Birth Preparation
Pregnancy, birth, and postpartum can bring a mix of excitement, uncertainty, and a lot of questions. Between social media, well-meaning family and friends, and conflicting advice, it’s easy to feel overwhelmed—or second-guess your choices.
Birth preparation physical therapy gives you trusted guidance, individualized support, and practical tools so you can feel confident in your body and your birth—whatever that looks like for you. Pelvic health physical therapists can support you throughout pregnancy to help you prepare for childbirth and reduce or prevent common musculoskeletal issues that can occur during and after birth.
Birth preparation physical therapy is a valuable asset to your prenatal care, offering direct support for prenatal concerns such as urinary leakage, constipation, pelvic pain, pain with intercourse, or abdominal separation while also establishing a functional foundation for a smoother labor and recovery.
At Nola Pelvic Health, we offer a four-session Pregnancy & Childbirth Prep package to help guide & support you throughout your pregnancy. These customized sessions provide comprehensive birth education while prioritizing your specific questions and personal goals for delivery. Designed for clients without significant symptoms, this package focuses on preventative wellness offering expert guidance and functional support to help you feel confident and physically prepared for both labor and your postpartum recovery.
Changes in the Pelvic Floor During Pregnancy
During pregnancy, your body goes through significant changes—especially in the pelvis and pelvic floor.
The pelvic floor is a group of muscles that span from the pubic bone to the tailbone and sit bone to sit bone. These muscles:
Support the bladder, uterus, and rectum
Help control bladder and bowel function
Play a role in sexual function
Contribute to pelvic and core stability
Facilitate the birthing process
As your uterus grows, it places increased load on the pelvic floor. This causes the pelvic floor muscles to naturally lengthen and adapt, which can impact strength, coordination, and support. Similar changes occur in the abdominal wall, which can contribute to postural control issues, diastasis recti (DRA), and changes in pressure management.
Hormonal shifts also cause ligaments in the pelvis to become more flexible, while the hips widen to accommodate pregnancy and birth. As a result, muscles must work harder to provide stability during walking, lifting, transitions, and daily movement. When these systems aren’t working efficiently, pelvic pain, back pain, or discomfort with daily activities can develop.
Birth prep physical therapy helps your body adapt to these changes while maintaining strength, mobility, and confidence in movement.
What Birth Prep Physical Therapy Looks Like
If you’re not experiencing symptoms—or symptoms are mild—the childbirth prep package (1 evaluation + 3 follow-up visits) is often sufficient. If symptoms are present, or you need more support, additional visits may be recommended to help you reach your goals or change outcomes effectively.
In physical therapy, we take time to understand you. We’ll discuss your pelvic health history, pregnancy experience, birth plan, and any changes you’ve noticed. We’ll also review bladder, bowel, sexual health, and movement concerns that may be relevant to your care.
If you are in your second or third trimester, we may perform an internal pelvic floor muscle assessment when appropriate and only with your consent. (Internal assessments are not performed during the first trimester.) This helps us understand pelvic floor muscle strength, coordination, tenderness/tension, and pushing strategy. We also assess abdominal, hip, and low back strength, and movement patterns externally.
What We Focus On in Birth Prep
Based on your individual findings and goals, sessions may include:
Pelvic floor awareness and coordination: Learning how to both engage and relax your pelvic floor—essential for pregnancy, labor, and pushing
Hands on therapy: Soft tissue and muscle release techniques to alleviate tension reduce discomfort, and restore the body to optimize function
Breathing and pressure management strategies: Techniques to protect your pelvic floor and abdominal wall and reduce the risk of issues like diastasis recti, prolapse, and leakage
Exercise Routine Modification or Development: Learn how to effectively and safely move throughout your pregnancy to get stronger & improve your mobility.
Movement and body mechanics: Learn safer, more comfortable ways to lift, carry, sleep, get in and out of bed, and stay active throughout pregnancy
Perineal Preparation: Education and hands-on guidance for perineal massage, tissue preparation, and strategies to reduce the risk of tearing during delivery
Labor and pushing techniques: Practice with breathing, & pushing in various positions for delivery—with or without an epidural—to support a more efficient and easeful birth
Early postpartum recovery: Learn tips and strategies to support pelvic floor and core recovery after delivery, and help you feel your best.
Preparing for Labor, Delivery, and Postpartum
As you approach the end of pregnancy, we tailor sessions to your birth preferences—whether you’re planning a home birth, birth center delivery, or hospital birth. We’ll review labor positions, pushing strategies, and comfort techniques aligned with your goals and medical needs.
We also discuss what to expect in the early postpartum period (weeks 1–6) and how to protect your pelvic floor during healing. We recommend returning for a postpartum pelvic floor assessment after your 6-week check-up to ensure recovery is progressing well and to support a safe return to activity.
Why Birth Prep Matters
Birth preparation physical therapy isn’t about controlling your birth—it’s about understanding your body, feeling prepared, and having tools you can trust.
You’ll leave sessions feeling:
More confident in your body
More comfortable with labor and pushing strategies
Better equipped to reduce the risk of pelvic floor injury and tearing
Supported in staying active and pain-free during pregnancy
If you want to feel good in your body and continue doing the activities you love—safely and confidently—birth prep physical therapy is a powerful option.