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Pivotal Performance

Nicole Muriel is an Occupational Therapist who specializes in pelvic floor preventive care and treatments. The Pelvic Floor is something important that every woman who has given birth, needs to know about. Your stomach and pelvic floor muscles do not heal themselves, so they will need extra attention in the first year of postpartum. This includes both vaginal and cesarean deliveries. Studies have shown that pregnancy can affect urinary incontinence for many women regardless of their mode of delivery. Unfortunately, many women are either too embarrassed to discuss their pelvic floor dysfunction or do not know they even have a pelvic floor issue.

What is my Pelvic Floor?

The pelvic floor is a group of muscles in the floor of your pelvic area which has very complex duties. The pelvic floor is what holds in and releases urine and fecal matter at the appropriate times. This sheath of muscles supports the organs in the pelvis and some even form a sling around the rectum and vagina. Think of the pelvic floor like a bowl that holds your sexual and digestive organs together.

If you suffer from any of these following conditions, we can help you!

During pregnancy there are outward and obvious signs that the body is changing. However, changes are also occurring which are less obvious to us like your pelvic floor muscles, the nerves and soft tissues that support them.

In some cases, women can experience issues with urinary incontinence (leakage of urine), overactive bladder, painful intercourse, or organ prolapse where the bladder, uterine, or rectum can slip into the vaginal canal.

These conditions can occur right away or some years later. Most women are taught to believe this is a natural part of pregnancy, but this is not true at all. Having any pelvic floor issue can have devastating impacts on a women's quality of life and mental health if not tended to.

While every woman will have a unique pregnancy, labor, and delivery; there are some things that women can do to help prevent pelvic floor injuries.

1. Pelvic Floor Exercises

Research supports the importance of pelvic floor exercises during pregnancy and early postpartum to help decrease the risk of pelvic floor injury.

Pelvic Tilt: Start in the supine position with your knees bent and your feet flat. Tilt your hips slowly towards your feet and then tilt your hips back, pressing your lower back into the mat. (FYI Pelvic Tilts are my absolute favorite)

Other pelvic and core exercises that can be done are:

  • Bridges

  • Squats

  • Split tabletops

  • Bird dogs

2. Modifying Obstetric Practices

The promotion of more spontaneous vaginal births without forced or early pushing, avoiding the use of instruments during delivery unless medically necessary, or avoiding an episiotomy.

Warm compresses to the perineum and perineal massage with a lubricant during delivery could also help. Perineal massage may potentially reduce perineal damage by increasing vasodilation to the area, tissue stretching, increasing muscle relaxation.

3. Adjusting Delivery Position

The traditional position of delivery is lying on your back with legs in stirrups, upright. However, many side lying birthing positions have been found to be more beneficial. As with any recommendation consult with your OB/GYN or Midwife first.

Pelvic floor therapy is not only beneficial but can be crucial for some women. Benefits from establishing good pelvic floor health can include increasing your ability to have a great sex life. Yes! I said it…. having a healthy pelvic floor can help a woman to achieve good orgasms.

For more information about pelvic floor health, visit Nicole Muriel at or email her at

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