Push Prep: How to Prepare the Pelvic Floor for Birth

A one-on-one prenatal session, with a board-certified pelvic floor specialist, designed for pregnant moms who want to feel confident and prepared for the pushing phase of labor.

This hour-long session focuses on helping you understand, and physically feel, how your pelvic floor muscles work during birth.

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As physical therapists, we consistently see a disconnect between how women prepare for birth and how they are supported afterwards. Most women know they will need help postpartum, but very few are given the tools or guidance to prepare before birth in a meaningful way.

Many women are told to “just push when the time comes,” but few are taught how to push effectively.

This is why we created Push Prep. We want women to know how to prepare the pelvic floor for birth.

Push Prep supports your prenatal journey with education, hands-on guidance, and evidence-based techniques that support a smoother, more efficient pushing phase.

Why Push Prep Matters:

The pelvic floor muscles form a supportive sling at the base of the pelvis. During birth, these muscles must lengthen and relax, not contract, to allow your baby to descend.

Research shows:

Difficulty relaxing the pelvic floor can contribute to prolonged pushing.
Coordinated pushing with pelvic floor relaxation may reduce the length of the second stage of labor.
Awareness and training of pelvic floor mechanics improves muscle coordination and maternal confidence.
Reduced pelvic floor tension may decrease risk of perineal trauma.

Many women unintentionally contract their pelvic floor when instructed to “push,” which can work against the body and prolong labor.

Push Prep helps prevent this by teaching moms how to prepare the pelvic floor for birth by properly lengthening and releasing these muscles when it matters most.

Moms who complete Push Prep often report:

Increased confidence entering labor
Reduced fear about the pushing phase
Better understanding of their body
Feeling more in control during delivery
Less anxiety about “doing it wrong”

Who Is Push Prep For?

Push Prep is ideal for:

First-time moms
Moms who previously experienced prolonged pushing
Anyone with pelvic floor tension or overactivity
Women wanting an unmedicated birth
Moms seeking a VBAC
Anyone who wants to feel proactive and prepared for birth

What Happens During a Push Prep Session?

Push Prep is performed in-office in a private, comfortable setting with a board-certified pelvic floor physical therapy specialist.

Your session includes:

1. Education on the Pelvic Floor’s Role in Birth

You’ll learn:

How to prepare the pelvic floor for birth
How the pelvic floor supports your baby during pregnancy
How these muscles must relax and lengthen during pushing
The difference between bearing down effectively vs. clenching
Breathing mechanics that support optimal pressure management

Understanding the “why” builds confidence and reduces fear.

2. Guided Practice with Tactile Biofeedback

With your consent, your therapist may use gentle internal or external assessment techniques to help you:

Feel when you are contracting vs. lengthening
Learn how to coordinate breath with pelvic floor release
Practice proper bearing-down mechanics
Avoid paradoxical contraction (tightening when you mean to relax)

This hands-on feedback ensures you are truly lengthening the pelvic floor safely and not straining, holding your breath improperly, or pushing in a way that increases tension.

One of the most valuable parts of Push Prep is tactile biofeedback.

Biofeedback has been shown in pelvic floor rehabilitation research to improve muscle awareness, coordination, and motor control. Practicing this before labor helps create muscle memory so that when the time comes, your body knows what to do.

Preventing Prolonged Pushing & Unnecessary Strain

Improper pushing strategies such as breath-holding with pelvic floor contraction can:

Increase pelvic floor strain
Prolong the second stage of labor
Increase fatigue
Contribute to perineal injury

Push Prep teaches you how to prepare the pelvic floor for birth and helps ensure that you are lengthening rather than tightening your muscles. Thus, protecting your pelvic floor while supporting efficient descent of your baby.

Meet Your Pelvic Floor Physical Therapist

Hi! I am Dr. Isabella, I am a Performance Physical Therapist and Board Certified Women’s Health Specialist. I have a passion for empowering women to regain confidence, take back control, and continue to live an active lifestyle without pain or symptoms. I strive to educate every patient about the crucial role of the pelvic floor and the surrounding musculature as it is the key role to understanding what is “normal”.

I earned my Doctor of Physical Therapy degree from the University of North Florida in 2023. Upon graduation, I completed a postdoctoral Women’s Health and Pelvic Health Residency Program where I received specialized training in pelvic floor rehabilitation for urinary incontinence, functional bowel disorders, pelvic organ prolapse, pelvic pain, obstetric and postpartum physical therapy.

I lived most of my life in Naples, Florida but was born in Bogota, Colombia. I grew up going to the beach, which reinforced my love for beach volleyball, spikeball, and picture-perfect sunsets. I enjoy spending free time with my husband playing various sports, competing in beach volleyball tournaments, and traveling to see new places!

See what others have to say about working with me…

"Prenatal pelvic PT truly kept my pain during pregnancy to a minimum..."

“Prenatal pelvic PT truly kept my pain during pregnancy to a minimum and gave me a better awareness of my body and how to modify exercises as things changed. When I developed tailbone and later pubic symphysis pain, Dr. Isabella was a lifesaver. Being established in care meant I could be seen quickly, given techniques, get relief from dry needling, and be fitted for an SI joint belt ASAP. Starting pelvic PT early allowed me to really learn diaphragmatic breathing and pelvic floor relaxation, which became muscle memory during labor. When I gave birth on hands and knees, I vividly remember relaxing my pelvic floor, and unlike my first delivery, I had no tearing, even with a fast birth and a nuchal hand. Postpartum pelvic PT was pivotal in my recovery, allowing me to start diaphragmatic breathing within hours of birth, address pain quickly, and feel supported both physically and mentally as I returned to activity with my toddler. Pelvic PT was the most important preparation I did for pregnancy and recovery, and I only wish I had this level of support with my first baby.” - Melissa M.
"She was an integral part of my pregnancy and postpartum journey..."

"I started seeing Dr. Isabella at the very beginning of my pregnancy, and she was an integral part of my pregnancy and postpartum journey. She helped me navigate SI and pubic symphysis pain so effectively that I was able to complete a half marathon at 16 weeks pregnant! Her focus on core strength throughout my pregnancy significantly reduced the impact of diastasis recti, giving me a much stronger starting point for recovery postpartum. She assessed my core and pelvic floor postpartum to see where I needed to focus my attention on restrengthening. She helped me build back my glutes and core, including a structured return to run plan. Beyond being an awesome PT, what truly sets Isabella apart is how much she cares about you holistically. I was able to bring my baby to appointments and Isabella would hold her or even include her in my workout, which made it possible for me to actually show up for myself without worrying about childcare. She is a true partner in the birthing and recovery process!" -Savannah L.
"She truly brought me back to life postpartum."

“Dr. Isabella at Samson is incredible! She truly brought me back to life postpartum. Her care is attentive, professional, and full of compassion. She is so knowledgeable and takes the time to explain everything, making me feel comfortable and confident throughout the process. I couldn’t recommend her more highly—if you’re looking for pelvic floor physical therapy, she’s the absolute best!” -Krissty L.