Childbirth and the Pelvic Floor: Difference between revisions
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Introduction | == Introduction == | ||
The pelvic floor can be significantly impacted by birth<ref>Van Geelen H, Ostergard D, Sand P. A review of the impact of pregnancy and childbirth on pelvic floor function as assessed by objective measurement techniques. Int Urogynecol J. 2018;29(3):327-38.</ref> - so much so that pelvic floor dysfunction after birth is considered a major public health issue”.<ref>Burkhart R, Couchman K, Crowell K, Jeffries S, Monvillers S, Vilensky J. Pelvic floor dysfunction after childbirth: occupational impact and awareness of available treatment. OTJR (Thorofare N J). 2021;41(2):108-15. </ref> However, it is also important to remember that the pelvic floor plays a key role in childbirth and how the birth itself progresses.<ref name=":0">Afolabi I. Childbirth and the Pelvic Floor Course. Physioplus, 2022.</ref> | |||
NB: When discussing the “pelvic floor in birth”, we are referring not only to the pelvic floor muscles but to the entire [[Overview of Female Pelvic Floor Muscle Anatomy and Physiology#The Pelvic Floor|pelvic floor]], including the pelvic organs, ligaments, myofascia, muscles, nerves, etc. These structures all interact within the pelvic bowl (also known as the pelvic ring). | |||
This page explores specific ways to help maintain pelvic health during childbirth and to enhance it after birth. In particular, it discusses the five key priorities identified by Ibukun Afolabi<ref name=":0" /> for pelvic health in childbirth - the 5 “Ps”: | |||
# Proactive prevention | |||
# Pelvic biomechanics | |||
# Position | |||
# Pressure management | |||
# Perineal preservers | |||
== Proactive prevention == | |||
As mentioned, childbirth, whether it be vaginal or via caesarean, can adversely impact pelvic health. However, Afolabi<ref name=":0" /> asks the following questions: | |||
* Is the problem giving birth itself? | |||
* Is childbirth inherently problematic? | |||
* Could the problem be something else? | |||
Afolabi<ref name=":0" /> argues that giving birth in itself is not the problem. Instead, the problem lies with how women are primed, expected and instructed to give birth. And she believes that this can be improved when current knowledge is applied to the birthing context. | |||
== Pelvic biomechanics == | |||
[[Biomechanics and Dynamics of the Pelvic Girdle|Pelvic movements]] are generally described as rotations about one of three cardinal axes. Each rotation acts to create motion in one plane:<ref>Lewis CL, Laudicina NM, Khuu A, Loverro KL. [https://anatomypubs.onlinelibrary.wiley.com/doi/10.1002/ar.23552 The human pelvis: variation in structure and function during gait]. Anat Rec (Hoboken). 2017;300(4):633-42. </ref> | |||
* Rotation about a mediolateral axis causes motion in the sagittal plane often called anterior or posterior tilt | |||
* Rotation about an anteroposterior axis causes motion in the frontal plane - occurs when one side of the pelvis goes lower while the other goes high and is often called pelvic drop or hike | |||
* Rotation about a vertical axis causes motion in the transverse plane, called forward and backward rotation or anterior and posterior rotation. | |||
The following video explains the movements of the pelvis in detail. | |||
Pelvic movements can have a positive impact on labour. Maternal movement of the pelvis during birth enables babies to navigate through the pelvic inlet to the pelvic outlet - and to avoid any barriers. | |||
== References == | |||
[[Category:Physioplus Content]] | |||
[[Category:Course Pages]] | |||
[[Category:Womens Health]] | |||
[[Category:Pelvic Health]] | |||
Revision as of 01:31, 10 January 2022
Top Contributors - Jess Bell, Kim Jackson, Carin Hunter and Olajumoke Ogunleye
Introduction[edit | edit source]
The pelvic floor can be significantly impacted by birth[1] - so much so that pelvic floor dysfunction after birth is considered a major public health issue”.[2] However, it is also important to remember that the pelvic floor plays a key role in childbirth and how the birth itself progresses.[3]
NB: When discussing the “pelvic floor in birth”, we are referring not only to the pelvic floor muscles but to the entire pelvic floor, including the pelvic organs, ligaments, myofascia, muscles, nerves, etc. These structures all interact within the pelvic bowl (also known as the pelvic ring).
This page explores specific ways to help maintain pelvic health during childbirth and to enhance it after birth. In particular, it discusses the five key priorities identified by Ibukun Afolabi[3] for pelvic health in childbirth - the 5 “Ps”:
- Proactive prevention
- Pelvic biomechanics
- Position
- Pressure management
- Perineal preservers
Proactive prevention[edit | edit source]
As mentioned, childbirth, whether it be vaginal or via caesarean, can adversely impact pelvic health. However, Afolabi[3] asks the following questions:
- Is the problem giving birth itself?
- Is childbirth inherently problematic?
- Could the problem be something else?
Afolabi[3] argues that giving birth in itself is not the problem. Instead, the problem lies with how women are primed, expected and instructed to give birth. And she believes that this can be improved when current knowledge is applied to the birthing context.
Pelvic biomechanics[edit | edit source]
Pelvic movements are generally described as rotations about one of three cardinal axes. Each rotation acts to create motion in one plane:[4]
- Rotation about a mediolateral axis causes motion in the sagittal plane often called anterior or posterior tilt
- Rotation about an anteroposterior axis causes motion in the frontal plane - occurs when one side of the pelvis goes lower while the other goes high and is often called pelvic drop or hike
- Rotation about a vertical axis causes motion in the transverse plane, called forward and backward rotation or anterior and posterior rotation.
The following video explains the movements of the pelvis in detail.
Pelvic movements can have a positive impact on labour. Maternal movement of the pelvis during birth enables babies to navigate through the pelvic inlet to the pelvic outlet - and to avoid any barriers.
References[edit | edit source]
- ↑ Van Geelen H, Ostergard D, Sand P. A review of the impact of pregnancy and childbirth on pelvic floor function as assessed by objective measurement techniques. Int Urogynecol J. 2018;29(3):327-38.
- ↑ Burkhart R, Couchman K, Crowell K, Jeffries S, Monvillers S, Vilensky J. Pelvic floor dysfunction after childbirth: occupational impact and awareness of available treatment. OTJR (Thorofare N J). 2021;41(2):108-15.
- ↑ 3.0 3.1 3.2 3.3 Afolabi I. Childbirth and the Pelvic Floor Course. Physioplus, 2022.
- ↑ Lewis CL, Laudicina NM, Khuu A, Loverro KL. The human pelvis: variation in structure and function during gait. Anat Rec (Hoboken). 2017;300(4):633-42.
