Why Preparing the Pelvic Floor for Birth Should Be Standard Care
By Dr. Allison Feldt, PT, DPT ··3 min read
As providers, we know that pregnancy and birth place tremendous stress on the female body. Yet many women still enter labor with little to no preparation of the muscles that will be most directly affected during delivery: the pelvic floor and core.
This lack of preparation often leads to complications that could be reduced or prevented with targeted interventions. It is time to start treating pelvic floor birth prep as a standard part of prenatal care, not an optional add-on.
The Reality Without Preparation
When patients attempt vaginal delivery without pelvic floor and core preparation, we often see:
Perineal tearing, both internal and external
Prolonged pushing phases, sometimes lasting hours
Pelvic organ prolapse, with bladder and rectal descent that often persists postpartum
Escalation to emergency C-sections
Increased use of interventions such as vacuum or forceps, which further traumatize the pelvic floor
These outcomes impact not only delivery but also a patient’s long-term health, quality of life, and future pregnancies.
Why Birth Prep Works
Patients who undergo structured pelvic floor preparation learn how to optimize muscle coordination and mobility before labor begins.
At Body Motion Physical Therapy, our clients have achieved a 90 percent vaginal delivery success rate and an average push time of 30 minutes, even among first-time moms. The difference is prevention-focused, pelvic-specific preparation.
The Gap in Current Care
Unfortunately, not all pelvic floor PT during pregnancy is created equal. Too often, patients are discharged once their back pain improves or are given only Kegel-based exercise prescriptions.
Here is what does not prepare patients for delivery:
Isolated Kegel training
Avoidance of internal pelvic floor work during pregnancy
Symptom-only treatment approaches without attention to pelvic floor mobility and stretching
Insurance models rarely cover prevention, which means many in-network providers are unable to offer true birth prep. This is a systemic gap in women’s healthcare.
A Different Approach
At Body Motion, we have developed and tested a birth preparation protocol that prioritizes:
Internal pelvic floor mobilization and stretching to reduce tearing and optimize tissue mobility
Core coordination training to improve pushing efficiency
Education and empowerment so patients understand their bodies before labor begins
These interventions produce measurable outcomes, from shortened push times to reduced trauma and faster postpartum recovery.
Why This Matters for Us as Providers
As a community of providers including PTs, OBs, midwives, and beyond, we have an opportunity to redefine how women experience birth. Prevention-focused care should not be reserved for the few who happen to find the right specialist.
By incorporating pelvic floor birth prep into standard prenatal pathways, we can:
Reduce birth-related trauma
Lower rates of unnecessary surgical intervention
Improve maternal recovery and long-term pelvic health outcomes
Our patients deserve more than reactive care. They deserve proactive preparation that empowers them to birth with confidence and minimizes preventable complications.
About the author
Dr. Allison Feldt, PT, DPT
Allison is a pelvic floor physical therapist and the founder of Body Motion PT in Edmonds. A mom who knows the aftermath of pregnancy and birth firsthand, she's on a mission to help women restore their core and pelvic floor at every stage of life.
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