregnancy and labor.
• Get down on your hands and knees, arms shoulder-width apart and knees hip-width apart, keeping your arms straight but not locking the elbows.
• As you breathe in, tighten your abdominal muscles and tuck your buttocks under and round your back.
• Relax your back into a neutral position as you breathe out.
• Repeat at your own pace, following the rhythm of your breath.

Squat
It may not be the most elegant position, but squatting is a time-honored way of preparing for and giving birth. This exercise strengthens your thighs and helps open your pelvis.
• Stand facing the back of a chair with your feet slightly more than hip-width apart, toes pointed outward. Hold the back of the chair for support.
• Contract your abdominal muscles, lift your chest, and relax your shoulders. Then lower your tailbone toward the floor as though you were sitting down on a chair. Find your balance — most of your weight should be toward your heels.
• Take a deep breath in and then exhale, pushing into your legs to rise to a standing position.

Tailor or Cobbler Pose
This position can help open your pelvis and loosen your hip joints in preparation for birth. It can also improve your posture and ease tension in your lower back.
• Sit up straight against a wall with the soles of your feet touching each other (sit on a folded towel if that's more comfortable for you).
• Gently press your knees down and away from each other, but don't force them.
• Stay in this position for as long as you're comfortable.

Remember to start slowly and work at your own level for each exercise.
In addition to the well-known benefit of relieving urinary incontinence in pregnant women, regular pelvic exercises (also known as Kegel exercises) make them less likely to have a prolonged second stage of labor (pushing stage), according to a study in the British Medical Journal (2004;329:378–80). Pelvic exercises consist of alternately squeezing and relaxing the muscles of the pelvic floor, as when stopping and starting the flow of urine.

Following the first stage of labor, characterized by contractions that lead to increasing dilation of the cervix (the opening of the uterus), the second, or active, pushing stage, ends with the birth of the baby. (The placenta is delivered in the third stage and the fourth stage is the recovery phase during which the mother’s condition stabilizes.)

Women who have a prolonged second stage of labor are more likely to damage the tissues around the birth canal and to need an episiotomy (a surgical cut into the vagina and surrounding tissues to facilitate delivery). 

They are also more likely to bleed excessively after the birth and to need a Cesarean section to deliver the baby.

The goal of the new study was to determine the effect of pelvic-floor-strengthening exercises on labor in 301 pregnant women. The women were assigned to either a pelvic-exercise-training group or a control group.

The women in the exercise group trained with an exercise therapist for 60 minutes one time per week for 12 weeks between the twentieth and thirty-sixth weeks of pregnancy.

The women were also encouraged to perform 8 to 12 intensive pelvic muscle contractions two times per day at home during this period. The control group was not given pelvic exercise instruction, but was not discouraged from doing the exercises.

The duration of the second stage of labor and the number of prolonged second stage labors were recorded. Women in the pelvic-exercise-training group were far less likely to have a prolonged second stage of labor (lasting more than 60 minutes) than women in the control group.

The new study provides more evidence of the benefit of pelvic-exercise training in pregnant women. Pelvic-floor exercises also increase circulation to the area, and may help speed healing time and decrease pain after delivery.

Previous studies have shown that these exercises also improve urinary incontinence, which occurs when the muscles in the pelvic area become stretched during pregnancy, losing much of their strength and elasticity, and providing less support for the uterus and bladder.

1 comment:

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