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Anatomy of pregnancy and birth - perineum and pelvic floor

Key facts

  • Your pelvic floor lies across the bottom of your pelvis.
  • It is made up of muscles, ligaments and tissue that supports your bladder, uterus and bowel.
  • Your perineum is part of your pelvic floor and is the section of tissue between the opening of your vagina and anus.
  • It's possible for your pelvic floor to become weak or damaged during pregnancy and childbirth.
  • You can prepare your pelvic floor for pregnancy and childbirth by doing pelvic floor exercises or perineal massage.

    • What is the pelvic floor and perineum?

    Your pelvic floor lies across the bottom of your pelvis. It includes a group of muscles (Opens in new tab), called the levator ani muscles, as well as connective tissue.

    Your levator ani are broad muscles that are made up of 3 pairs, with one of each pair on each side of your pelvis. They are important for supporting your bladder (Opens in new tab), bowel (Opens in new tab) and uterus.

    Your perineum is below your pelvic floor. In females, it is the area of tissue between the opening of your vagina and anus.

    Illustration showing the pelvic floor muscles and perineum.

    Illustration showing the pelvic floor muscles and perineum.

    What does the pelvic floor do?

    Your pelvic floor:

    What can happen to my pelvic floor during pregnancy and childbirth?

    During pregnancy and childbirth, your pelvic floor can become weak, stretched, strained or damaged.

    Damage to your pelvic floor can sometimes lead to urinary or bowel incontinence (problems controlling your wee and/or poo) during and after your pregnancy. Incontinence can range from a small leak to a complete loss of control of your bladder or bowel. This can affect your mental health and wellbeing.

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

    Your doctor may also assess your mental health to check if you need support.

    To find a physiotherapist, doctor or maternal, child and family health service near you, use the Pregnancy Birth and Baby Service Finder tool.

    FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

    What can happen to my perineum during childbirth?

    During a vaginal birth, as your perineum stretches, it can 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 severe tears can affect your pelvic floor muscles or the muscles around your anus. This can make your recovery more difficult.

    Episiotomy

    In some situations your doctor or midwife may ask you if they can make a cut in 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 come out.

    If your doctor or midwife recommends an episiotomy, they will explain the procedure. Your consent is needed (Opens in new tab) before the procedure is done.

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

    Read more about birth injuries.

    Read about shared decision making and understanding informed consent and your rights when having a baby.

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

    You can help prepare your pelvic floor and perineum for pregnancy and childbirth by doing muscle training or massaging your perineum. 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, all people are recommended to exercise their pelvic floor muscles every day to improve their strength.

    Ask your physiotherapist for advice about which exercises are right for you.

    Perineal massage

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

    If you are planning a vaginal birth, you can start perineal massage at around week 34 of your pregnancy. It's continued right up until the birth.

    Speak with your doctor or midwife for guidance if you would like to start doing perineal massage.

    Safety tip

    Perineal massage is not suitable if you have:

    Resources and support

    Aboriginal and/or Torres Strait Islander peoples

    Sexually and gender-diverse families

    Speak to a maternal child health nurse

    Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 (Opens in new tab) or video call. Available 7am to midnight (AET), 7 days a week.

    Last reviewed: November 2024

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