When people talk about the pelvic floor, the conversation almost always jumps to postpartum recovery. But here's something we don't say often enough: pregnancy itself starts changing your pelvic floor from the very beginning and that's true even if you're planning (or end up having) a cesarean birth.
So what's actually changing, and what can you do about it? Let's break it down.
Your Pelvic Floor Has 5 Jobs
Before we get into the changes, it helps to know what your pelvic floor does for you every day:
- Sump pump – helps move blood and lymphatic fluid through your pelvis and legs
- Sexual function – involved in the rhythmic contractions of orgasm; too much tension or irritation here can affect intimacy
- Support – along with bones and ligaments, forms a sling that holds up your pelvic organs and helps create your body's shape
- Stability – works with your deep abdominal and back muscles to stabilize your spine and pelvis so you can lift, walk, and move
- Sphincteric control – keeps urine and stool in until you're ready to go, staying "on" most of the time and relaxing on cue
As your uterus, placenta, and baby grow, the added weight, shifting hormones, and increased pressure can affect every one of these jobs.
Circulation: Swelling & Varicosities
Pregnancy brings real vascular changes that, combined with the extra pressure from your growing uterus, can lead to more swelling, especially in the vulva, and sometimes varicose veins in that area (vulvar varicosities).
What can help:
- Compression garments or maternity leggings
- Staying well-hydrated
- Elevating your hips/legs when you can
Sexual Function: Discomfort with Intercourse
Increased pelvic pressure, tissue sensitivity, and hormonal shifts can make intercourse feel different, sometimes uncomfortable, during pregnancy.
What can help:
- Extra lubrication
- More time for foreplay
- Experimenting with positions to find what feels good for your body right now
- Utilizing cushions/pillow (a wedge can be helpful!)
Support: That Heavy, Achy Feeling
More weight on your pelvic floor often means more heaviness or pressure, especially later in the day or later in pregnancy.
What can help:
- Positions that bring your hips higher than your shoulders for temporary relief - think downward dog, puppy pose, glute bridges, or open-knee-chest
- Staying ahead of constipation, which adds even more downward pressure
Stability: Diastasis Recti & Pelvic Girdle Pain
As your belly grows, your abdominal muscles naturally stretch and separate at the midline - this is called diastasis recti, and it's a normal, expected part of pregnancy. It can change how well your core stabilizes your spine and pelvis, which is why you may need to modify certain lifts or go lighter in the gym (relative to your normal).
Some women also notice pelvic girdle pain - discomfort around the pubic bone, hips, or SI joints. Maternity support garments and SI belts have research behind them for easing this kind of discomfort, so they're worth discussing with your provider.
Sphincteric Control: Leaking During Pregnancy
This one is more common than most people realize - research shows that more than 4 in 10 pregnant women experience some urinary leakage, often starting early and increasing as pregnancy progresses. Your pelvic floor is under more load, and your bladder is sharing space with a growing baby.
What can help:
- Good toileting habits, no "power peeing" or bearing down to empty faster
- Staying hydrated (cutting back on fluids can actually make bladder irritation worse)
- Avoiding constipation
- Reaching out for support if leaking is bothersome, frequent, or getting worse, even during pregnancy, this isn't something you just have to live with
You Don't Have to Wait
Pelvic health support isn't just a "fix it after baby" project. You can start caring for your pelvic floor right now, during pregnancy and doing so can make a real difference for how you feel today and how you recover afterward.
If any of this sounds familiar, or you'd just like a baseline check-in, we'd love to help.
Schedule a free discovery call and let's talk through what support looks like for you.
With peace and love,
Dr. Ellyn Halley, DC, Doula, Coach
Doc Halley Solutions
Follow me on Instagram + TikTok for more content - ellynhalley.dc
In person chiropractic care! You can find me at 1500 Green Bay St, La Crosse WI 54601 within the same space as the Parenting Place and The Motus Project. I am excited to offer in person care to women in the Coulee Region, and offer hybrid care - in person + online. You can book your first appointment or schedule a consult below!
If you're looking for an "all in one" program that includes a prenatal exercise program, birth education, pelvic prep + mobility, nutrition information, and more - combined with regular support + check ins - I have you covered. Check out my Empowered Pregnancy program for incredible prenatal support. SUMMER SALE - $50 off with code EMPOSUMMER
Looking for more support around exercise, pelvic health, and nutrition (and birth prep if you're pregnant!)? Apply for 1:1 coaching with me:
**Disclaimer: The content in this email is not intended to be medical advice. The content here is for informational purposes only. Please consult with your healthcare provider regarding any medical or health related diagnosis or treatment options.
