Women's Health Physiotherapy During Pregnancy: Why it’s important

By Senior Physiotherapist, Megan Parkyn-Schneider

Introduction 

Pregnancy brings remarkable changes to a woman's body. While these changes support the growth and development of a baby, they can also place increased demands on the musculoskeletal, pelvic floor, cardiovascular, and respiratory systems. 

Women's health physiotherapy provides targeted assessment, education, and exercise prescription to help women stay active, manage common pregnancy-related symptoms, and prepare for birth and recovery. Increasing evidence supports the role of physiotherapy as part of antenatal care to improve comfort, function, confidence, and overall wellbeing throughout pregnancy. 

 

Why Women's Health Physiotherapy Matters 

  • Supports physical and emotional wellbeing during pregnancy 

  • Helps prevent and manage pregnancy-related pain 

  • Promotes safe physical activity 

  • Optimises pelvic floor health 

  • Assists preparation for labour and birth 

  • May improve postnatal recovery 

The goal is not simply to treat symptoms, but to help women remain active, confident, and informed throughout pregnancy. 

 

Benefit 1: Reducing Pregnancy-Related Back and Pelvic Girdle Pain 

Low back pain and pelvic girdle pain affect a substantial proportion of pregnant women and can significantly impact daily activities, sleep, work participation, and quality of life. 

Current research demonstrates that: 

  • Individualised exercise programmes reduce pain and disability 

  • Manual therapy and movement-based interventions may improve function 

  • Education regarding posture, load management, and activity modification is beneficial 

  • Early intervention may reduce symptom progression 

Clinically Relevant Statistics 

  • Approximately 50-70% of pregnant women experience low back or pelvic girdle pain during pregnancy. 

  • Exercise-based interventions are consistently recommended in international clinical guidelines. 

Physiotherapy Strategies 

  • Strengthening exercises 

  • Mobility exercises 

  • Pelvic support advice 

  • Activity modification 

  • Functional movement retraining 

  • Manual therapy when appropriate 

 

Benefit 2: Supporting Pelvic Floor Health 

Pregnancy increases load on the pelvic floor muscles, which can contribute to: 

  • Urinary incontinence 

  • Pelvic organ prolapse risk 

  • Reduced pelvic floor function 

High-quality evidence supports supervised pelvic floor muscle training during pregnancy. 

Key Findings 

Women who perform structured pelvic floor muscle training during pregnancy are: 

  • Less likely to experience urinary incontinence during pregnancy 

  • Less likely to experience urinary incontinence after birth 

  • More aware of pelvic floor function and recovery needs 

Physiotherapy Strategies 

  • Pelvic floor assessment 

  • Individual exercise prescription 

  • Breathing coordination training 

  • Education regarding safe exercise and pressure management 

 

Benefit 3: Encouraging Safe Exercise During Pregnancy 

National and international guidelines emphasise that regular physical activity during uncomplicated pregnancies is safe and beneficial. 

Research shows that appropriately prescribed exercise can: 

  • Improve cardiovascular fitness 

  • Reduce excessive gestational weight gain 

  • Improve mood 

  • Reduce fatigue 

  • Improve physical function 

Emerging evidence also suggests that antenatal exercise may reduce the likelihood of some pregnancy complications in selected populations. 

Physiotherapy Strategies 

  • Individual exercise screening 

  • Strength training guidance 

  • Pregnancy-specific exercise modification 

  • Return-to-exercise planning 

  • Monitoring for warning signs that require medical review 

 

Benefit 4: Improving Core and Breathing Function 

Pregnancy affects: 

  • Abdominal wall function 

  • Rib cage mechanics 

  • Breathing patterns 

  • Pressure regulation within the trunk 

Women's health physiotherapists help women understand how changing anatomy can influence movement, exercise, and symptom development. 

Physiotherapy Strategies 

  • Diaphragmatic breathing training 

  • Core muscle education 

  • Pressure-management techniques 

  • Functional strengthening 

Potential Benefits 

  • Improved movement efficiency 

  • Reduced discomfort during exercise 

  • Better preparation for labour and recovery 

 

Benefit 5: Preparing for Labour and Birth 

While physiotherapy cannot guarantee a specific birth outcome, education and physical preparation can increase confidence and improve self-management. 

Women's health physiotherapists commonly provide education regarding: 

  • Labour positions 

  • Breathing techniques 

  • Perineal massage 

  • Relaxation techniques 

  • Pelvic mobility 

  • Pushing mechanics 

Benefits for Expectant Mothers 

  • Increased confidence 

  • Reduced fear surrounding labour 

  • Greater understanding of birth options 

  • Better preparation for physical demands of childbirth 

 

Benefit 6: Supporting Mental Wellbeing 

Physical activity and education during pregnancy are associated with improved psychological wellbeing. 

Research suggests exercise may: 

  • Reduce stress 

  • Improve mood 

  • Improve energy levels 

  • Support overall quality of life 

For many women, physiotherapy provides reassurance and confidence when navigating bodily changes throughout pregnancy. 

 

Benefit 7: Setting the Foundation for Postnatal Recovery 

One of the greatest advantages of antenatal physiotherapy is that it helps to establish habits and set the groundwork before delivery. 

Women who engage in physiotherapy during pregnancy often leave with: 

  • Pelvic floor awareness 

  • Exercise knowledge 

  • Recovery expectations 

  • Strategies to manage common postnatal challenges 

Potential Long-Term Benefits 

  • Earlier recognition of symptoms 

  • Improved recovery confidence 

  • Safer return to exercise 

  • Ongoing pelvic floor management 

 

Myth vs Fact  

Myth: 

"I should avoid exercise during pregnancy." 

Fact: 

For most uncomplicated pregnancies, regular exercise is safe and strongly recommended. 

Myth: 

"Urinary leakage during pregnancy is normal and cannot be helped." 

Fact: 

Although common, urinary leakage is not something women simply need to accept. Pelvic floor muscle training has strong evidence for prevention and management. 

Myth: 

"Women's health physiotherapy is only needed after birth." 

Fact: 

Physiotherapy can play a valuable role throughout pregnancy, helping prevent and manage symptoms before they become more significant. 

 

Conclusion 

Women's health physiotherapy is an evidence-based component of modern antenatal care. Through targeted assessment, education, exercise prescription, and pelvic floor training, physiotherapists help women manage pregnancy-related symptoms, remain active, prepare for labour, and support recovery after birth. 

The latest research continues to reinforce a simple message: proactive care during pregnancy can improve comfort, confidence, and function, benefiting both maternal health and long-term wellbeing. If you are currently pregnant you can book in with one of our women’s health physiotherapists to start your prenatal care.  

References  

American College of Obstetricians and Gynecologists. (2020). Physical activity and exercise during pregnancy and the postpartum period(Committee Opinion No. 804). Obstetrics & Gynecology, 135(4), e178-e188. https://doi.org/10.1097/AOG.0000000000003772 

Davenport, M. H., Ruchat, S. M., Poitras, V. J., Garcia, A. J., Gray, C. E., Barrowman, N., Skow, R. J., Meah, V. L., Riske, L., Sobierajski, F., James, M., Kathol, A. J., Nuspl, M., Marchand, A. A., Nagpal, T. S., Slater, L. G., Weeks, A., Adamo, K. B., Davies, G. A., & Mottola, M. F. (2018). Prenatal exercise for the prevention of gestational diabetes mellitus and hypertensive disorders of pregnancy: A systematic review and meta-analysis. British Journal of Sports Medicine, 52(21), 1367-1375. https://doi.org/10.1136/bjsports-2018-099355 

Davenport, M. H., McCurdy, A. P., Mottola, M. F., Skow, R. J., Meah, V. L., Poitras, V. J., Gray, C. E., Garcia, A. J., Barrowman, N., Riske, L., Sobierajski, F., James, M., Kathol, A. J., Nuspl, M., Marchand, A. A., Nagpal, T. S., Slater, L. G., Weeks, A., Davies, G. A., & Adamo, K. B. (2019). Impact of prenatal exercise on both prenatal and postnatal anxiety and depressive symptoms: A systematic review and meta-analysis. British Journal of Sports Medicine, 52(21), 1376-1385. https://doi.org/10.1136/bjsports-2018-099697 

Hay-Smith, E. J. C., Herderschee, R., Dumoulin, C., & Herbison, G. P. (2011). Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women. Cochrane Database of Systematic Reviews, (12), Article CD009508. https://doi.org/10.1002/14651858.CD009508.pub2 

Mottola, M. F., Davenport, M. H., Ruchat, S. M., Davies, G. A., Poitras, V. J., Gray, C. E., Garcia, A. J., Barrowman, N., Adamo, K. B., Duggan, M., Barakat, R., Chilibeck, P. D., Fleming, K., Forte, M., Korolnek, J., Nagpal, T. S., Slater, L. G., Stirling, D., Zehr, L., & No. 367 Consensus Guideline Committee. (2018). 2019 Canadian guideline for physical activity throughout pregnancy. British Journal of Sports Medicine, 52(21), 1339-1346. https://doi.org/10.1136/bjsports-2018-100056 

Thompson, E. L., Vamos, C. A., & Daley, E. M. (2020). Physical activity during pregnancy and the role of healthcare providers. Obstetrics and Gynecology Clinics of North America, 47(3), 543-557. https://doi.org/10.1016/j.ogc.2020.05.008 

Woodley, S. J., Lawrenson, P., Boyle, R., Cody, J. D., Mørkved, S., Hay-Smith, E. J. C., & Dean, S. G. (2020). Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews, 2020(5), Article CD007471. https://doi.org/10.1002/14651858.CD007471.pub4 

World Health Organization. (2020). WHO guidelines on physical activity and sedentary behaviour. World Health Organization. https://www.who.int/publications/i/item/9789240015128 

 

Stuart McKayComment