Am I too tight to push? How to Prepare your Pelvic Floor for Birth

How to Prepare your Pelvic Floor for Birth

Imagine having to stretch your hamstring or bicep three times its normal length - impossible!

But that's just what the muscles of your pelvic floor have to do in order to give birth vaginally. So it's no wonder that a lot of women are concerned with whether their pelvic floor will be able to stretch that much - or whether they might be 'too tight to push'.

In this article, Women's Health Physiotherapist Lyz Evans discusses whether you can actually be too tight to push and how you can prepare your pelvic floor for birth.

What does it mean to be too tight to push?

When you hear the phrase ‘too tight to push’ it is actually referring to the tightness of a woman’s pelvic floor and pelvis.

As women, we can hold a lot of tension in the pelvic floor. Women who are chronically stressed or who have done a lot of pilates may have an over-active or hypertonic pelvic floor.

This can make it hard for the pelvic floor to stretch in the way that it needs to during birth and labour and for the baby’s head to push past the pelvic floor muscles in order to descend into the birth canal.

Tight v Strong - What's the Difference?

Before we go any further, I just want to clarify the difference between having a tight pelvic floor and a strong pelvic floor.

When people are saying people are too tight to push they are most likely referring to the “tone” of a muscle and its ability to relax and passively stretch without great resistance.

This is VERY  different from strong! You can have a very strong pelvic floor that can contract and relax well, with normal tone, and hence is not “ too tight”.

Within the Empowered Motherhood Program (both our Pregnancy and Postnatal Programs) we do specific pelvic floor exercises and workouts that help you to move your pelvic floor through the full range of motion.

This means that you learn to fully engage and contract the pelvic floor and fully relax and release. Through these exercises, you can create a strong and healthy pelvic floor that can engage and also relax to its full potential - and is ready for birth!

Can you actually be too tight to push?

Hypertonic and high toned pelvic floors are something I am seeing more of. Perhaps that is a result of a more “ stressed” society of women who are often having babies a little later in life.

In addition, women who have done a lot of Pilates or exercise where there has been an emphasis on tightening the pelvic floor may present with a hypertonic pelvic floor.

So how does a ‘high-toned’ pelvic floor impact birth?

Let’s look at some research…

A study of 277 first time pregnant mums assessed their pelvic floor muscles and how they affected delivery outcomes. The study assessed pelvic floor:

• Resting Tone
• Muscle Strength
• Endurance

What they found is that for women that had strong pelvic floor muscles or who had good endurance that there was no impact on delivery outcomes such as tear rates, Caesarean section rates, episiotomy rates or instrumental delivery rates.

However, for women that had significantly higher pelvic floor resting tone, they were more likely to end up with a prolonged second stage of greater than 2 hours (Bo 2013).

What does this actually mean?

If you have a higher resting tone in your pelvic floor than it is likely to make the second stage of labour more difficult. Which makes sense as there is a more difficult barrier for the baby to have to overcome to pop its little head out into the world!

We know from other research that a prolonged second stage of labour is more likely to result in pelvic floor muscle dysfunction, nerve denervation, fetal distress and pelvic organ prolapse in the longer term.

So what can we do about it?

The good news is that you can do something about it. You can change the tone of your pelvic floor muscles.

In the Empowered Motherhood Program, as part of our birth preparation program, we teach you how to prepare your body and pelvic floor for birth.

Our birth preparation program includes perineum stretching and pelvic floor relaxation techniques. We walk you through all the steps of how to relax your pelvic floor and how to start to do self-release or partner release massage.

We also teach you about the relaxing phase of the pelvic floor as this is critical for birth. We encourage the majority of mums from around 35 weeks to start to really focus on the feeling of lengthening, relaxing, and opening the pelvic floor.

All of these tools are designed to reduce your second stage of labour and fully prepare your pelvic floor for birth.

You can try all of our Programs for free with our Free 5 Day Trial - a part of all of our memberships!


REF: Bo 2013 Too tight to give birth. Assessment of pelvic floor muscle function in 277 nulliparous pregnant women. IUJ (24) 2065 - 2070