The Midpelvis: The Pelvic Floor Anatomy & Movement Support

Pelvic Floor: The Mid Pelvis


The pelvic floor is the mid-pelvis that baby descends through during labor. The pelvic floor is a collection three layers of muscles that cross the pelvis in order to support the organs that lie in the pelvis, to include your baby & uterus. The layer shown in the image is the pelvic diaphragm, and the top layer. The mid-pelvis tends to be around 5-6cm dilation and -1 to +1 station.

mid pelvis pelvic floor anatomy.jpg

The pelvic floor NEEDS to relax in order to allow baby to descend; this is where the relaxation during inhalations will be extremely helpful! If we spend pregnancy tense and constantly trying to contract, contract, contract the pelvic floor, we may find ourselves having trouble during labor in the mid-pelvis.

The pelvic floor is a key component of our core’s ability to stabilize but is affected by pregnancy; as our baby grows, our pelvis floor takes on an additional load! Our pelvic floor tends to be in a compromised state and requires healing in the postpartum, but the healing is not necessarily only Kegels. Remember, our core is a coordinated system; cleaning one gear in a rusty system doesn’t improve the entire system!

Working with a pelvic floor physical therapist will help identify any issues that you may have in the postpartum; some moms have overactive and tight pelvic floor, while others may have underactive and weakened pelvic floors.

In our local area, Womack Army Medical Center has two great Pelvic Floor Physical Therapists & Appalachian Physical Therapy, Pinehurst has a PFPT as well!


The Mid Pelvis Laboring Positions


Movements that will support baby’s descent through the pelvic floor (mid pelvis) will be diagonal type movements, to include lunges and peanut ball supported movements!

Side lunges can be done on the ground kneeling, standing with a foot on a stool, or even walking upstairs sideways by two steps at a time.  If restricted to the bed or the mother needs rest, using the peanut ball can help tremendously to support the opening of the pelvic floor.

Side lunges can be done on the ground kneeling, standing with a foot on a stool, or even walking upstairs sideways by two steps at a time. If restricted to the bed or the mother needs rest, using the peanut ball can help tremendously to support the opening of the pelvic floor.

Lunges are done sideways or in a diagonal pattern; can be done standing on a small stool (some labor rooms will have tiny step stools) or can be done kneeling (as pictured above). Lunges can involve movement in and out of the lunge slowly and with control in between contractions (or during if mom can continue to move during a contraction). If kneeling, ensure to place a pad or pillow under the knee so that it is supported and comfortable. Sometimes gardening pads can be helpful tools during labor for this position or other kneeling/all four positions!

If mom is restricted to the bed, or simply tired and wants to rest, using the peanut ball in the bed is a helpful way to still accomplish that diagonal movement. Place the peanut ball under both her knee and ankle, with mom leaning towards her belly side. The peanut ball’s support will prevent mom from rolling completely on her belly!

To promote movement in the pelvis to support fetal descent, mom (with some assistance) can slowly move her shin forward and backwards on the ball. Option also to rest in this position, with a stretching sensation happening in the groin area.

Gina Conley