Preparing the pelvic space for birth

When we talk about preparing the body for birth, there is often a lot of conversation around pelvic floor strength. But birth asks something else of the pelvic space too.
It asks for softening, yielding, adaptability, and the ability to let go.

This is a big part of the intention behind the Internal Pelvic Release Work (IPRW) I offer at @flourish.

What is Internal Pelvic Release Work?

Internal Pelvic Release Work is a gentle, individualised approach to working with and connecting a woman to her internal pelvic space.

My intention with IPRW is not to diagnose pelvic floor conditions. If something presents that I feel requires further assessment or diagnosis, I will always refer to an appropriately qualified pelvic health practitioner.

Instead, my work centres around awareness, connection, mobility and adaptability of the tissues. One of my favourite moments is when a woman begins to recognise the difference between holding and letting go, because sometimes we don't realise how much tension we are carrying until we are given the opportunity to actually feel it.

The pelvic space is more than the pelvic floor
Anatomically, I like to think of the internal pelvis as a beautiful three-dimensional space, rather than one isolated group of muscles.
Internally, this includes the superficial perineal muscles and the deeper structures — puborectalis, pubococcygeus and iliococcygeus, and one of my favourite areas to work with, the obturator internus, right in the hip space.

But these structures don't exist in isolation. They have relationships with the coccyx, sacrum, ischial spines, pelvic fascia and the surrounding ligaments. It's also why hip pain, restriction, or a history of pelvic and hip tension can be an important part of the conversation.

Coming from my chiropractic background, I naturally look beyond the internal pelvic space too, considering the relationship between the pelvis and the hip flexors, adductors, glutes, diaphragm and abdominal wall. The pelvic space is part of the whole body, and I believe it deserves to be cared for that way.

What does the work feel like?
The best way I can describe my technique is intuitive, gentle, woman-led touch.
Using one or two fingers, depending on the individual woman, I gently explore areas of tone or resistance within the accessible pelvic tissues. There is no intention to force a tissue to release or push through resistance. Instead, we give the body time, time to breathe, time to feel, time to soften, and time to notice.

“Ohhh… this is me holding. And this is what letting go feels like.”

That awareness can be incredibly valuable.

Why might this be helpful when preparing for birth?
During vaginal birth, the pelvic space and surrounding connective tissues need to accommodate significant change as baby descends and rotates through the pelvis. Strength has its place, but so does the ability to lengthen, yield and adapt.

Previous birth experiences, scar tissue, pain, injury and stress may all influence the way a woman experiences and holds tension through this space. This is why birth preparation through IPRW isn't about trying to create the “perfect” pelvic floor. It is about helping a woman become more familiar with her own body:

— Can I recognise when I'm holding?
— Can I breathe into this space?
— Can I soften when I feel pressure?
— Can I remain connected to my body when something feels unfamiliar?

These are beautiful skills to explore before birth.

The nervous system is a big part of the picture
This is probably one of my favourite parts of the work. Our pelvic tissues don't exist separately from our nervous system. Our perception of safety, our breath, our past experiences and the environment around us can all influence how we hold our bodies.

For some women, simply experiencing gentle internal pressure in a safe, supported environment, while learning to breathe, stay connected and consciously soften — can be incredibly valuable preparation. It isn't just about changing a tissue. It's about changing a woman's relationship with that space.

When do I begin IPRW during pregnancy?
For an uncomplicated pregnancy, I generally introduce the more birth-focused internal work from around 34 weeks, depending on the individual woman, her pregnancy and her circumstances.

Every woman is different, and the work always reflects the body in front of me. Most importantly, I never want a woman to feel that she needs Internal Pelvic Release Work in order to birth well. IPRW is simply another option available to women as they prepare for birth.

My hope is that you move towards birth feeling a little more aware, a little more connected, and a little more easeful within your pelvic space.

In health,
Dr Grace Stottelaar - Chiropractor and Internal Pelvic Release Provider