I want to introduce you to what is arguably one of the most important, but most underrated muscle groups in your entire body. Meet your pelvic floor! You use it every time you use the bathroom, have an orgasm, and most significantly when you have a baby. But have you experienced its full potential? Do you know where it is located and everything it can do? Let's get better acquainted.

If you could look at the pelvic floor (PF), you would see an interconnected sheet of muscles positioned like a hammock and connected to your coccyx (tail bone) in the back and the pubis in the front. Like a hammock, the PF cradles your bladder, uterus, intestines, and colon, and is an active participant in bladder, bowel, and sexual function. Running down the middle of the PF are three orifices (or openings) that offer breaks in the muscle sheet. In women, these orifices are the urethra, vagina, and anus. (Men have a PF too, but only two orifices: the urethra and anus.) The PF forms two muscle rings in a figure eight around these orifices: one ring around the urethra/vagina area, the other around the anus. These muscular rings control the functions of these orifices. Like any muscle in your body, the more toned and strong the PF rings are, the more control you have over your urinary and rectal functions, and most importantly, vaginal power (yes, power!). Want to know how to tap that power? Let's learn some more of the amazing things a powerful PF can do.

The Pelvic Floor in Sex

While our society may prefer to think of female sexuality as passive and even downplay its importance, our sexual physiology is anything but passive. During sex, the PF muscles and vaginal tissues become engorged, increasing tightness coordinated with active contractions as the PF muscles grip the penis. A strong PF does for sex what olympic training does for an athlete! The beauty of PF exercises is that sex is one of the best times to practice them. You get instant feedback from your partner and they improve your own sexual response as your PF muscles become stronger. How many other exercise routines are this much fun?

The second trimester of pregnancy is a time of heightened sexuality for most women due to increased engorgement of pelvic tissues at this time. This is the perfect time to practice PF exercises during sex, barring any medical contraindications. It's great for preparing for birth (which of course is a very athletic event), and you and your partner will enjoy them.

In her book, Essential Exercises for Childbearing Years, Elizabeth Noble provides examples of what she calls “sexercises” for couples to try (highly recommended!) as well as further discussion on the sexual benefits of a strong PF, such as female ejaculation. She also points to the connection between female sexuality and the birth experience, as both are very sensual, spiritual experiences, with similar progression, contractions, and benefits from making sounds (discussed further below).

The Pelvic Floor in Childbirth

The ability of the PF to enhance our sexual experience is impressive enough, but the true potential of the PF (and the vagina!) shines in childbirth. Part of what makes birth so powerful, and sometimes frightening, is that part of labor every unmedicated laboring women experiences when there is a sense that their body is acting without them. It can be frightening to feel like you've lost control, but it's also very powerful when you surrender to the power you feel and work with it rather than trying to fight it. It's an amazing, primal, spiritual time that really cannot be adequately put into words.

Here is a glimpse of the physiology behind what is happening during labor and the role of the PF. During the second stage of labor and leading into the actual birth, Oxytocin is produced in abundance by the pituitary gland to stimulate contractions. The pituitary gland receives its cues from the PF. As the baby's head descends, pressure increases on the PF. This information is then relayed to the pituitary gland, signaling the need for more Oxytocin. The lower the baby descends, the higher the PF pressure, the stronger the feedback of Oxytocin, the more powerful the contractions, until finally the baby is born. But, as Noble points out, this “urge to push is a reflex that unites nerve sensation with hormone production—only if you have no anesthesia.” (1) Epidurals and other labor anesthetics interrupt the natural feedback loop between the PF nerve sensations and oxytocin production, which in turn can cause contractions to diminish.

One of the greatest concerns for first-time moms about giving birth is how something as large as a baby is going to fit through their vagina. Again, this is where the strength of the PF is of greatest benefit. First, it is important to understand the tremendous elasticity of the vagina itself. A really apt description I've heard repeatedly is comparing the vagina to the neck on a turtleneck sweater. It seems like your head would never be able to fit through, but the material is designed to stretch around your head as you pull it through, then pulling tight again around your neck. Much the same way, the vagina is designed to stretch well beyond what you might think, gradually, to accommodate the baby's head and body. While it might seem like the less toned, more slack PF would stretch out of the way of a descending baby better than a tight, toned one, the opposite is true. Dr. Kegel (yes, that Dr. Kegel!) described how a strong, powerful PF will easily stretch and move as the baby passes through, whereas a weaker one is thinner and is more likely to be stretched past its limits and possibly damaged. (2)

I will again point to Noble's book, Essential Exercises, at this point as she provides a beautiful description of how the PF transitions from a strong supportive muscle sheet in pregnancy to controlled stages of relaxing to allow the baby to be born. All of this is made possible, and easier, with a well-exercised, strong PF.

While not directly using the term “pelvic floor”, Ina May Gaskin talks extensively about what she calls Sphincter Law as it applies to all sphincters of the body, including those used in birth. (3) In Ina May's Guide to Childbirth, she discusses the power of the mind/body connection that can affect sphincter function, whether speeding up a bodily process or shutting it down completely. All of this applies to labor, as well, and makes sense on a primal, survival level. If we feel afraid or threatened, the natural relaxation of the PF, the cervix, and the vagina are interrupted. We're prepared to stop laboring and move to a safer place. If we can't move to a safer place, labor might just halt all together and require further interventions. This warrants a much deeper discussion than I will go into here, but it suffices to say there is a strong connection between our minds and our bodies that allows us a very active role in labor, even when we feel like we're not in control, that is better facilitated as we learn more about what how our bodies function in labor and what we are capable of doing.

The Postpartum Pelvic Floor

The importance of exercising the PF postpartum, and having a strong PF prior to having your baby, comes into play as you are healing (from birth and from any perineal tearing, including episiotomies) and your body is returning to its pre-pregnancy state. Since the PF is so important in providing physical support to all of your organs in the pelvis, it is vital that the PF shrink and tighten to prevent organs from sagging out of place. If it is strong going into pregnancy, it will recover more easily. Likewise, a weaker PF will be pushed to its limits and may require more work to provide adequate organ support. In Essential Exercises, Noble points out that starting PF exercises as soon as possible after birth, even within the first week, can help speed overall healing, prevent or lessen common PF dysfunctions that many women assume are part of having children (such as urinary incontinence, hemorrhoids, and impaired sexual response). She provides a number of exercises beyond the basic Kegels for all stages of pregnancy, but particularly for this critical recovery postpartum period. (1)

(4)

Conclusion

It's easy to take for granted the importance of having strong, active PF muscles, and it's easy to assume that some common dysfunctions “down below” are just part of who we are with no way of fixing them. Most of us get the “Kegels” discussion from our OB/GYN, but not much explanation about why it's important to exercise the pelvic floor. If we're honest, our culture is not comfortable talking about female organs, especially in terms of their power. We get a pretty sterile, static education about our organs, their basic functions, and a very passive approach to what they are “allowed” to do outside of what we know they can do physiologically. Birth is allowed to be medical and physiological, but not powerful or spiritual.

But you don't have to move too far past cultural propriety or embrace that much of your primal self to understand the importance of self-knowledge. Knowing not simply how our bodies work on the physiological level, but how that physiology is interwoven with our spiritual side, our sense of self-worth, that is where our true power lies. That is what makes birth so much more than a biological, or as some perceive it, a medical event. Making society comfortable with the female body starts with being comfortable with it ourselves, and creating and spreading knowledge without fear.

References

(1) Noble, Elizabeth. Essential Exercises for the Childbearing Year, 4^th Edition. Harwich: New Life Images, 1995.

(2) Kegel, Arnold. “Stress incontinence of urine in women: physiologic treatment”. J Int. Coll Surgeons 1956 (25) 487-99.

(3) Gaskin, Ina May. Ina May's Guide to Childbirth. New York: Bantam Books, 2003.

(4) McNeeley, S. Gene , MD. (2008, December). Pelvic Floor Disorders. Retrieved from http://www.merckmanuals.com/home/womens_health_issues/pelvic_floor_disorders/pelvic_floor_disorders.html

 I first encountered One World Birth on Facebook on August 30, right before they officially launched their site and filming project on September 1. I'm in the process of becoming certified as a Childbirth Educator with BirthWorks International, so I was instantly drawn to the One World Birth philosophy. As an educator in training, my passion is making knowledge about natural birth options (doulas, midwives, pelvic floor exercises, relaxation techniques, etc.) available to as many women as possible. Toni and Alex share this idea of universally available information, but on a global scale. Their vision is to provide information on all aspects of birth, from leading names among birth professionals around the world, in order to shine a spot light on the problems with birth in our current medical systems and promote awareness and informed choice in birth. 

 Heartburn is a common complaint during pregnancy. Often heartburn only surfaces during the third trimester but sometimes it can be an annoyance throughout pregnancy. Heartburn is felt in the throat, esophagus, chest, or top of the stomach. If you aren’t sure if you have had heartburn, you probably haven’t had it.

Why does heartburn plague women during pregnancy? Well, baby can push up against the stomach moving its contents back up the esophagus. This is helped along by hormones during pregnancy that are relaxing muscle and tissue. These hormones not only help the pelvis open up, but can also loosen your esophageal sphincter, the gatekeeper between your stomach and esophagus.Stomach contents can then flow back up and cause the uncomfortable sensation of heartburn.

If you would like more information on prenatal nutrition see forthcoming articles or email a Registered Dietitian at This email address is being protected from spambots. You need JavaScript enabled to view it. . 

Any position is safe while pregnant as long as both partners are comfortable, you and your partner are getting the pleasure wanted and both partners avoid putting pressure on the uterus, or weight on the woman's belly.

Experts say that women should avoid lying on their back or right side for long periods of time after four months into the pregnancy. Aside from that, finding positions that work for you and your partner can be fun, creative and innovative. Pillows and bedding can come in handy as well.

Here are some common, safe positions that are both pleasurable and comfortable, even in the third trimester.

Side By Side

This position allows for easier access than most, but penetration can be more difficult. Crossing your legs or bodies can allow easier access to the vagina and dry rubbing is also common in this position.

Using the Backdoor

This positon is good for g-spot stimulation and can be comfortable in the third trimester. This position can be done almost anywhere, bed, over a dresser or couch.

Edge of the Bed

You can lie on the bed bed on your side, or on your back at the edge of the bed and your partner can be off the bed, either on their knees or standing up.

Missionary

A safe position is always missionary as long as the partner is not putting pressure on the uterus or the belly, propping with pillows will make this position much more comfortable.

Missionary on the Edge

One variety of the missionary position, sometimes called Missionary on the Edge, will often work up until the beginning of the fifth month of pregnancy. For this position, the woman lays on her back at the foot of the bed with her knees bent. She should perch her feet at the edge of the mattress. The man either stands o kneels in front of her.

T-square

Another possible position for the first trimester is the T-square. In this position, the woman lies flat on her back, and the man lies perpendicular to her making the shape of a T-square.

Cowgirl

One of the best positions during pregnancy is the Woman on top position. Sometimes known as the Cowgirl, this position takes all of the pressure off of the woman’s abdomen, and also allows her to control the speed and the depth of thrusting.

Sitting Position

A sitting position can also be more comfortable during pregnancy. Here a man will sit on a chair or the edge of the bed. The woman straddles the man, either facing him or facing away from him.

The rear entry position or “doggy style” position, involves the woman being down on all fours. The man enters from behind, standing or kneeling behind the woman. The woman can use pillows to support her stomach and chest, especially during later pregnancy. A variation of this position, the “leap frog,” has the woman resting her arms and her head on the mattress.

Spooning Position

Both man and woman lie on their sides, with the man in the back, facing the woman’s back. This position is great in the third trimester as it keeps the weight off of the abdomen. However, keep penetration shallow, as deep penetration is sometimes uncomfortable later in pregnancy.

Source for some positions: http://www.thelaboroflove.com/articles/what-are-the-best-sexual-positions-during-pregnancy

Sometimes during pregnancy, women find they become short of breath or have difficulty breathing. This is a little scary but common as the baby is putting pressure on our diaphram leaving less room for our lungs to expand and this gets worse as the baby grows. There are many things you can do to calm yourself such as meditation, yoga, taking a walk, etc. This video is from Michelle Collins, a practicing midwife and teacher. She gives a great explanation on what causes breathing issues during pregnancy and ways to cope with it. (www.vanderbiltnursemidwives.org)

So I have Endometriosis...I have since I was 20 years old. It is believed that up to 25% of the female population in North America have it. It is not a nice diagnosis but something that is treatable. The hard part about it is that there are many differerent and conflicting ideas on it - how you get it, how to treat it and how it affects fertility. When I was diagnosed I found that many sources of information but once again it was conflicting information. I love this video because it explains what endometriosis is in terms any normal person can understand. I hope it helps you and I will continue to post information that will help anyone who does have it.

Jessica Alba, Jennifer Gardner, Gwen Stefani...these are just a few of the celebrities in this video. It shows pregnant celebrities sporting all types of fashion including evening and day wear. They simply look beautiful and show some really hot outfits that will look great this season!

 Finally pregnant women are shown for their sexy beautiful selves! This bra fitting guide is a must see to get those pregnant and postpartum hormones flying. Celebrate your gorgeous body with these sexy nursing bras.

 A film documenting the state of maternal care in America and showing the people that get hurt by the use of harmful procedures and drugs. The video warns of the extreme serious risks of the drug cytotec to induce labor which is still often used in major hospitals because it works better than pitocin and is extremely cheap. A major risk of being induced with cytotec is uterine rupture and mom and baby can both die, this happens far too often. The FDA says they have no way to stop hospitals from using this dangerous induction drug, even though the drug packaging clearly says "Not for use on pregnant women". Hospitals have been biting the bullet at times and settling for large payouts...that drug must be dirt cheap if one hospital can pay nearly 27 million in settlements. To make all this worse, the deaths are poorly documented with no real details of why mom and/or baby did not live. How can this improve when there are not proper records kept to facilitate accurate investigations? The drug  manufacturer, hospitals, and the FDA must believe profits are more important than moms and babies and no one will catch on. Mamas spread the word...this is not right and women need to know the risks of induction!!

This is such a cute video comparing midwives to a diner that delivers. Delivers it does with tons of great options for birthing women to stay comfortable, happy and healthy. This is a must watch if you find yourself wondering what a midwife does. It's also pretty funny with men asking if they can get in the tub. This will give you a chuckle...or a tear if you're postpartum. If you want a midwife for your pregnancy and birth, the group that brought us this video will help you at Where's My Midwife?