What does a pelvic floor and deep core assessment involve?

Your pelvic floor can be assessed via an internal vaginal examination or using an ultrasound machine.

If you opt for an ultrasound assessment, the probe is placed over the lower tummy or over the perineum (the area between the vaginal and the anus).

An internal vaginal examination is a more thorough form of pelvic floor assessment. During an internal exam we assess your pelvic floor tone, strength, endurance, and speed. We also check if your pelvic floor is turning on automatically when you cough or exert effort.

Your deep core assessment is done using the ultrasound machine. During this assessment you will be able to see on the display monitor the three layers of your abdominal wall; rectus abdominis, obliques and transverse abdominis (also known as your deep core). When we cue a gentle deep core contraction you will be able to see this deepest layer slide and fatten. Similar to a corset tightening around your back.

Our patients often describe their deep core assessment as a ‘light bulb’ moment; they finally understand what it is, why it’s important and how to turn it on.

What is abdominal muscle separation?

Abdominal separation occurs in more than 50-80% of pregnant women.

Abdominal separation refers to the thinning and widening of the linea alba. The linea alba is the connective tissue that connects the left and right abdominal muscles. It’s important to know that a degree of abdominal separation is required during pregnancy (especially in the 3rd trimester) to create space for your growing baby.

However, if abdominal separation is excessive this can place too much stretch on your linea alba and can affect the integrity of your abdominal wall.

Your linea alba is similar to your ankle ligaments. To walk on an uneven surface, your ankle must permit some side-to-side movement. Your ankle ligaments stretch to permit this. The same principle applies to your linea alba. It should stretch to create room for your baby. If we use the analogy of rolling your ankle, the strain placed on the ligaments can become too great, resulting in ligament injury.

If your ankle is not properly treated, the ligaments may become floppy, reducing the support to your ankle. The same can be said when it comes to excessive abdominal separation. If your abdominal muscles widen too much, your linea alba can become thin and floppy. This effects the way your abdominal wall functions and can result in reduced support to your spine and pelvis, leading to pain and dysfunction.

During your pre-natal assessment we educate you on how to best prevent and/or treat excessive abdominal separation.

What is labour preparation?

Labour preparation involves one or more physiotherapy sessions. During these sessions, we educate you and provide you with some great evidence-based tools and resources. This will empower and prepare you for your delivery.

Your labour preparation involves:

Education on ideal labour and birth positions

Breathing and pelvic floor relaxation techniques

Pelvic floor and perineal stretching techniques (taught to you and/or your partner)

+/- Pelvic floor internal release & stretching (performed by your pelvic health physiotherapist)

Why is labour preparation important?

There is a high level of evidence to support labour preparation. Labour preparation has been shown to improve your overall birth experience, reduce the length of the active pushing stage of labour and reduce the severity of perineal tearing.

The research shows that 90% of women experience tearing during their first vaginal delivery and 75% with subsequent deliveries. The degree of tearing can vary from mild (graze to the skin), moderate (tear to the skin and pelvic muscles), to severe (tear to the skin, pelvic muscles and anal sphincters).

Given the high incidence of tearing, reducing the risk through appropriate labour preparation is vital.

What does a labour preparation appointment involve?

Our physio Jacinta answers all your labour prep appointment questions here.