Preparing Pelvic Floor For Birth – What I would Do If I Was Pregnant Again For The First Time

Preparing for birth can feel overwhelming, especially with so much conflicting advice online. In this birth prep podcast episode, I wanted to share something a little more personal and reflective. If I could go back and experience pregnancy and birth again for the first time, what would I actually do differently now with all the knowledge and experience I have today 14 years later, as a pelvic floor physiotherapist and mum of three?

Over the years, I’ve worked with countless women through pregnancy, birth preparation, and postpartum recovery, and one thing has become very clear to me: there is no perfect birth. I am pro vaginal birth, pro elective caesarean, pro emergency caesarean. Most importantly, I am pro women feeling informed, supported, and positive about their birth experience.

Looking back, there are so many things I wish I had known during my own first pregnancy. At the time, pelvic floor conversations were not nearly as common as they are now. There were fewer resources, less education around postpartum recovery, and far less discussion about proactive pelvic floor support during pregnancy.

In this episode, I share the things I personally would prioritise if I was preparing for birth again today. Not from a place of fear or regret, but from a place of understanding how much better supported women can feel when they have the right information, preparation, and recovery support around them.

Of course, every woman’s body, pregnancy, and birth journey is completely unique, so this episode is not about telling anyone what they should or should not do. It is simply an honest reflection on what I would personally approach differently with the benefit of hindsight and the clinical experience I now have supporting women through both birth and postpartum recovery.

Considering Age When Preparing for Birth

One of the things I would think about more carefully now is age and how it may influence recovery.

This is not about creating fear or saying women should choose one type of birth over another based on age. It is simply about understanding that our bodies recover differently depending on a range of factors, including age, pelvic floor health, tissue strength, and overall physical condition.

If I was preparing for birth again today, I would want to understand my own body and recovery profile more clearly so I could make informed decisions alongside my healthcare team.

Genetics and Preparing for Birth

Another thing I would absolutely consider more carefully is family history and genetics.

I would speak more openly with the women in my family about their pregnancies, births, pelvic floor recovery, prolapse symptoms, or postpartum experiences.

Family history does not wholly determine your outcome, but it can provide valuable information that helps build a clearer picture of your own recovery considerations.

I often describe birth preparation as putting together puzzle pieces. There is rarely one single factor that determines how birth or recovery will go. It is usually a combination of things that help us better understand our body and our support needs.

Pelvic Floor Assessment to Help With Birth Prep

If there is one thing I strongly recommend now that I did not prioritise during my own first pregnancy, it would be having a pelvic floor assessment during pregnancy.

As a pelvic floor physiotherapist, I now see how valuable these assessments can be for both labour preparation and postpartum recovery planning.

To Assess for Overactive Pelvic Floor

I personally experienced symptoms of an overactive pelvic floor in my twenties, but I never really connected that to labour and birth preparation at the time.

Looking back, I absolutely would have wanted support understanding how my pelvic floor muscles were functioning during pregnancy.

An overactive pelvic floor can sometimes make it harder to properly relax during labour, which may impact birth progression and recovery.

To Assess Strength and Ability to Relax

Pelvic floor function is not just about strength.

Being able to properly relax the pelvic floor is equally important, especially during birth.

Some women unknowingly contract their pelvic floor when they think they are relaxing. A pelvic floor assessment can help identify this and provide guidance on muscle coordination, breathing, relaxation, and birth preparation techniques.

Gives a Baseline for Postnatal Recovery Goals

One of the biggest benefits of a pelvic floor assessment during pregnancy is having a baseline before birth.

This is something I now appreciate so much more clinically.

When I assess women during pregnancy, it gives me a much clearer understanding of what their postpartum recovery goals may realistically look like later on.

Without that baseline, it can sometimes be difficult to know whether postpartum weakness or symptoms are new or whether they reflect that individual’s normal pelvic floor function before birth.

Exercising Regularly During Pregnancy to Support Childbirth

If I was pregnant again for the first time, I would absolutely continue prioritising regular movement and exercise during pregnancy.

Not intense exercise.
Not pushing through pain.
Not “bouncing back.”

Just supportive, realistic movement that feels manageable and sustainable.

Exercise during pregnancy can support both childbirth and postpartum recovery, but I also completely understand how hard movement can feel when dealing with fatigue, nausea, pelvic girdle pain, or simply trying to get through daily life.

I experienced significant pelvic girdle pain myself during pregnancy, so I know firsthand how frustrating it can feel when your normal exercise routine suddenly becomes difficult.

Looking back, I would focus less on doing everything perfectly and more on finding gentle ways to consistently support my body throughout pregnancy.

Perineal Massage to Help Reduce Pelvic Floor Trauma

One thing I genuinely wish I had done during my first pregnancy is perineal massage.

At the time, the research simply was not as available or widely discussed as it is now.

We now have good evidence showing that perineal massage may help reduce the risk of severe tearing and episiotomies during first-time births.

If I was preparing for birth again today, it is absolutely something I would include in my birth preparation.

6 Week Postnatal Check Post Birth

I strongly believe every woman deserves a proper six-week postnatal assessment after birth.

Not just a quick medical clearance, but a genuine recovery check-in.

If I was pregnant again today, I would absolutely prioritise seeing a pelvic floor physio postpartum to assess:

• Pelvic floor recovery
• Abdominal separation
• Whole body strength
• Return to exercise readiness
• Recovery progress and rehab planning

Birth places enormous demands on the body, and women deserve support rebuilding and recovering afterwards.

Postnatal Rehab After Birth

Postnatal rehab is something I feel incredibly passionate about now, especially with the benefit of hindsight.

After my first baby, I honestly thought I had recovered well because I felt relatively okay physically.

I had stayed active during pregnancy, my birth was considered straightforward, and I assumed my body would naturally recover on its own.

But looking back, I now realise I did far too much too soon.

I went for longer walks than I should have.
I did not properly honour the early recovery phase.
And I developed prolapse symptoms that were fortunately temporary but incredibly confronting at the time.

Now, I believe postpartum rehab should be considered essential care, not optional care.

What I Wouldn’t Do If I Was Pregnant Again for the First Time

There are also several things I personally would avoid if I was preparing for birth again today.

Lots of Birth Prep Stretches

I would not spend excessive time doing aggressive “birth prep stretches” aimed at trying to widen the pelvis or force flexibility.

I have seen many women develop pelvic girdle pain from over-stretching during pregnancy.

We do not currently have strong evidence showing these types of stretches improve birth outcomes.

Instead, I believe the focus should be on pelvic floor relaxation, body awareness, and balanced movement support.

Ignore Pelvic Floor Until Postpartum

I also would not ignore my pelvic floor until after birth.

This is something I absolutely did during my first pregnancy because I simply did not fully understand how important proactive pelvic floor support could be.

Now, I know early awareness and preparation can make a huge difference in both birth experiences and postpartum recovery.

Put Exercise in the Too Hard Basket

Even when exercise feels difficult during pregnancy, I would not completely stop moving.

I now understand how valuable even gentle exercise can be for pelvic floor support, mental wellbeing, circulation, strength, and postpartum recovery.

What I Wish I Would Have Changed With the Benefit of Hindsight

Looking back now, there are several things I genuinely wish I had done differently during my own pregnancies and postpartum experiences.

I Didn’t Do Perineal Massage or Properly Learn About Birth

I did the standard hospital birth classes, but honestly, I did not truly understand the physiology of labour or what was happening during transition.

When labour intensified, I completely panicked because I did not understand the process.

Looking back, I wish I had done more education around birth itself and possibly explored hypnobirthing or other birth preparation courses.

I Would Have Considered Having an Epidural Earlier

This may surprise some people, but I would absolutely have been more open to having an epidural earlier during my first and second births.

Emerging research suggests epidurals may potentially support pelvic floor relaxation in some situations because they reduce guarding, tension, and muscle tightening during labour.

My third birth experience with an epidural felt completely different and significantly calmer for me personally.

I Would Have Given My Pelvic Floor More Attention During Postpartum Rehab

Most importantly, I wish I had truly respected the postpartum recovery phase more carefully.

I felt good.
I thought I had recovered.
And because of that, I pushed myself far too quickly.

I did not properly honour that six-week postpartum recovery window, and looking back, I now understand how important that phase truly is for long-term pelvic floor recovery and healing.

Final Thoughts

If there is one thing I hope women take away from this birth prep podcast episode, it is this:

There is no perfect birth.
There is no single right approach.
And there is absolutely no shame in needing support.

Whether you have a vaginal birth, elective caesarean, or emergency caesarean, what matters most is feeling informed, supported, and cared for throughout the process.

And if I could go back and do pregnancy again for the first time, that is exactly what I would focus on most.

** This podcast has general information only. Always seek the guidance of your doctor or other qualified health professional with any questions or concerns you may have regarding your health or medical condition. 

Links

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