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Protecting Your Pelvic Floor

How Much Do You Know About This Part of Your Anatomy?

By Jacqueline Rupp

9. d. Because many of these interventions have a higher degree of pelvic floor damage associated with them it is best to try to keep your birth as simple as possible. Work with your health care provider or doula to develop a birth plan that's right for you.

"Many healthy women experience interventions that were developed to address specific problems and are now used liberally or routinely," says Dr. Sakala. "Many women do not 'require' these common interventions, but nearly all end up with some or many of them. If a woman uses epidural analgesia, for example, many other co-interventions are used routinely (e.g., electronic fetal monitoring, IV drips) or are more likely (e.g., bladder catheter, assisted delivery with vacuum or forceps) because there is now a need to monitor, prevent or treat side effects associated with epidurals."

10. b. Labor doesn't have to be a hurried affair. As long as mother and baby are well and there is no immediate danger, labor and delivery should progress naturally. "Women often experience great pressure to move labor along, as evident with liberal use of synthetic oxytocin to 'stimulate' labor, staff-directed pushing and other practices," says Dr. Sakala. "Unless there is a specific concern and clear sense that the baby needs to be born quickly (such as with a prolapsed cord or ominous fetal heart signs), the pressure may be due to a hurried mentality on the part of the staff."

A slow delivery allows the perineal tissues to stretch, which can avoid tears and pelvic damage. "Insist on pushing in upright or side-lying positions according to the natural urges, which may or may not begin at full cervical dilation," advises Goer. "Refuse vaginal instrumental delivery based on arbitrary time limits for making progress. Give birth with your legs no more than comfortably apart, and when the baby's head is ready to be born, think in terms of 'breathing' or easing out the baby's head rather than pushing it out, preferably between contractions."

Want to see more?

• Birth Positions: How the Right Position Can Prevent an Episiotomy
• Powerful Pushing: New Method Promises Safer, More Efficient Delivery
• Pregnancy Nutrition From A to Z: A Comprehensive List of Nutrition Issues for Moms-to-be
• The Grand Tour: A Quick Trip Through the Labor and Delivery Room
• Pelvic Power: The Benefits of Kegel Exercises for Pregnancy and the Rest of Your Life
• Talk about it!