Anyone who runs antenatal classes knows well the dynamics that come into play in a pregnant woman when, finally free from work commitments, she feels the need to nest. She therefore begins a frantic search for a childbirth preparation course, often using proximity, convenience, or the fact that it is organized at the hospital where she plans to give birth as her main criteria. Generally, what a woman expects from the content of the course are the classic concerns of every mother to be: information on labor, birth, pain, timing, breastfeeding, and caring for the baby. The perineum, a perfect stranger, does not make it onto the list of things she feels she needs to know…

The discovery that the key to a good birth experience depends on the harmonious, yielding opening of the pelvic muscles takes expectant mothers by surprise, and adds a great deal of meaning to the work of midwives. That's why, for a long time now, the goals of my antenatal classes have been twofold: to nurture the inner bond with the baby, and to support a gentle passage through the mother's body. To begin with, it's important to give these muscles a simple, recognizable name, so calling them «the birth muscles» makes things much easier. The next step is to locate them, giving them boundaries and a geography, with mountains, valleys, plains, inner and outer areas…

To continue building this understanding, we can talk about their functions: their capacity to produce a movement of welcoming and expulsion, of protection and trust, of closing or opening, of softness or firmness. As well as their capacity to widen spaces or narrow them, to hold deep emotions, and to come into harmony with breath and voice. The final step calls for the woman to let go of her fears, and to entrust herself to the forces of nature which, rich in ancient wisdom, will guide her body toward readiness for the birth of her child.

Working on the pelvic muscles during pregnancy is important and useful for several reasons:

  • Pregnancy places a series of demands on the continence system and the muscles that support the organs, caused by the progressive increase in the volume and weight of the uterus and the baby
  • During pregnancy, the body's center of gravity shifts due to changes in weight and shape; as a result, many muscles and ligaments have to work harder to keep the body upright
  • Since every shift away from the ideal center of gravity changes the distribution of body weight, the resulting alteration in the relationships between the different structures of the musculoskeletal system also affects their function
  • The increased curvature of the upper back and the accentuated lower back curve cause, on one hand, a shift in the intra-abdominal pressure vector, which comes to bear mainly on the front part of the pelvic floor (the area of least resistance), and on the other hand, a situation that is deeply unfavorable to the pelvic and perineal muscles' ability to contract and/or relax (anterior tilt of the pelvis)
  • Changes in posture can cause biomechanical dysfunctions in the lumbar, sacroiliac, and pubococcygeal joints. When these joints have a limited range of motion, the distribution of body weight becomes unbalanced, causing a change in pressure on those same joints and, as a result, in the tension of the perineal, fascial, and tendon soft tissues
  • More generally, these same changes can cause pain along the spine, lower back pain, sciatica, joint pain, constipation, diarrhea, incontinence, and muscle tension.