Pelvic floor muscle exercises

The muscles of your pelvic floor come under great strain in pregnancy and childbirth. Pelvic floor exercises help to strengthen them.

Having a strong pelvic floor helps you:

• support the weight of your growing baby
• control unintentional peeing (urinary incontinence)
• support sexual function

It's important to do pelvic floor exercises if you are pregnant. They can reduce your risk of urinary incontinence after giving birth.

Benefits of exercise during pregnancy

Where the pelvic floor is

The pelvic floor is a layer of muscles that runs from your pubic bone at the front of your body to your lower spine at the back. Think of these muscles as a hammock or trampoline that support and hold your pelvic organs in place.

Your pelvic organs include your uterus (womb), vagina, bowel and bladder. The muscles should react automatically when you cough or sneeze by squeezing and stopping you from leaking urine.

Getting to know your pelvic floor (video)

If your pelvic floor is weak

If your pelvic floor muscles are weak, you may pee small amounts when you sneeze, cough and exercise during pregnancy or afterwards.

Pelvic floor exercises help to strengthen these muscles. These are sometimes called Kegel exercises. They will help you to control the urge to empty your bladder and make it to the toilet on time. You should not have to keep going to the toilet 'just in case'.

Pelvic floor muscles come under a lot of strain during pregnancy and childbirth. They can sometimes be slow to squeeze well after birth and become less effective at controlling your bladder.

Preparing to do pelvic floor exercises

You will need to get into the correct position before you start doing the exercises.

Get comfortable

Choose a comfortable position with the muscles of your thighs, bottom and stomach relaxed. Lying on your side is a good position when you start for the first time.

You can gradually move on and practise the exercises while sitting, standing, walking, or doing other activities.

Correct posture

Holding the right posture will make it easier to do the exercises well. If you are sitting, make sure you sit upright and supported. If you are lying down, push your back flat against the floor.

Correct posture during pregnancy (video)

How to do the exercises

There are 2 ways to do pelvic floor muscle exercises.

It can help to imagine that your pelvic floor is a lift or elevator. The initial squeeze is like the elevator door closing and is followed by a lift of the muscle.

Long hold exercises

These exercises help to build endurance in the muscles.

1. Tighten the muscles around your bottom (anus) as if you are trying to stop a fart.
2. While holding the muscles around your bottom, tighten and lift the muscles around your vagina as if you are trying not to pee.
3. Hold both squeezes for as long as you can (this might be only a couple of seconds to begin with). Keep breathing normally while squeezing the muscles.
4. After each squeeze, relax for the same amount of time as the squeeze.
5. You should have a clear feeling of release when you relax between squeezes.
6. Repeat the exercise several times until the muscle feels tired. Aim for 10 repetitions.

Start with squeezes that last for 5 seconds. Then do it for longer as you feel stronger. Aim to eventually squeeze for 10 seconds.

You may feel the lower part of your stomach draw in when you do this. Gentle tension below your belly button is a good sign. But do not suck in your tummy muscles.

Short holds

These exercises help your muscles react quickly to sudden increases in pressure. For example, a sneeze or cough.

Imagine your pelvic floor is like a lift or elevator.

1. Squeeze the lift door shut, as if you are stopping a fart or pee.
2. Quickly pull up the muscles around your bottom (anus) and vagina, raising them all the way up to an imaginary top floor.
3. Relax the squeeze, as though the lift has dropped back down to the ground floor.
4. Repeat the squeeze as many times as you are able to. Stop when your muscles feel tired.

How to do pelvic floor muscle exercises (video)

When to do pelvic floor muscle exercises

Aim to do pelvic floor muscle exercises 3 times each day while you're pregnant.

It can take time to train the muscles. You can reduce it to 1 session a day when you feel your muscles are strong and react well when you squeeze them.

Practise during activities

If you leak with activities such as walking, take note of your posture and walk tall with your ribcage and pelvis in a neutral position. This will help to naturally engage your abdominal muscles.

Squeeze when you cough or sneeze

Squeezing while you cough or sneeze helps you to avoid accidentally leaking pee. As you breathe in to cough or sneeze, quickly tighten your pelvic floor muscles. Keep squeezing while you cough or sneeze.

Why pelvic floor exercises are so important (video)

Common mistakes

Common mistakes when trying to exercise your pelvic floor muscles include:

• clenching your bum muscles - your bum should not move much when you are doing the exercises
• squeezing your inner thigh muscles
• sucking in your tummy - a gentle tension below the naval is fine, but anything more than this is not helpful
• not relaxing the muscles between squeezes
• holding your breath - try counting out loud while squeezing to avoid this

Other tips

Other tips include:

• do not go to the toilet 'just in case' - learn to take control of your bladder and have confidence in your ability to hold
• drink normally - you should drink 1.5 to 2 litres of water a day if you are pregnant
• avoid fizzy drinks, artificial sweeteners and alcohol - these can irritate the bladder
• keep a healthy weight - having overweight can put more strain on your muscles
• avoid constipation and straining by eating more fibre
• remind yourself to do the exercises by setting an alarm on your phone or putting a sticker on your fridge, car mirror or bathroom mirror

How to know if your pelvic floor is working

You can do some tests yourself to see if your pelvic floor is squeezing well. These are not exercises.

The stop test

When peeing, try to stop or slow mid-stream.

The self test

To do an internal self test, lie down in a comfortable position:

1. Put your thumb into your vagina.
2. Squeeze the muscles around your vagina - you should feel a squeeze around your fingers.
3. Press your thumb towards your anus - you should feel a sensation in your rectum (back passage).
4. Move your thumb to the left and right and pull in the muscles around your anus - you should feel your pelvic floor muscle working.

Recovering after your baby's birth