Childbirth Preparation with a Pelvic Floor PT – Part 3: The Pelvic Outlet

We’ve followed your baby’s journey through the pelvic inlet and midpelvis—now we arrive at the pelvic outlet, the final stage of descent and the space baby moves through during crowning and delivery.

This is the phase often associated with pushing, but just like the rest of labor, the more we understand about the body’s mechanics here, the better we can support it.

What is the Pelvic Outlet?

The pelvic outlet is the bottom opening of the pelvis. It’s shaped more like an oval with its widest diameter front-to-back (anterior-posterior). At this point, baby is rotating and extending the head to emerge through the vaginal opening.

In this final phase of labor, the pelvic floor muscles need to lengthen and soften to allow baby to pass through.

🧠 Remember: The pelvic floor isn’t just a passive structure—it must actively release. If it’s holding tension, it can slow or complicate baby’s exit, increasing the chance of tearing or instrumental delivery.

Movements That Help at the Pelvic Outlet

To open the outlet, we want to bring the ischial tuberosities (sit bones) apart and allow the tailbone to move back. This creates internal rotation of the hips and pelvis.

✅ Try positions like:

Side-lying with top leg supported by partner or peanut ball

Quadruped (hands and knees) with knees together and feet apart

 These positions allow the sacrum and coccyx to move freely, and the pelvic floor muscles to open.

How a Pelvic Floor PT Helps During the Outlet Phase

A pelvic floor PT can prepare you for:

Outlet-opening positioning with hands-on guidance for active birth partners/participants

Coordinated pushing—timing breath with abdominal and pelvic floor release

Hands-on pain management techniques for partners/support during contractions and active labor

Most importantly, we help you practice pelvic floor relaxation before labor, so that by the time you’re pushing, your body already knows what to do.

What if Your Pelvic Floor Is Too Tense?

Signs of chronic tension include:

Pain with penetration

Constipation

Pelvic pain or pressure

Urinary leakage

If you’re feeling any of these now, addressing them before labor makes it easier for the pelvic floor to relax and “get out of the way” when it matters most.

Get Prenatal Pelvic Floor Support in East Longmeadow, MA

At Renew Health in East Longmeadow, we help pregnant individuals prepare for labor with targeted pelvic floor therapy and movement coaching. Our team is trained to support each phase of labor—especially the critical midpelvis rotation phase.

👉 Book a prenatal pelvic floor therapy evaluation today and learn personalized strategies for a smoother labor.

📍 Renew Health – East Longmeadow, MA