How Pelvic Floor Therapy Prepares You for an Easier Birth

When we think about pregnancy, we spend nine months nurturing our growing baby—tracking development, preparing nurseries, attending appointments. But all too often, there’s one essential piece we overlook: how the baby is actually going to come out.

At District Physical Therapy, we believe that childbirth preparation should go beyond nursery colors and birth plans. We focus on one of the most powerful, often misunderstood, tools in a birthing person’s body: the pelvic floor.

The Pelvic Doorway: Understanding the Role of the Pelvic Floor in Labor

The pelvic floor isn’t just about preventing leakage or bouncing back postpartum. It plays a critical role in the mechanics of birth. During labor, especially in the second stage (when you’re pushing), your baby’s head needs to descend through the pelvic canal and exit through the “pelvic doorway.” That doorway is made up, in part, by your levator ani muscles—a group of muscles that lift and support the pelvic organs.

But here’s the surprising part: not all pelvic floors cooperate under pressure. During birth, what should ideally be a parasympathetic, calm, and opening process can become dominated by the sympathetic nervous system, leading to tension, resistance and difficulty relaxing the pelvic floor.

What Happens When the Pelvic Floor Doesn’t Relax?

A review published in the American Journal of Obstetrics & Gynecology (AJOG) (March 2024) sheds light on a phenomenon called levator ani coactivation. This occurs when, instead of relaxing during pushing, a person’s pelvic floor contracts involuntarily. This reduces the space in the birth canal (particularly the anteroposterior diameter of the levator hiatus), making it harder for the baby to descend.

In other words, the muscles can unintentionally work against the natural process of birth.

This issue can lead to:

• A higher fetal head station (baby doesn’t descend as easily)

• A longer second stage of labor

• Increased need for interventions like vacuum, forceps, or C-sections

How District PT Can Help

At District PT, we are trained to teach your body what relaxation during labor actually feels like. We don’t just talk about it—we help you experience it. Using gentle manual techniques, breathing strategies, and movement-based awareness, we help you:

• Recognize what it feels like when your baby’s head is descending and putting pressure on the pelvic floor

• Learn how to breathe through the sensation and allow the muscles to lengthen and yield

• Practice positions and cues that facilitate optimal muscle coordination, especially during pushing

This is where our work goes far beyond Kegels. Strengthening is one piece—but so is letting go.

Birth is Not Just About Power—It’s About Permission

Our approach centers on giving your body the permission to release—to soften, open, and trust that the muscles designed to support your organs and posture can also make way for new life. So if you’re preparing for birth, consider pelvic floor physical therapy not just as recovery, but as preparation. Think of it as training for the most incredible athletic feat your body will ever perform.

Let’s make sure your pelvic floor isn’t standing in the way—it’s paving the way.

Want to learn more or book a prenatal pelvic floor evaluation?

Schedule online by visiting District PT or call us at 703-261-4062.

Let’s get you ready—not just for the baby, but for the moment you meet them.