Key Differences between IAP regulation, Valsalva and Straining
One thing active pregnant mamas constantly hear is to be careful not to increase intra-abdominal pressure (IAP) because it will cause a diastasis or pelvic floor disorders. This is most common in the mamas who still lift and exercise during pregnancy. While the people who say this are all well-meaning and trying to be helpful, they often don’t realize the only way to not increase IAP is to stop breathing and that’s not beneficial to anyone! But before you decide to stop breathing to prevent an increase in IAP, let’s discuss the differences between straining (what people think of when they hear IAP), Valsalva and true IAP
Straining / Bearing Down during Pregnancy
Think of a time that you were really constipated and just wanted to go to the bathroom. That forceful pushing and straining or “bearing down" you did in order to achieve a bowel movement is abdominal straining. During straining the pelvic floor eccentrically contracts and relaxes to help improve voiding. (1) While bearing down can be beneficial in the case of constipation (but still not advised, if you have chronic constipation please reach out to a local functional medicine doctor to help you get better bowel movements), it is not ideal as we move through our daily life. Constantly bearing down can actually lead to pelvic organ prolapse.
Valsalva during Pregnancy
The Valsalva Maneuver is also when one bears down but in this case the pelvic floor muscle response is to contract and lift the pelvic floor to stop the flow of urine. A few studies have shown that the Valsalva can help with pelvic organ prolapse by reducing the amount the pelvic floor drops but this should only be completed with a trained women’s health physical therapist because if done incorrectly, may lead to a bearing down movement instead. (2,3)
Intra-abdominal Pressure and Pregnancy
IAP is the pressure within the abdominal cavity and changes can be felt every time you breath. This is accomplished through proper diaphragmatic breathing which utilizes the diaphragm, lower rib expansion and even the pelvic floor! As you breathe in your diaphragm expands downward and slightly outward while the pelvic floor relaxes down to mimic the movement of the diaphragm. This movement naturally draws air into the diaphragm and increases IAP. As you breath out, the diaphragm moves upward and the pelvic floor gently lifts and tightens so support the pelvic floor and surrounding muscles.
IAP Regulation and Pregnancy
IAP regulation should be automatic or natural and should focus on generating optimal IAP. This is easier said than done though because it can take some time to retrain our breathing depending on the causes of altered breathing. And yes it might take a little time and patience to get your breathing out of your chest into full belly and pelvic floor breathing. Once we are able to regulate IAP subconsciously, this becomes one of the best ways to activate the deep core muscle control.
Benefits of Intra-abdominal Pressure and Pregnancy
BIRTHFIT is based on Dynamic Neuromuscular Stabilization which is one of the leading researchers in understanding the benefits of IAP and how to properly regulate the natural changes that occur with breathing. Their research shows that IAP regulation can lead to the following benefits:
An increase in IAP stabilizes the spine (goodbye low back pain)
IAP “can unload the spine during static and dynamic lifting tasks” (hello better support while lifting or living)
Provided anterior lumbopelvic postural stability (goodbye hip and pelvic pain)
Creates balanced co-activation of diaphragm and pelvic floor (hello pelvic floor health)
So the next time you second guess lifting or exercising for fear of IAP, remember that IAP is actually supportive! But you might want to double check to make sure you aren’t bearing down while doing that lift…nobody wants to clean that mess.