Prenatal Pelvic Floor Physical Therapy

Get the prenatal PT support you deserve for strengthening your body during family planning, pregnancy, labor, and delivery preparation.

Receive treatment for pelvic pain, leaking urine during pregnancy, bladder prolapse during pregnancy, signs of prolapse during pregnancy, pelvic floor “weakness,” pain with sex during pregnancy, and more.

At Bodyful, we offer individualized, evidence-based, and unique pelvic floor exercises for pregnancy, including guidance for urine leakage during pregnancy (including third trimester), lower back pain during pregnancy (including first trimester), and upper stomach pain during pregnancy (including second trimester) when these symptoms are related to the pelvic floor or core support movement system.

Prenatal PT

Prenatal pelvic floor therapy may be beneficial for low-risk pregnancies, including first-time pregnancies. Many pregnant people seek care for concerns like prolapse during pregnancy, leaking pee during pregnancy, or uncertainty about when to start pelvic floor therapy during pregnancy.

A 2020 meta-analysis states:
“About one‐third of women have urinary incontinence and up to one‐tenth have fecal incontinence after childbirth.” (Woodley et al., 2020)

Perineal massage by a pelvic PT, both during pregnancy and during the second stage of labor, is effective in reducing perineal injury (decreased risk of episiotomy and tearing).

Pelvic floor muscle training helps treat signs of prolapse during pregnancy and can be an important part of managing pelvic pressure or bladder prolapse during pregnancy. Signs of prolapse during pregnancy blog.

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When to Start Prenatal PT?
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prenatal pelvic floor therapy Oakland ca

When To Start Prenatal PT?

“When to start pelvic floor exercises during pregnancy?”

The Woodley et al. (2020) review “provides evidence that early, structured pelvic floor muscle training in early pregnancy for continent women may prevent the onset of urinary incontinence in late pregnancy and postpartum.”

You can start as soon as you are ready — it is never too early or too late to learn how to coordinate your pelvic floor muscles with your movement system. Early care can also support people already experiencing leaking pee during pregnancy, prolapse symptoms, or pelvic pain.

Top 5 prenatal pelvic floor exercises

Prenatal Pelvic Floor Exercises

Why is pelvic floor muscle training recommended during pregnancy?

Trained pelvic muscles might be less vulnerable to injury, and a history of prenatal pelvic floor exercises may improve the postpartum rehabilitation process. You can reduce your future risk of urinary incontinence by treating urinary incontinence during pregnancy. (Hage-Fransen MAH et al., 2021)

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  • Is prenatal internal pelvic floor therapy safe?

    Pelvic floor internal therapy and pelvic floor exercises during pregnancy are generally safe after the first trimester for most people seeking prenatal pelvic floor physical therapy, including those experiencing leaking pee during pregnancy, signs of prolapse during pregnancy, or preparing for labor. However, pelvic PT and exercise should be avoided if you have any of the following:

    High blood pressure or pre-eclampsia

    Uterine contractions

    Vaginal bleeding

    Uncontrolled dizziness

    Throbbing headaches

    Shortness of breath unrelated to normal pregnancy changes

    Numbness or tingling

    A diagnosis of incompetent cervix

    Placenta previa

    Severe anemia

    Decreased fetal movement during exercise

    Chest pains

    Amniotic fluid leakage

    If you have questions about whether pregnancy pelvic floor PT is appropriate for your specific symptoms—such as bladder prolapse during pregnancy, urine leakage during the third trimester, pain with sex during pregnancy, or abdominal or back discomfort—we can help you determine the safest approach.

    Internal pelvic therapy explained

  • Do I need a prescription from my MD/OBGYN?

    If your OBGYN or midwife has cleared you for sexual intercourse and exercise, then pelvic floor therapy is completely safe. You can work with a PT up to 45 days without a referral, and after that time we just need your MD to sign the plan of care.

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  • When can I do perineal massage?

    Perineal massage is encouraged by 35 weeks gestation. We can train you how to practice at home, during an in-person visit or during a virtual pelvic floor therapy visit.

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  • What is perineal massage?

    Perineal massage is more than just stretching “tight” muscles. It is a nervous-system–supported practice that trains your brain to yield as your pelvic floor stretches under increasing pressure. This is especially helpful during pregnancy for those preparing for labor, experiencing pelvic floor tension, or navigating symptoms like pain with sex during pregnancy.

    Practice perineal massage with continuous breath support so any reflexive pelvic floor muscle tightening is reduced. This improved coordination and relaxation response can support labor prep and may help prevent tearing during birth.

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pregnancy pelvic floor exercises Oakland CA

How To Relax Pelvic Floor Muscles For Birth?

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If you are looking for prenatal pelvic physical therapy to prepare for labor and delivery, pelvic floor muscle training is a great place to start. You will get feedback about how your pelvic floor responds to cues to push, hold, cough, relax, and how it adapts to different labor positions.

“Pelvic floor muscle training during pregnancy proves to be an effective preventive intervention for reducing the risk of urinary incontinence and the occurrence of third- or fourth-degree perineal tears.” (Zhang D et al., 2023)

Prenatal pelvic floor muscle training “might be effective at shortening the first and second stage of labor” in the first-time pregnant person. (Du, 2015)

What About Perineal Massage To Reduce Tearing?

“Pelvic floor muscle training and perineal massage improved childbirth-related parameters and pelvic floor symptoms.” (Schreiner, 2018)

If this is your first pregnancy, there is strong evidence that supports the use of perineal massage during pregnancy — and during the second stage of labor — to reduce perineal injury. (Yin et al., 2024)

Training your pelvic floor muscles during pregnancy to relax and stretch may also improve pelvic floor function and reduce the risk of fecal incontinence, flatus incontinence, and urinary incontinence postpartum.

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If you are experiencing pelvic pain, bladder prolapse during pregnancy, leaking urine during pregnancy, pain with sex during pregnancy, pain after sex while pregnant, or any symptoms that feel new or confusing, please contact us.

The longer you experience pain, the more challenging it can be to rewire your brain’s relationship to your symptoms, and it may be harder to change your pain prognosis in the future.

Join Dr. Maryssa for gentle approaches to somatic movement therapy.

If you are unable to visit us in person, we offer Online Pelvic Physical Therapy to California residents.

Join Dr. Charette for Reformer Pilates pregnancy modifications!