Prenatal Pelvic Care: Supporting Your Body Through Pregnancy and Birth
Guest post by: Rachel Daof, Pelvic Floor Therapist at the pelvic model PT in highland Park, CA
Pregnancy brings a lot of changes to your body, your movement, and how you feel day to day. While your OB or midwife monitors baby’s health, pelvic floor physical therapy focuses on you, helping you move comfortably, feel more connected to your body, and prepare for birth and postpartum recovery.
At The Pelvic Model, we specialize in prenatal care that supports the physical demands of pregnancy. Whether you're dealing with pain or simply want to prepare your body for birth, here's how pelvic floor therapy can help.
Who Should See a Pelvic Floor Physical Therapist During Pregnancy?
Pelvic floor therapy during pregnancy is especially helpful for people who:
Are experiencing pelvic pain, pressure, or discomfort in the back, hips, or pubic area
Have symptoms like leaking urine, heaviness, or feeling unstable during movement
Have a history of painful periods, endometriosis, constipation, or pelvic floor tension
Are noticing changes in posture, breathing, or core control as pregnancy progresses
Plan to have a vaginal birth and want to learn how to release the pelvic floor and push effectively
Are preparing for a planned cesarean and want to support core and scar recovery
Have had a prior birth injury, tear, or difficult recovery and want to approach this pregnancy differently
Simply want to understand how their body is adapting and prepare proactively for labor and postpartum
You don’t need a referral or a diagnosis — if you’re pregnant and want your body to function as well as possible through birth and beyond, pelvic PT can help.
What Happens During a Prenatal Pelvic Floor Evaluation?
Pelvic Model treatment room
Every person’s body is different. During our first session, we take time to understand how your body is adapting to pregnancy and identify any tension, instability, or movement patterns that may affect your comfort or birth experience.
Here’s an idea of what we are evaluating and topics we offer education around:
1. Muscle Tightness vs. Strength
Muscles generate the most power when they’re at an optimal length — not too tight, and not too loose. This is called the length-tension relationship. If a muscle is too short (tight), it loses its ability to contract fully. If it’s too long (stretched out), it can’t generate force either.
In the pelvic floor, this means that a muscle that feels “tight” may actually be weaker, because it’s stuck in a shortened position and can’t function well. That’s why simply doing Kegels doesn’t work for everyone. Some people need to release and lengthen their pelvic muscles before they can strengthen them.
We assess where your muscles fall on this spectrum so we can target exactly what your body needs to feel strong, supported, and ready for birth.
2. Core and Pelvic Floor Coordination
When we say “core,” we’re not just talking about your abs — we’re talking about an entire system that includes your diaphragm, pelvic floor muscles (PFMs), abdominal wall, and deep back stabilizers. These muscles work together to support your spine, manage pressure, and stabilize your body through movement. During pregnancy, this system has to adapt to a growing belly, postural changes, and shifting pressure from the inside out.
At The Pelvic Model, we focus on prehab, preparing your core system before delivery, so that recovery is smoother later. This means helping you:
Build awareness of how your diaphragm, pelvic floor, and abs work together
Improve motor control so your body can respond to movement, pressure, and breath naturally and improve diastasis recti
Learn how to breathe in a way that lengthens and relaxes your pelvic floor, an essential skill for labor and delivery
Strengthen your core in a safe, functional way that adapts with your changing body
When your body knows how to coordinate these systems before birth, it’s easier to reconnect postpartum. It can also help reduce symptoms like leaking, heaviness, or instability as you move through pregnancy.
3. Screening for Aches and Pains
Pregnancy naturally changes how your body moves. As your posture shifts, joints loosen, and your center of gravity changes, it’s common to feel new discomfort — in your back, pelvis, hips, or ribs. At your evaluation, we take a full-body approach to understanding why those aches are happening, rather than just treating the spot that hurts.
We look at how your muscles and joints are working together: are certain areas too tight while others are underworking? Is one side of your body compensating for the other? Are you moving in a way that’s creating strain without realizing it? These patterns show up in how you walk, how you stand, how you lift — even how you breathe.
By assessing how your body is managing pressure and movement during everyday activities, we can figure out what’s contributing to the discomfort. Then we guide you through gentle hands-on work and specific exercises to reduce the strain and restore better balance across your whole system — so your body can move and support you more comfortably as pregnancy progresses.
4. Pushing Mechanics
How you push matters for the birth and for how your body feels afterwards. During labor, there are generally two types of pushing patterns: open-glottis and closed-glottis. At The Pelvic Model, we help you understand the difference so you can find the style that feels more intuitive, effective, and safe for your body.
Open-glottis pushing means exhaling as you bear down, like blowing out through a straw or releasing a strong breath with effort. It helps coordinate your diaphragm and pelvic floor, keeps pressure more evenly distributed through your body, and allows for more gradual, controlled descent of the baby. This approach often aligns with your body’s natural urge to push and can be helpful in conserving energy during longer pushing stages. It’s also gentler on the pelvic floor and may reduce the risk of tearing.
Closed-glottis pushing involves holding your breath and bearing down — similar to performing a Valsalva maneuver. This method can create more immediate intra-abdominal pressure and is sometimes encouraged in more directed pushing scenarios. It may be effective when a strong, sustained push is needed — but when overused or poorly coordinated, it can increase pressure on the pelvic floor and lead to more fatigue.
We don’t teach just one “right” way. Instead, we guide you in practicing both types so you can recognize what your body responds to best. The goal is to give you the tools to push with your body — not against it — in whatever birth setting you're in. Building this awareness prenatally can help you feel more confident and in control during labor, whether you're guided to push or following your body’s natural signals.
5. Perineal Prep
As the body prepares for delivery, the tissues around the vaginal opening — the perineum — need to be able to stretch and release. But not everyone has good awareness or control of this area, especially if there’s tension, fear, or unfamiliarity. During prenatal visits, we work on helping you connect to the pelvic floor in a way that supports relaxation, not just strength.
This may include breathwork, body awareness exercises, and pelvic floor lengthening techniques to help reduce unconscious clenching and improve mobility in the muscles that surround the vaginal opening. If appropriate, we may also guide you or your partner in how to begin perineal massage later in pregnancy — always with consent and clear education.
The goal isn’t to “stretch” the perineum ahead of time, but to build awareness, mobility, and comfort with sensation — so you’re more able to soften and release during labor and birth.
Final Thoughts
Prenatal pelvic care is about more than just managing symptoms — it’s about supporting how your body moves, breathes, and adapts during pregnancy. By addressing things like muscle balance, core coordination, pelvic alignment, and birth prep, we help lay the foundation for a smoother labor and postpartum recovery. This kind of care works best as part of a team approach — one that includes your doula, your provider, and your own body’s wisdom.
If you’re curious whether pelvic floor therapy might be a good fit during pregnancy, we’d love to connect.
You can learn more at thepelvicmodel.com to see how we our team can support you in pregnancy and postpartum.
Want to hear more me on this topic—check out this podcast from Healthfit Huddle.
