What is the pelvic floor and perineum?

Your pelvic floor lies across the bottom of your pelvis and is made up of muscles, ligaments and tissue.

The perineum is part of the pelvic floor. In females, it is the area of tissue between the opening of the vagina and the anus. It is typically between 2 and 5 centimetres long.

Your pelvic floor muscles are also part of your pelvic floor.

What does the pelvic floor do?

Your pelvic floor supports the organs of your pelvis, which includes your:

• bladder
• uterus
• bowel

You use your pelvic floor muscles to help control your bladder and bowel.

What can happen to my pelvic floor during pregnancy?

Your pelvic floor and pelvic floor muscles can become weak or damaged during pregnancy. This can sometimes lead to incontinence (problems controlling your wee and/or poo) during pregnancy.

Incontinence can range from a small leak to a complete loss of control of your bladder or bowel. Sometimes incontinence and bladder weakness continue after the birth.

See your doctor if you have problems controlling your bowel or bladder. They may refer you to a specialist physiotherapist for assessment and a customised pelvic floor exercise program.

What happens to my pelvic floor during childbirth?

During a vaginal birth:

• your perineum stretches to make room for your baby
• your pelvic floor muscles can help deliver your baby

What problems can affect my perineum and pelvic floor during childbirth?

During a vaginal birth, it is possible for your perineum to tear. Often these tears are not serious and will heal naturally.

Your midwife or doctor may offer you a warm compress to place on your perineum when it starts to stretch during childbirth. This can help reduce your risk of having a severe tear.

More serious tears will sometimes occur and can affect your pelvic floor muscles or the muscles around your anus. This can make your recovery more difficult.

In some situations your doctor or midwife may ask you if they can make a cut to your perineum during childbirth. This is called an episiotomy and is used to make the opening of your vagina wider. This gives your baby more space to emerge.

If your doctor or midwife recommends an episiotomy to prevent a serious tear to your perineum, they will explain the procedure. Your consent is needed before the procedure is done.

Your midwife will guide you on how best to recover from a perineal tear or cut.

Can I help prepare my pelvic floor for pregnancy and childbirth?

There are ways to help prepare your pelvic floor for pregnancy and childbirth. These can help prevent problems afterwards.

Pelvic floor muscle exercises

You can exercise your pelvic floor muscles to improve their strength. You can do these exercises before you get pregnant, during and after pregnancy.

In fact, it’s recommended that all people exercise their pelvic floor muscles every day to improve their strength.

Perineal massage

Perineal massage may help stretch your perineum and reduce your risk of tears during childbirth.

Perineal massage is usually started at around week 35 of pregnancy in women planning a vaginal birth. It’s continued right up until the birth. Talk to your doctor or midwife about how to do perineal massage if you would like to use this technique.