What if the difference between your pelvis and pelvic floor?

The pelvis is the bony basin made of the hip bones, sacrum, and coccyx that supports the spine and houses organs, while the pelvic floor is the muscular and connective‑tissue hammock that lines the bottom of that basin and supports the bladder, rectum, and reproductive organs while helping control continence and sexual function.

Your vulva

Annotation of parts of the vulva

Get to know your vulva! Quite often many women and birthing people will refer to their vulva as the vagina, however this is anatomically incorrect.

The vulva is what you see from the outside and the vagina is the muscular structure inside. Every vulva is different. Look at the diagram and see if you can identify these on yourself.

Sometimes your vulva may look different during pregnancy due to the increased pressure and weight of baby(s).

It is useful to get to know your vulva to be able to identify any changes from what is normal for you and you can also look to see if you are doing pelvic floor exercises correctly. 

Your perineum

Annotation of the parts of the vulva

Your vagina is the passage through which your baby passes during vaginal birth.

Above your vagina is your urethra, the small hole you  wee  from.

Either side are your labia:  T he larger labia are on the outside, and the smaller labia on the inside.

Below your vagina is your anus, which is a ring of muscle which helps to control when you need a poo (open your bowels). Your anus has two sphincter muscles, an internal ring which sits inside an external ring, like a circle inside a circle. Between your vagina and your anus is your perineum.

More information on episiotomy and perineal tears

Your pelvic floor

The pelvic floor plays  an important role  in your health and wellbeing, and should  be kept strong and active, just like any other muscle.   Strong  pelvic floor muscles  boost your core strength and stability. They can improve your sexual function too.  They:  

  • help to keep your pelvic openings (anus, urethra) closed to prevent incontinence
  • support the bladder, womb, and bowels to help prevent prolapse
  • assist in stabilizing the joints of your pelvis
  • work with the abdominal muscles to support the spine and help with maintaining good posture
  • help with sexual function.

Your pelvic floor muscles

In pregnancy  

During  pregnancy  your body goes through many  changes  and it can be difficult to know what changes are normal and when you should seek help.

As your pregnancy progresses, changes can happen to your bladder, bowel, vaginal, and sexual health as your pelvis comes under more pressure. This causes stretching and tiring of the pelvic floor muscles meaning they may not work as effectively. It is important to be aware of how to optimise your pelvic health to support your pelvic floor function.  

After childbirth  

During a vaginal birth, your pelvic floor muscles will stretch for you to birth your baby. Some births may cause an injury to the perineum and pelvic floor muscle which will take time to heal.

This can affect how well the muscles work. During birth, the nerves that control the pelvic floor muscles will have been compressed and after birth they may take time to recover. During this  time  the muscles are likely to feel weaker than normal.  

Pelvic floor dysfunction  

Pelvic floor dysfunction (PFD) is used to describe conditions that are caused by the pelvic floor muscles not working as they should. 

Symptoms can include: 

  • urinary incontinence - leaking of wee
  • overactive bladder - urgency to wee more than seven times a day
  • pelvic organ prolapse - one or more of the pelvic organs start to come down into the vagina anal incontinence - leaking of poo or wind
  • dyspareunia - pain or discomfort during sex. 

Is pelvic floor dysfunction normal? 

We prefer to say symptoms of pelvic floor dysfunction can be common but they do not have to be your new normal and it should not be accepted that it's a normal part of pregnancy and giving birth. Symptoms can occur but should only last for a short time and should be mild. 

The most common symptom to experience during pregnancy and after birth is urinary incontinence (leaking wee). 

  • It occurs in around 40 to 50 per cent of women and birthing people as pregnancy progresses and immediately after birth.
  • Around 25 per cent of pregnant women and birthing people can also have anal incontinence (leaking poo). 

Leaking wee - stress incontinence 

This is the most common symptom that occurs during pregnancy and after birth. It happens when you do something that increases the pressure in your tummy such as: 

  • cough
  • sneeze
  • laugh
  • lift something or your baby
  • jump
  • dance
  • run
  • sing. 

This is usually because the pelvic floor muscles aren't able to fully support the closure of the tube leading to the bladder (urethra), during these activities to prevent any wee from escaping. 

Video: Bladder and vaginal problems during and after pregnancy

Overactive bladder 

This is when your bladder has become sensitive to the feeling of filling with wee and will give you sensation to wee more often and sometimes more urgently. 

You may find you don't get a break overnight and the urge to go can wake you up. Sometimes with strong urges, you may leak wee when trying to get to the toilet that you're not able to control. 

Try to avoid drinks that can irritate the bladder such as fizzy or caffeinated drinks. It is normal to go more often towards the end of pregnancy and should settle down in the weeks after birth. If things don't improve, support from a pelvic health physiotherapist may help. 

Pelvic organ prolapse 

A prolapse, sometimes called pelvic organ prolapse, is when one or more of the vaginal walls or the top of the vagina weakens and moves downwards causing pressure, bulging or heavy feeling inside the vagina or at the vaginal entrance. Whether the bulge stays within the vagina or starts to come out will depend on the factors causing the prolapse. 

A prolapse is common (around one in 12 people) if you have had a vaginal birth although this is not the only cause, it can occur at any time even in someone who hasn't had children. 

The symptoms you will most likely feel are: 

  • vaginal heaviness
  • awareness of a lump of bulge
  • deep lower abdominal aching
  • general vaginal discomfort
  • or you may have no symptoms at all. 

Having a prolapse can also affect how your bladder and bowel function and can also make sex uncomfortable. 

For more information, read the pelvic organ prolapse leaflet

Leaking poo (anal incontinence) 

Anal incontinence is leaking wind or poo, sometimes with urgency and sometimes without warning. It is less common than any bladder symptoms, however it will still affect around one in ten adults and will have a higher impact on quality of life and can be very upsetting. 

Discomfort with sexual intercourse 

Your vagina can sometimes feel different during pregnancy or after birth. This can be due to the changes that occur to your body during pregnancy and birth. However, sex should never be painful. Should you experience any pain with sex that does not settle, please access further support from your GP or pelvic health physiotherapist. 

Medications for pelvic floor dysfunction 

There are medications that can help with bladder and bowel symptoms if it is required. Most commonly for overactive bladder, which can calm down the urgency, and medications can be given to speed up or slow down transit of poo through the bowel for constipation or leaking poo. 

However, all conservative treatment with physiotherapy advice and/or support should be followed first and this is often the most helpful treatment. 

Pelvic floor exercises

Pelvic floor exercises involve squeezing the muscles around your vagina and anus. You can do this by imagining you are desperate to pass urine and you are trying to stop yourself. Hold this for as many seconds as you can, up to a maximum of 10 seconds. Release and rest for 5 seconds.

Repeat this 'tighten, hold and release' movement as many times as you can. Aim to do 10 in a row. These exercises will increase your stamina. They can be completed in different positions such as lying with your knees bent, sitting or standing - however feels most comfortable for you. If it feels too difficult to do the exercises while standing, you could start in the lying or seated positions and gradually build to standing.  

Pelvic floor exercises are known as the silent exercises, whilst you should feel a contraction of your pelvic floor muscles, no one else should know you are doing them. This means that your tummy, bottom and thighs should not be visibly moving and it is important that you do not hold your breath. 

You should work at your own speed, and you will need to determine your own 'starting level'. For example, if you can hold the contraction for 2 seconds and repeat 4 times, this is your starting level. 

To increase the reaction of your pelvic floor muscles you should also do some 'fast squeezes'. To do this, tighten your muscles as before, but stronger and faster. Then release straight away. Aim to do 10 of these in a row. 

You should try and do these exercises at least twice a day. 

Watch our videos to find out more about the pelvic floor, and how it is affected by pregnancy and childbirth, and how to exercise these muscles. 

What else can I do to help my Pelvic Health?

Healthy bladder 

The bladder is a storage organ in your pelvis that is continuously filling until it reaches its full capacity when you would then go to the toilet for a wee.

Most people will recognise they need to go for a wee when the bladder has about 150ml in it, but usually this signal can be comfortably ignored. Then you may get another signal around 300ml, and could may well ignore it still. But it is usually when the bladder is approximately 400 to 500ml that you can't hold any longer and have to go for a wee.

If you aim to drink one and a half to two litres of water per day, you can expect around five to eight visits to the toilet a day. 

There are several things that can affect bladder health, these include: 

  • Toilet facilities - if you can't go as regularly or have difficulty accessing them.
  • Fluid intake - this should be mostly water. Other drinks such as milk, herbal (caffeine free) teas, diluted squash and juices can be ok. Caffeinated or fizzy drinks may cause bladder irritation causing you to wee more often.
  • Bowels - constipation, straining can cause bladder problems.
  • Difficulty emptying your bladder.
  • Urine infections. 

Common bladder symptoms include

  • Urinary incontinence - leaking wee, either with stress or urgency.
  • Urgency.
  • Frequency. 

Further resources

Healthy bowel 

Having good bowel health and function is really important to keep you feeling healthy and usually when things aren't working as they should be, it starts to have an impact on your day-to-day life. 

What's normal? 

  • The normal number of trips for a poo can be from three times a day to three times a week.
  • Your poo can look very different in shape, size and even colour.
  • Optimal consistency of your poo is type 3 or 4 on the Bristol Stool Chart below. It should be firm but not hard and easy to pass without the need to strain.
  • Poo like this is easier to hold onto and less likely to cause urgency or leaking. 

Type 1: Separate hard lumps, like nuts (hard to pass) - Type 2: Sausage-shaped but lumpy - Type 3: Like a sausage but with cracks on the surface - Type 4: Like a sausage or snake, smooth and soft - Type 5: Soft blobs with clear-cut edges - Type 6: Fluffy pieces with ragged edges, a mushy stool - Type 7: Watery, no solid pieces. Entirely Liquid

Common problems

The two most common problems with bowels are anal incontinence (leaking of wind or poo) and constipation (difficulty in having a poo and causing regular straining). 

The best way to poo: 

  • Listen to your bowel, it will tell you when you need to go. If you miss the signal to poo, it can then be harder to open your bowels later.
  • Use a footstool. Placing your feet on a stool or toddler step will bring you into a squatting position and will help you to poo more comfortably and without straining.
  • Don't strain, this can contribute to the weakening of the pelvic floor muscles. Relax the belly as you breathe in and as you breathe out imagine making the sound “moo”. These together will help poo move through the bowel. 

Further resources

Constipation during and after pregnancy

Weight management 

For information on Weight Management in Pregnancy, please visit

Maintaining a healthy weight in the long-term will help to support your pelvic health and reduce your risk of developing bothersome pelvic health symptoms. 

Physical activity and healthy living 

Maintaining an overall healthy lifestyle will support many aspects of your health and achieving recommended levels of physical activity will reduce your risk of developing bothersome pelvic health symptoms.  

Further resources