Like many women, you may not have given your pelvic floor muscles much thought. But pregnancy and childbirth give these crucial muscles an incredible workout, and taking care of them — with exercises to both strengthen and relax — can prevent problems during pregnancy, birth, and postpartum.
It doesn't take intensive workouts, either. Read on to learn more about the pelvic floor, how you can care for it while pregnant, and simple exercises to try.
What is the pelvic floor?
Your pelvic floor is made up of several layers of muscles and connective tissue that sit at the base of your pelvis. This system plays a key role in many essential functions, including supporting your pelvic organs, controlling bladder and bowel function, regulating abdominal pressure, and stabilizing your spine and core. The pelvic floor is even involved in sexual function and orgasm.
Although you might not think of it often (if at all), your pelvic floor deserves attention during pregnancy. While anyone can experience pelvic floor issues, they're especially common during and after pregnancy.
How does pregnancy affect the pelvic floor?
During pregnancy, your pelvic floor muscles must support more weight as your baby grows.[1] These muscles also stretch to accommodate your baby as she grows. Hormonal changes help increase the flexibility of your muscles and connective tissue, but over the course of 40 weeks, this still puts significant strain on the pelvic floor.
Childbirth (whether you give birth vaginally or via C-section) can also impact these muscles. Research shows that pelvic floor tissues can stretch more than three times their normal length during a vaginal birth.[2] While a C-section places different stresses on the body, the pelvic floor is still affected by both pregnancy and delivery.
What's the purpose of pelvic floor exercises?
Many pelvic floor experts recommend preparing your pelvic floor for pregnancy and childbirth with both strengthening and relaxation exercises. Research suggests that learning how to both engage and release your pelvic floor can go a long way towards helping prevent post-pregnancy pelvic floor dysfunction.[3]
You may be familiar with Kegels, but these exercises are just one way to care for your pelvic floor during pregnancy (and postpartum, too). In fact, many women don’t realize how important it is to also know how to relax these muscles (more on that below).
"I had physical therapy after my first and it was learning how to relax my pelvic floor that changed everything for me!" says What to Expect Community mom RYT1735.
Which exercises strengthen the pelvic floor?
In early pregnancy and through the second trimester, most experts recommend focusing on building strength and endurance. This helps your body adapt to the increasing demands on your pelvic floor as your baby grows.
To do this, practice pelvic floor contractions (aka Kegels) regularly. You can work them into your exercise routine. For example, if you lift weights, try engaging your pelvic floor as you exhale during a bicep curl.
You can also add pelvic floor work to your warm-up or cool-down — for instance, by performing 10 to 20 contractions before and after a walk or bike ride.
Make sure you're performing a full pelvic floor contraction and release each time. Try this:
- Sit comfortably with your knees bent.
- Take a deep inhale, feeling your ribs expand.
- On the exhale, gently contract and lift your pelvic floor.
- Imagine that your pelvic floor is an elevator that you’re trying to slowly move from the bottom floor of a building up to a higher floor. Or imagine picking up a blueberry with your vaginal muscles. These visualizations can help ensure you're engaging the full muscle group.
Which exercises relax the pelvic floor in preparation for labor?
As you enter the third trimester, it becomes increasingly important to focus on relaxation. Your pelvic floor needs to fully release and stretch during labor to allow your little one to pass through!
"I think being able to connect with those muscles and actively release them between pushes helped me to not get too tired and not get a bad prolapse," says Community mom MrsMamaBell.
It may feel unfamiliar to practice relaxing and lengthening the pelvic floor. But this skill can come in handy during the second stage of labor when you're pushing. Visualization can help:
- Begin by sitting comfortably and taking a few deep breaths, feeling your ribs expand.
- As you inhale, picture a flower gently opening.
- Try to feel your pelvic floor soften and release as you do this. Repeat for 10 to 20 breaths.
You can work this into an exercise routine or practice anytime you think of it.
When should I talk to my doctor about pelvic floor concerns?
Some women experience symptoms of pelvic floor dysfunction during pregnancy or postpartum, including pelvic organ prolapse or bladder issues such as leaking urine. Talk with your doctor or midwife if you notice any unusual symptoms at any point.
Get more expert advice, track your pregnancy journey, and connect with other moms-to-be with similar concerns on the free What to Expect app.
Should I go to a pelvic floor physical therapist?
Many women find a pelvic floor physical therapist (PFPT) helpful during pregnancy and postpartum, and you don't have to have extreme symptoms to see one.
A PFPT can:
- Develop a personalized plan for you.
- Help ensure you're performing exercises correctly and may help prevent issues as your pregnancy progresses.[4]
- Help you prepare for labor. Some offer guidance on labor positions and pushing techniques so you can feel more confident and prepared for delivery.
"My pelvic floor physical therapist gives me specific exercises to do to prepare for birth and help relieve my pains from growing humans," says Community member ktmapes, who is pregnant with twins. "I always leave feeling like a whole new person."
"I went to physical therapy and it was life-changing!" says Community mom Alyssamae4722. "I've had various aches and pains throughout this pregnancy and my PT is great. We're working on muscle strength and pelvic floor work to prepare for this pregnancy."
Your doctor or midwife may refer you to a PFPT, or you can book a session on your own.
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