In plain words
The levator ani is the main group of muscles in the pelvic floor. It forms a hammock-like sling across the bottom of the pelvis. It supports the bladder, the uterus, and the rectum, and it helps control the bladder and bowel. In pregnancy and birth, these muscles stretch a lot. The nerves that run to them can be stretched or bruised too. Most people who have a vaginal birth notice some change in how the pelvic floor feels. For many, the changes are small and recover over weeks to months. Some people notice leaking, heaviness, or pain. Pelvic floor physical therapists are trained to assess and treat these muscles. A provider can refer a mother to one if symptoms appear.
The deeper version
The levator ani complex comprises the , pubococcygeus, and iliococcygeus muscles, with fascial attachments to the arcus tendineus and the pubic bone, and is innervated by the and sacral plexus. Vaginal birth causes stretch and denervation, and in a substantial minority of first vaginal births, , as shown on transperineal ultrasound (Dietz and Lanzarone, 2005). Pelvic floor muscle function is assessed by digital examination, manometry, and ultrasound. is widely recommended and trials show benefit for urinary incontinence. The controversy continues over the optimal supervision and intensity of training, and whether antenatal training reduces postpartum incontinence.
Where it comes up
- Your pelvic floor after birthPostpartum: Your Body
- Returning to exercisePostpartum: Your Body
- Peeing after birth and leakingPostpartum: Your Body
- Prolapse: heaviness, bulging, and what helpsPostpartum: Your Body
What mothers here say about levator ani
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Sources
- Dietz HP, Lanzarone V — Levator trauma after vaginal delivery. Obstetrics and Gynecology, 2005