Why You Should Look: What Every Woman Should Know About Her Pelvic Floor and Vaginal Anatomy

If you’ve ever looked at your own anatomy and felt a flicker of alarm — wait, is that normal? — you are not alone, and you are not broken. You’re just experiencing what happens when nobody ever showed you a baseline to compare against.

That’s the core message from this episode of the Barbell Mamas Podcast, where pelvic floor physical therapist and researcher Dr. Christina Prevett breaks down the anatomy education gap most women grow up with — and why closing that gap matters long before you’re lying on an exam table asking, “is this normal?”

This post unpacks the episode’s key teaching points: vaginal anatomy basics, how your pelvic floor is supposed to function day to day, and why diagnoses like diastasis recti and pelvic organ prolapse are far messier — and far less alarming — than the labels suggest.

The Anatomy Education Gap Most Women Never Talk About

Here’s an uncomfortable truth: most women reach adulthood without a clear picture of their own anatomy. Research on adolescent sexual health has found that a majority of older teens can’t correctly identify how many openings exist in their own genital anatomy — many of whom are already sexually active.

This isn’t a personal failing. It’s a systemic gap. Sex ed tends to cover periods and pregnancy prevention, but rarely walks through the actual structure of the pelvis. And that gap doesn’t stay confined to “personal” knowledge — it follows women into the clinic, where understanding pelvic anatomy is essential for making informed decisions about symptoms, injuries, and postpartum recovery.

Myth #1: Your Vagina Is a Hollow Tube

Anatomy diagrams are part of the problem. They typically show the uterus and fallopian tubes branching out like a tree, with the vagina drawn as a simple open tube beneath it.

In reality:

• Your vaginal walls touch. They are not rigid, hollow, or tube-shaped. If you use a mirror or your phone to look at your own anatomy, you will see the walls resting against each other — and that’s expected, not a problem.
• Your vaginal walls are designed to move. They shift with your body position, with gravity, and with the position of your other organs throughout the day.

This matters because many people first really look at their own anatomy in the postpartum period — often during a moment when something already feels different. Without ever having a personal baseline, any movement or change can feel alarming, even when it’s well within normal variation.

Your Body Changes Throughout the Day — And That’s Normal

Just like your height is slightly taller in the morning (your spinal discs lose water and compress with gravity throughout the day), your vaginal walls also have more “give” later in the day, after standing, walking, or exercising, compared to first thing in the morning.

This natural daily fluctuation increases with:

• Pregnancy
• Vaginal delivery
• Age

That increased range of motion is part of why some women’s bodies eventually reach a “tipping point” where the same long-standing movement pattern suddenly becomes symptomatic — not because one single workout caused damage, but because of an accumulation of normal physiological change meeting a new threshold.

The Overuse Injury Comparison

Think about it the way you’d think about a shoulder injury: it usually wasn’t the one pull-up that caused the problem — it was weeks of accumulated stress finally reaching a breaking point. Pelvic floor symptoms work similarly. Blaming a single run, a single workout, or a single deadlift session at “X weeks postpartum” oversimplifies something that’s actually multifactorial. Birth itself remains the most significant known driver of permanent change in vaginal wall range of motion — not your training.

Pelvic Floor 101: Relaxation Matters as Much as Strength

The pelvic floor only enters most people’s vocabulary once something feels wrong — usually in pregnancy or postpartum. But understanding how it actually works changes the conversation.

Your pelvic floor needs to do two things well:

1. Contract — to maintain continence (not peeing or pooping when you don’t intend to)
2. Relax — to allow you to pee, poop, and give birth

This is where the “anti-Kegel” conversation in birth prep comes from: the pelvic floor must be able to relax for labor. But that doesn’t mean strengthening it during pregnancy is pointless or contradictory — pelvic floor strengthening in pregnancy is about reducing the risk of stress urinary incontinence, not about birth prep specifically. These are two separate goals, and your pelvic floor is fully capable of learning both contraction and relaxation without one undermining the other.

This relaxation skill is especially relevant for athletes — lifters, runners, and multi-sport athletes alike — who are conditioned to brace and “close their holes” under high effort. Learning to consciously relax the pelvic floor is a skill, and it’s one worth practicing well before labor.

Bathroom Habits That Actually Matter

A few practical, often-overlooked basics:

• Daily bowel movements are the goal. Skipping a day occasionally is fine, but going three, four, or more days between bowel movements is not something to normalize — regardless of your age.
• Toilet position matters. Having your knees higher than your hips (a more flexed hip position) makes elimination easier and reduces straining. This is particularly relevant for older adults using raised toilet seats, which can put the body in a mechanically disadvantageous position.
• Straining is hard on the pelvic floor. Chronic straining during bowel movements — often worsened by poor positioning — adds unnecessary load to pelvic floor tissues.

Diastasis Recti: Why the Diagnosis Is More Complicated Than a Finger Count

If you’ve been told you have diastasis recti based on a “two-finger gap” test during a head lift, here’s what the research actually shows.

The original theory: A gap of more than roughly one inch (about two finger-widths) between the rectus abdominis muscles was believed to predict risk for postpartum issues like pelvic girdle pain and urinary incontinence.

What the data actually shows: For every study finding a positive association between diastasis recti and urinary incontinence, there’s another study finding no association at all. The relationship isn’t as clean as the original hypothesis suggested.

A more likely explanation: Core and pelvic weakness may be the underlying factor driving both issues independently, rather than diastasis recti directly causing incontinence or pain. Rebuilding strength in the rectus abdominis, obliques, glutes, and surrounding musculature appears to be more clinically meaningful than chasing a specific finger-width measurement.

The cutoff itself is questionable. A study conducted in a urology clinic — on patients not being seen for any abdominal wall concern — found that roughly half showed a two-finger-breadth gap during a head-lift assessment. This pattern also shows up in newborns and in older adults, especially those with more central body weight. That raises a real question: is a two-finger gap actually a marker of dysfunction, or is it simply common human anatomical variation?

Prolapse: When a Label Creates More Distress Than the Symptom Itself

A similar conversation is happening around pelvic organ prolapse. Increasingly, researchers and clinicians are recognizing that a Stage 2 prolapse finding — i.e., a certain degree of vaginal wall movement toward the vaginal opening — falls within a normal range for many women, particularly after vaginal birth.

This doesn’t mean symptoms aren’t real. It means the issue is more layered than the diagnosis label suggests:

• A diagnosis can create its own sensitization. When you’re told something is “dysfunctional” that actually falls within normal anatomical variation, it can generate anxiety and hyperawareness that wasn’t there before — independent of whether anything is actually wrong.
• Validating symptoms doesn’t require a scary label. What most people actually need is a provider who explains why they’re feeling these changes, validates the experience, and builds a plan around their new baseline — not necessarily a diagnosis that implies something is broken.
• The goal often isn’t “reversal.” Much like a partial rotator cuff tear is typically managed rather than surgically reattached, pelvic floor changes after birth are often about building strength and confidence around a new normal — not necessarily restoring some exact prior state. (Pelvic floor muscle training can modestly influence range of motion, but that’s a more nuanced conversation than a simple “fix.”)

The Real Reason “Is This Normal?” Feels So Loud

Here’s the deeper insight from this episode: pregnancy and postpartum genuinely rewire your attention toward your body. Heightened sensitivity to the pelvis is common during this window — your brain is, quite literally, prioritizing protection of your baby, and that means more cognitive bandwidth gets devoted to monitoring bodily sensations.

That’s adaptive and protective. But it also means new or unfamiliar sensations can take up disproportionate mental space, especially when you have no personal baseline to compare them to. If you never looked before pregnancy, you have nothing to measure “different” against — so anything new can register as alarming, even when it’s a completely typical postpartum adaptation.

The Takeaway: Look Before You Need To

The biggest preventive step here isn’t a treatment — it’s information delivered before you’re in crisis mode. Knowing your own anatomy, understanding what’s structurally normal, and learning how your pelvic floor is supposed to function gives you a baseline to recalibrate against when changes happen.

This is preventive education that ideally starts before conception, continues through pregnancy, and gets reinforced postpartum — not delivered for the first time in a moment of worry.

Key Takeaways

• Vaginal walls naturally touch and move — this is anatomy, not a malfunction.
• Range of motion changes throughout the day, with pregnancy, with vaginal birth, and with age.
• Pelvic floor symptoms are typically multifactorial, not caused by one workout or one run.
• Pelvic floor health requires both contraction and relaxation skills.
• Diastasis recti and pelvic organ prolapse diagnoses are being actively re-examined in the research — a measurement isn’t always evidence of dysfunction.
• Understanding your own baseline anatomy is one of the most protective things you can do for your postpartum mental and physical health.

---

This post is based on a Barbell Mamas Podcast episode and is intended for educational purposes. It is not a substitute for individualized medical advice from your own pelvic floor physical therapist or healthcare provider.