Written by

Gina Conley, MS

August 7, 2024

Third Trimester Fitness: 6 Pelvic Floor Moves to Prep for Birth

Birth Preparation, Fitness, Pelvic Floor, Prenatal

The pelvic floor plays a crucial role in our comfort and function throughout pregnancy and childbirth. However, common exercises prescribed for birth preparation may not be sufficient. Understanding the nuances of pelvic floor position and its role in birth can help you appreciate why these exercises are essential for your preparation.

During childbirth, the pelvic floor needs to release and open to allow the baby to pass through more easily. Common exercises for “prepping” the pelvic floor for birth include Kegels (which we do not recommend) and wide-leg positions such as deep squats and the butterfly pose. In this blog, we will break down six exercises that go beyond deep squats to help release tension in your pelvic floor as you prepare for birth.

Pelvic Floor Birth Prep: More Than Deep Squats and Definitely Not Kegels

The pelvic floor attaches to the pelvis, and different pelvic positions can alter its tension. Ideally, as we walk and move, the pelvic position changes, adjusting the tension in the pelvic floor. Additionally, during breathing, the pelvic floor should move up and down in sync with the breath cycle. However, during pregnancy, we often get “stuck” in certain positions, which can increase pelvic floor tension in specific areas. This tension might affect the baby’s position for birth and the pelvis’s ability to open.

No single movement stretches the entire pelvic floor. Wide leg positions (external hip rotation with abduction) typically stretch more of the anterior pelvic floor, while closed knee positions (internal hip rotation with adduction) target the posterior pelvic floor.

The pelvic position also significantly impacts the pelvic floor. An arched back (spinal extension, anterior pelvic tilt) tends to stretch the anterior pelvic floor more, whereas a rounded back or tucked butt position (spinal flexion, posterior pelvic tilt) stretches the posterior pelvic floor more effectively.

During pregnancy, we often favor a more extended spine position (arched back), external hip rotation, and shifting weight towards the right side. This typically results in an overactive right side pelvic floor, a tighter posterior pelvic floor, and decreased space in the posterior pelvis. If the posterior pelvic floor is tight, it can decrease space in the posterior pelvis and push your baby forward. If your baby is pushed forward, they may not be able to apply pressure against the cervix (which could delay or prolong labor) and they may overlap the pubic bone making it harder for them to engage. If we can release this tension, it will create more space in the posterior pelvis to make room for baby for birth!

The exercises in this blog target these common positioning tendencies to release tension in these areas, making it easier for your baby to enter and navigate the pelvis for birth.

Pelvic Floor Birth Prep Exercises

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These exercises offload the right hip, so that pelvic floor half can release and let go, while stretching the left posterior pelvic floor that is shortened.

In each of these positions, you will inhale DOWN and OUT into the pelvic floor–you should feel the sitz bones spread apart as you inhale. Then for the exhale, you may want to contract to LIFT UP in the pelvic floor (for me, I find this allows me to release more) or you may want to exhale to let go and relax.

Watch this YouTube video for more of a breakdown on how to breathe, and then utilize this breathing pattern into each of the exercises listed below!

1) Side Lying Hip Shift with Manual Release

In the side-lying position, we are going to bring the hips into an asymmetrical position–opposite of what is common. Drive the RIGHT knee forward and left hip BACK.

Then you can reach around to grab under the sitz bone to pull upward as you inhale down and out. Feel the sitz bones spread apart as you do this movement.

In addition to an external release, you could insert a pelvic wand internally and massage the pelvic floor with the wand. We recommend working with a pelvic floor physical therapist if you want more guidance on how to use a pelvic wand for internal pelvic floor release.

2) 90/90 Side Body Opener

In the 90/90 side body opener, we are offloading the right hip to release the tension and stretching the right side body. Due to our common postural tendencies with the right hip oriented more backward in internal pelvic rotation (closed hip position) and the left hip oriented more forward in external pelvic rotation (open hip position), the right side body also tends to become compressed. This side body opener helps to release the tension in the side body/rib cage to improve breath to the pelvic floor!

In this position, press both knees into the ground as you sink into the side body. Inhale to feel the pelvis widen at the bottom, and exhale to lift up in the urethra or front half of your pelvic floor.

Went into spontaneous labor at 38 wks with baby #1 last night (born this morning) and was able to push through a very fast and intense labor (8 hrs active, 4 hrs of contractions with basically NO BREAK in between that got me from 1cm dilated to fully 😵‍💫) unmedicated! Pushed for an hr! I thank you both, your prenatal fitness program, and prepping pelvic floor fit birth for how much I rocked this delivery. THANK YOU!!!

I just wanted to leave a review for you, I took your prenatal bundle with the birth course, fitness app, and pelvic floor prep. I can't say enough good things about it, my only regret was not enrolling sooner! After having some nagging SI and pelvic pain, at 22 weeks I enrolled in your program and started the workouts on the app. After a few weeks,my pain was minimal except for the days I missed a workout or getting in movement. The birth course was very informative and I felt confident and excited about giving birth. While I did need to be induced at 39 weeks, I felt confident and understood my options. I had a great and speedy delivery with just a minor tear. I attribute this to the strategic movements I learned in the course throughout my labor and breathing during pushing, along with wonderful hospital staff. We were blessed with a healthy baby girl Ellie Jo. I look forward to using the fitness program again in the future and other courses you have! Thank you for all the time you put into creating such thorough content!

For what it's worth, I'm a PT myself (not a pelvic floor specialist), but am going to a PFPT. I also took a CEU course for my license and my own learning on pelvic floor health in pregnancy. With that background, I am utterly impressed with the content of your course so far. I was wondering if it'd be repetitive at all from the CEUs I recently took, but it hasn't been. It's so informative, thorough, and covers way more topics than I ever expected. Thank you!!

3) All Fours Hip Shift: Pelvic Tilts and Lifts

Hip-shifted positions orient the pelvis asymmetrically to stretch one half of the posterior pelvic floor more effectively. To offload the right side, place the left knee on a yoga block to shift your weight over. With your weight shifted to the left, start by arching and rounding your back to increase pelvis-femur mobility. After completing about 10 pelvic tilts, lift the right knee straight up and down, keeping the thighs fairly parallel to each other.

If you want more daily workouts to support a strong pregnancy as you prepare for birth, join our online prenatal fitness programs!

MamasteFit is unique in that we are one of the ONLY prenatal/postnatal training facilities in the United States. We develop our workout programs from our experience of working with in-person pre/postnatal fitness clients and work closely with physical therapists to refine our programming. In addition, we are birth workers, so we combine our experience as perinatal fitness trainers and birth professionals to ensure that our programs actually support your birth preparation and recovery!

Our prenatal fitness programs are offered in several formats:

40-Week Prenatal Strength Program in the Teambuildr App:
- This program is a self-paced workout with shorter demo videos. This is ideal if you like to workout in a gym setting and prefer a traditional workout delivery format.
- This program syncs to your current week of pregnancy, so you can start anytime, with one-time payment or month-to-month payment options.
- This program has a full and mini version, depending on how much time you have to dedicate to workouts!
Prenatal On-Demand Fitness Program:
- If you prefer to follow a video as you workout at the same time, this workout program will be the best option!
- This program syncs to your current trimester, so you can grab the trimesters you need!
Birth Prep Workout Program:
- If you already have a workout routine or you only want birth prep-focused workouts, check out this program!
- This program includes full-length workout videos to follow as you workout at the same time.
Prenatal Yoga Classes:
- If you want prenatal yoga, join our prenatal yoga program! This also syncs to your current trimester.

4) Half Lunge Hip Shift with Adductor Release

Next, we are moving more upright in a half lunge position. This position will be a static hold as you focus on shifting into the left leg and stretching the right upper groin.

The right adductor, especially upper groin, tends to be tighter than the left side. This can restrict movement of the right pelvis and impact your ability to create space in the pelvis for birth and release tension in the pelvic floor. Additionally, this tension could contribute towards a feeling of heaviness in the anterior pelvic floor.

Place a wedge under your right arch (you can also use a rolled-up towel). Then shift your weight towards the left knee as you rotate your belly towards that thigh. As you rotate, press into the right knee to keep it aligned to the right ankle to feel more of a groin stretch.

Instructor

GINA

Prepare Your Pelvic Floor for Birth

This course explore your pelvic floor anatomy, function, and how to prepare your pelvic floor for birth! This course includes educational videos, mobility exercises, relaxation drills, and how to relax your pelvic floor during labor tips.

5) Lateral Hip Shift with Adductor Release

Finally, we can stand up and add some movement to release tension in the pelvic floor. In the lateral hip shifts, you can use body weight or a light to medium weight.

In this movement, you will shift from leg to leg while alternating the rotation in your upper body. This will bring you into the posterior pelvic floor to stretch it and improve pelvic to hip movement to enhance pelvic mobility for birth.

Conclusion

Understanding the role of the pelvic floor and incorporating specific exercises into your birth preparation routine can significantly enhance your comfort and functionality during pregnancy and childbirth. By addressing common areas of tension and asymmetry, these targeted exercises help create more space in the pelvis, facilitating an easier passage for your baby. Moving beyond traditional exercises like Kegels and deep squats, the techniques discussed in this blog provide a comprehensive approach to releasing pelvic floor tension. By integrating these practices into your routine, you can better prepare your body for the demands of childbirth, promoting a smoother and more efficient birthing process.