Is Your Pelvis Ready for Birth?

3 things on the birth-ready pelvis checklist

There are many things that pregnant women do to prepare for birth. The list may include  childbirth classes, baby showers,  or putting the nursery together. But how often do you hear of  birthing people preparing their pelvis for labor and delivery? I believe this should be at the top of everyone’s list. 

The structures within the pelvis need to be functioning well in order to let the baby descend, engage and ultimately exit. I find that optimizing pelvic floor function and pelvic mobility before labor helps birthing people to:

• avoid stalled labors

• decrease chance of perineal tears and pelvic organ prolapses

• feel more empowered and in control of their body

Here are the 3 things that I look at to determine whether a pelvis is ready for birth:

1) Pelvic Bone Mobility
The pelvic bones need to be able to shift and move to allow for the baby’s passage through the pelvis. Don’t worry, there is a hormone called relaxin that makes all of the ligaments around the pelvis much looser and mobile in preparation for birth. In the final stages of pregnancy, relaxin levels are 20x what they are in a non-pregnant body. There are two stages of pelvic movement: the inlet opens and then the outlet opens .

The inlet or the top of the pelvis opens to let the baby descend down into the pelvis. The ileum (the big wings at the top of the pelvis) swing apart and the sacrum (the triangle bone just below the spine) swings  backwards. 

Once the baby is engaged in the pelvis, the sits bones need to come apart and the tailbone needs to swing  backwards to open the outlet. 

If you have any restrictions in the joints of the pelvis, tightness in the muscles around the pelvis or restrictions in the fascia/connective tissue, these can keep the pelvis from moving like it needs to and allowing the baby to come down and out. 

A pelvic PT can check all of your pelvic joints, muscles and fascia to ensure that there are no restrictions before birth. I usually recommend that pregnant people come to see me around 34-36 weeks to check their pelvis.

2) Pelvic Floor Tone
The pelvic floor is a bowl of muscles at the base of the pelvis that attaches to all of the  pelvic bones. Its tone can range from very tense and tight to very relaxed. It’s similar to when you flex your bicep and you touch the muscle it feels hard, whereas if you relax the muscle it feels soft and mushy. For birth, we want the pelvic floor to be soft and mushy when we touch it. If it is holding too much tension/tone, it can keep the pelvis from moving and from letting the baby exit. 

3) Pelvic Floor Coordination
Last, but certainly not least, you need to have control over the contraction and relaxation of  your pelvic floor. The relaxation/lengthening of the pelvic floor is the most important part in preparing for birth. The bowl of pelvic floor muscles should be able to expand down and relax. You should practice this lengthening in every position that you may want to labor in, so that you feel confident that you have control over these muscles no matter what your body is doing. 

If you aren’t sure that your pelvis is ready for birth, please reach out to me and I would be happy to answer any questions that you might have!