Powerful Abdominals: Improved Birth Outcomes and Recovery
New Pregnancy research
Powerful Abdominals improve your birth and postpartum recovery!
The Pelvic Studio is passionate about providing evidence based holistic patient care from bump to bub and beyond. For those who are planning a vaginal delivery, we have some interesting new research!
A recent study by Qian et al. looked at abdominal muscle and uterine electrical activity during labour and found that those who had more powerful abdominal muscles (in particular rectus abdominis) had better vaginal birth outcomes.
Your rectus abdominis is a powerful muscle that flexes your trunk, such as when you crunch and sit-up to get out of bed. Rectus strength is very important especially in the pregnant and postnatal populations. This is because the rectus supports the linea alba (the central ligament to which the left and right abdominal muscles insert into). A strong rectus in pregnancy and postpartum ensures a great anchor point for the other abdominal muscles to work from and may help to prevent things like prolonged abdominal separation postnatally.
A quick anatomy refresher:
The first layer or outer most layer of the abdominal wall is the rectus abdominis (also known as your ‘six-pack’ muscle). Your rectus is a powerful muscle that flexes your trunk, such as when you crunch and sit-up to get out of bed
This study particularly highlighted that a strong rectus abdominus correlated with a shorter pushing stage.
It is well documented that a shorter pushing stage:
Reduces the incidence of an assisted delivery with a vacuum or forceps and Emergency Caesarean section
Reduces the risk of severe perineal and pelvic floor tearing and,
Reduces the incidence of long term pelvic floor issues such as bladder and bowel leakage and pelvic organ prolapse.
What is the ideal duration of pushing?
In an ideal world your active second stage of labour (duration of pushing) sits between 20 minutes and an hour! A "long" pushing stage is considered pushing for more than 90mins. Anything that shortens your pushing stage is highly beneficial to you and your pelvic floor!
In Summary..
Essentially, it's important to work on abdominal strength and endurance during your pregnancy so that you can push on urge more effectively. Pushing effectively may mean that your bub enters the world more efficiently and you can avoid "prolonged pushing" and the detrimental effects it can have on your pelvic floor.
What does this evidence look like in practice?
At The Pelvic Studio our prenatal care focuses on maintaining general whole-body fitness throughout your entire pregnancy, especially keeping you strong through your abdominal wall.
At your initial pregnancy appointment, we assess your abdominal wall function in its entirety. This includes assessing your linea alba, outer core and inner core muscles. Check out our blog The Pelvic Studio Blog: Tummy Muscle Separation in Pregnancy) for more information.
After your abdominal assessment your physio will provide more tailored advice regarding abdominal exercise in pregnancy. Given this new recent evidence, it's important to incorporate rectus abdominis (6-pack muscle) into your exercise regime, in a pregnancy friendly way!
Abdominal exercises are a staple in our prenatal classes. Class attendees also receive weekly home exercises, providing you with a repertoire of pregnancy-friendly exercises to do at home. We highly recommend all our pregnant patients attend our prenatal classes to give you a structured helping hand on how to navigate your fitness during your pregnancy journey.
Let's not forget about the pelvic floor!
It would be remiss of us not to discuss the role of the pelvic floor in regard to birth outcomes.
We've discussed the importance of pushing power to shorten your pushing stage. Another factor to consider is your pelvic floor. For bub to enter this world efficiently, your pelvic floor needs to be able to relax and get out the way! So, as part of your prenatal care, we not only assess your abdominal wall but also your pelvic floor.
Following your 20-week scan, if appropriate, your pelvic floor physio will assess your pelvic floor, checking your ability to contract and RELAX it. We also assess the flexibility/distensibility of your pelvic floor. We can assess this by taking a measurement from mid-urethra to mid-anus at rest and then, if appropriate, with gentle pushing. These measurements can objectively let you know where you’re at, and if there is anything we need to do to optimise your pelvic floor flexibility in preparation for birth.
During this assessment, we are also assessing how well you push and coach you on your pushing technique. From research we know that 1 in 3 women don't push correctly and actually contract their pelvic floor when pushing. For effective pushing you need to be able to relax your pelvic floor when you push.
Pelvic Floor Physiotherapy can be a useful tool to provide feedback on your pushing technique and find specific cues that help you best relax your pelvic floor when you push.
All this is to say, that whilst strong abdominals are important for efficient pushing, they’re not much good to you if your pelvic floor is resisting bub can passing through the birth canal!
Get in contact – we are here to help!
It’s important to take a holistic approach to assessing and optimising your body and mind for labour and birth. If you’re currently pregnant, and are looking for evidenced-based care, you can book an Initial Pregnancy Assessment via our website, or by emailing info@thepelvicstudio.com or calling our reception team on 03 6224 7195.
Not planning a vaginal delivery? We have PLENTY of evidence-based management to prepare for a Caesarean Delivery too!