Pregnancy & the Pelvic Floor: Part 1 What Is the Pelvic Floor, and Why Should You Care?
Written by Kelsie Mazur, DPT
When you hear the words “pelvic floor”, what's the first thing that comes to mind? If you're like most people, it's probably pregnancy, postpartum, or maybe someone joking about peeing when they sneeze. While those topics definitely matter, the pelvic floor is so much more than that.
Here's the thing: you don't have to be pregnant, have ever been pregnant, or even have pelvic floor dysfunction to benefit from understanding your pelvic floor. If you have a pelvis (which, spoiler alert, you do), then you have a pelvic floor.
Just like your shoulders, hips, or biceps, your pelvic floor is simply another group of muscles. It plays a huge role in how your body moves, supports you throughout the day, and responds to exercise. Whether you're lifting weights, running, chasing your kids around, or simply getting up from a chair, your pelvic floor is along for the ride.
What Actually Is the Pelvic Floor?
The pelvic floor isn't one magical muscle hidden somewhere deep inside your body. It's actually a group of muscles, ligaments, and connective tissue that form a supportive "hammock" at the bottom of your pelvis. These muscles stretch from your pubic bone in the front to your tailbone in the back and from one sitting bone to the other. I like to think of the pelvic floor as part of your body's core team. It works alongside your diaphragm, deep abdominal muscles, and back muscles to manage pressure, stabilize your trunk, and support your pelvic organs.
What Does the Pelvic Floor Actually Do?
Turns out... quite a bit.
Your pelvic floor:
Supports your bladder, bowel, and uterus (if you have one)
Helps you control when you pee or have a bowel movement
Plays an important role in sexual function
Works with your core every time you lift, run, cough, laugh, sneeze, or exercise
Helps manage pressure inside your abdomen throughout the day
One of the biggest misconceptions I hear is that the pelvic floor just needs to be strong.
Not exactly.
Think about your bicep. If I asked you to hold a dumbbell all day long without ever relaxing your arm, eventually that muscle would become tired, stiff, and probably pretty unhappy. Your pelvic floor is no different.
A healthy pelvic floor doesn't just contract; it also knows how to relax, lengthen, and coordinate with the rest of your body. Strength is only one piece of the puzzle.
So Why Does This Matter During Pregnancy?
Another common misconception is that the pelvic floor suddenly becomes important when labor starts. In reality, your pelvic floor has been preparing for birth for months before you ever step foot into the delivery room. From the very beginning of pregnancy, your body starts changing. Hormones begin preparing your muscles and connective tissues for childbirth, your posture gradually changes, your breathing mechanics shift, and your center of gravity slowly moves forward.
Then comes the growing baby.
As your baby, placenta, uterus, and amniotic fluid grow, they place progressively more demand on the pelvic floor. Imagine carrying a backpack that slowly gets heavier every single week—but you never get to take it off. Your muscles don't suddenly fail one day; they continuously adapt to meet the increasing demand. And the pelvic floor doesn't get to stop doing its normal job while all of this is happening.
It still has to support your pelvic organs.
It still has to help control your bladder and bowels.
It still has to work with your core every time you stand up, squat down, pick up your toddler, laugh at a funny joke, cough, sneeze, or head to the gym.
Pregnancy hormones (including relaxin, progesterone, and estrogen) also change how your muscles and connective tissues behave. While these changes are incredibly important for preparing your body for delivery, they also mean your pelvic floor has to work differently to provide stability and support.
As your abdomen expands, your diaphragm has less room to move downward with each breath. Your abdominal muscles lengthen, your posture adapts, and the pressure inside your abdomen changes. Since your diaphragm, abdominal wall, and pelvic floor all function as a team, changes to one affect the others.
This is exactly why pregnancy isn't about having the "strongest" pelvic floor. It's about having a pelvic floor that's adaptable. One that can contract when you need support, relax when you need to empty your bladder or bowels, lengthen as your body changes, and eventually stretch to accommodate childbirth. By the time labor begins, your pelvic floor has already spent months adapting to changing loads, shifting pressure, hormonal changes, and new movement patterns.
Understanding these changes is empowering. It helps explain why certain symptoms can pop up during pregnancy, why not every symptom is "just part of being pregnant," and why pelvic floor training is about so much more than simply doing Kegels.
Over the next few weeks, we'll break down what happens to the pelvic floor during each trimester, bust some common myths, talk about which symptoms are normal (and which deserve a conversation with your healthcare provider), and discuss practical ways to keep your body moving confidently throughout pregnancy.
Let’s chat! Book an assessment and let’s get you back to feeling good in your body.
No referrals, no waiting, just answers. Did you know that we offer free 1-on-1 injury screens? Wattage Physical Therapy will take an in depth look at your ergonomics, posture, muscle tone, muscle weaknesses, and movement patterns to create a plan for YOU. If this article intrigues you, you can directly email me, Kelsie at Kelsie@wattagept.com. I would be happy to help you start the process of living a life free from pain.