Pelvic Floor

Subject: Midwifery I (Theory)

Overview

The pelvic floor is a muscular diaphragm that separates his pelvic cavity above from the perineal space below. It is formed by the levator ani and coccygeus muscles and is covered by parietal fascia.The levator ani muscles on either side arise from the posterior side of the symphysis pubis. It is thus a composite muscle constituted by the pubococcygeus and iliococcygeus parts together with the ischioccygeus fibers arising from the ischial spine. The most important of these is the strong diaphragm of muscle slugs like a hammock from the wall of the pelvis through which the urethra, vagina, and anal canal pass. The main function of the pelvic floor is it supports a weight of abdominal and pelvic organs and also responsible for voluntary control of micturition and defecation and play an important part in sexual intercourse.During labor, we can prevent injury by explaining mother about breathing exercise during labor i.e. when to pant and push.Control of the fetal head during the second stage of labor is very important to prevent an excessive tear of the perineum.Care must be taken while delivering shoulder otherwise, a tear can happen, therefore wait for the rotation of the shoulders. Deliver the anterior shoulder first then the posterior shoulder.

Pelvic floor

The pelvic floor is a muscular diaphragm that divides the pelvic cavity from the perineal region. The levator ani and coccygeus muscles compose it, and the parietal fascia covers it.

The levator ani muscles on either side emerge from the symphysis pubis's posterior side. It is therefore a composite muscle made up of the pubococcygeus and iliococcygeus portions, as well as ischioccygeus fibers originating from the ischial spine. The most essential of them is the powerful diaphragm of muscular fibers that hangs like a hammock from the pelvic wall and allows the urethra, vagina, and anal canal to pass through.

 

Functions

  • The weight of the abdominal and pelvic organs is supported by the pelvic floor.
  • Its muscles are in charge of voluntary regulation of micturition and feces, as well as playing a crucial role in sexual intercourse.
  • It regulates the passive motions of the fetus through the birth canal and relaxes to facilitate its departure from the pelvis during delivery.

Prevention of injury

  • Educate the woman on the importance of breathing exercises during labor, such as when to pant and push.
  • The mother should not push too soon (before the cervix has fully dilated); instead, she should be encouraged and requested to push and pant at the appropriate moment. She should be requested to impact especially as the head is crowning, which should occur at the end of a contraction.
  • Explain to her the need of deep breathing and panting, as well as the dangers of pushing too quickly.
  • Controlling the fetal head during the second stage of labor is critical to preventing severe perineum tear.
  • Slow extension should be used to deliver the head.
  • Care must be given when delivering the shoulder; otherwise, a tear may occur; thus, wait for the rotation of the shoulders. Deliver the anterior shoulder first, followed by the posterior shoulder.

Pelvic floor exercise

If you try to halt the flow of pee when you go to the toilet, you may feel your pelvic floor muscles. However, it is not suggested that you halt your urine flow midway on a frequent basis since it can be detrimental to the bladder.

Sit comfortably and squeeze your pelvic floor muscles 10 to 15 times in a row to strengthen them. Hold your breath and do not tense your stomach, buttock, or thigh muscles at the same moment.

When you're comfortable practicing pelvic floor exercises, consider holding each squeeze for a few seconds. You can add additional squeezes each week, but be careful not to overdo it and always relax between squeeze sets.

After a few months, you should begin to see benefits. Your incontinence should improve, as should your sensitivity during sex. Even if you realize that the exercises are starting to work, you should keep practicing them.

 

 

REFERENCE

Tuitui R., suwal, S.N. 2001, Human anatomy and physiology, first edition, Makalu Books and stationers, Putalisadak, Kathmandu

Tuladhar K., Shrestha U., Henk C., 1992, Integrated science, First Edition, HLMC

Pathak T., 2057, A handbook of Anatomy and Physiology, 3rd edition, Vidhyarthi Pustak Bhandar, Bhotahiti, Kathmandu

Chaudhari B.D., 1996, Handbook of General anatomy, 3rd edition CBS Publisher and distributors

Tuitui R. 2002, A textbook of Midwifery A (Antenatal), 3rd edition, Vidyarthi Pustak Bhandari (Publisher and Distributor), Bhotahity, Kathmandu

Chaudhari B.D., 1998, Human Anatomy (Vol. 1, 2, 3), 3rd edition CBS Publisher and distributors
Things to remember
  • The pelvic floor is a muscular diaphragm that divides the pelvic cavity from the perineal region.
  • The levator ani and coccygeus muscles compose it, and the parietal fascia covers it.
  • The levator ani muscles on either side emerge from the symphysis pubis's posterior side. It is therefore a composite muscle made up of the pubococcygeus and iliococcygeus portions, as well as ischioccygeus fibers originating from the ischial spine.
  • The most essential of them is the powerful diaphragm of muscular fibers that hangs like a hammock from the pelvic wall and allows the urethra, vagina, and anal canal to pass through.
  • The pelvic floor's major job is to support the weight of the abdominal and pelvic organs. It is also responsible for voluntary control of micturition and defecation and plays a vital role in sexual intercourse.
  • We can prevent harm during childbirth by teaching the woman about breathing exercises and when to pant and push.
  • Controlling the fetal head during the second stage of labor is critical to avoiding a perineum tear.
  • Care must be used when delivering the shoulder; otherwise, a tear may occur; thus, wait for the shoulders to rotate. First, deliver the front shoulder, followed by the posterior shoulder.
Videos for Pelvic Floor
Pelvic Floor Exercises - Video 6: Bridging - Poise Pilates
Pelvic Floor Part 1 - The Pelvic Diaphragm - 3D Anatomy Tutorial
Questions and Answers

His pelvic cavity above and the perineal space below are separated by a muscular diaphragm called the pelvic floor. It is made up of the levator ani and coccygeus muscles, and the parietal fascia covers it.

The posterior aspect of the symphysis pubis is the origin of the levator ani muscles on either side. Thus, it is a composite muscle made up of the pubococcygeus, iliococcygeus, and ischioccygeus fibers that originate from the ischial spine. The strongest of these, through which the urethra, vagina, and anal canal pass, is the diaphragm of strong muscle that hangs like a hammock from the pelvic wall.

  • Teach the mother how to breathe during labor, including when to pant and push.
  • The woman should be encouraged and requested to push and pant at the appropriate moment rather than pushing too soon (before the cervix is fully dilated). When the head is crowning, which should occur at the conclusion of a contraction, she should be specifically instructed to impact.
  • Explain to her the importance of deep breathing and panting as well as the reasons why she shouldn't push herself too quickly.
  • To avoid excessive perineum tear during the second stage of labor, control of the fetal head is crucial.
  • Slow extension should be used to deliver the head.
  • Wait for the shoulders to rotate before delivering the shoulder because a tear could occur otherwise. Deliver the front shoulder first, followed by the back shoulder.

Pelvic floor exercise:

  • If you try to stop the flow of pee when you use the restroom, you can feel the muscles in your pelvic floor. However, because it can damage the bladder, it is not advised that you consistently stop the flow of pee midstream.
  • Sit comfortably and squeeze your pelvic floor muscles 10 to 15 times in a row to strengthen them. Do not hold your breath while also contracting your thigh, buttock, or stomach muscles.
  • You might try holding each squeeze for a few seconds once you grow used to performing pelvic floor exercises. You can increase the number of squeezes each week, but be careful not to overdo it. Always take a break in between squeeze sets.
  • You should start to see the results after a few months. You should experience less incontinence and more sensitivity during sex. Even if you notice that the exercises are beginning to have an effect, you should keep doing them.

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