Pelvic floor exercises help to strengthen the muscles of your pelvic floor. These come under great strain in pregnancy and childbirth.
Having a strong pelvic floor helps you:
- support the weight of your growing baby
- control unintentional peeing (urinary incontinence)
- support your pelvic organs
All pregnant women should do pelvic floor exercises. Doing pelvic floor exercises during pregnancy can reduce problems with bladder control (urinary incontinence) after the birth.
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 or 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
If your pelvic floor is weak
If your pelvic floor muscles are weak, you may leak pee when you sneeze, cough and exercise during pregnancy or afterwards.
Pelvic floor exercises help to strengthen these muscles. These are sometimes called Kegel exercises. These exercises 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.
If you are experiencing urinary incontinence, talk to your GP, obstetrician or midwife. They can refer you to a specialist physiotherapist at your local maternity hospital.
How to do pelvic floor exercises
You will need to get into the correct position before you start doing the exercises.
If you have not done pelvic floor exercises before or you have a weak pelvic floor, 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.
Then you can gradually move on and practice the exercises while sitting, standing, walking, or doing exercise.
Holding the right posture will make it easier to do the exercises correctly. 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
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 this is followed by a lift of the muscle.
Slow pelvic floor muscle exercise
- Tighten the muscles around your bottom (anus) as if you are trying to stop a fart.
- While holding the muscles around your bottom, tighten and lift the muscles around your vagina as if you are trying not to pee.
- Hold both squeezes for as long as you can - keep breathing normally while squeezing the muscles.
- After each squeeze, relax for the same amount of time as the squeeze.
- You should have a clear feeling of release when you relax between squeezes.
- 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. This is a good sign if it is a feeling of gentle tension below your belly button. But do not suck in your tummy muscles.
Imagine your pelvic floor is like a lift or elevator.
- Squeeze the lift door shut, as if you are stopping a fart or pee.
- Quickly pull up the the muscles around your bottom (anus) and vagina, raising them all the way up to an imaginary top floor.
- Relax the squeeze, as though the lift has dropped back down to the ground floor.
- Repeat the squeeze as many times as you are able to.
Pelvic Floor Muscle Exercises - How to do them
When to do pelvic floor muscle exercises
You should 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.
Practice during activities
Most women only leak when doing activities. To prevent accidents when out walking or doing exercises, learn to hold your posture and abdominal control. This means gently drawing in the lower tummy (below your belly button) or making it tense.
Squeeze when you cough or sneeze
Squeezing while you cough or sneeze helps 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 squeeze.
Why pelvic floor exercises are so important - HSE mychild.ie
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
- bearing or pushing down on your breath while squeezing
Other tips include:
- do not go to the toilet 'just in case' - learn to take control of your bladder and have confidence
- 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
- watch your weight - being overweight can put more strain on your muscles
- avoid constipation and straining by eating more fibre in your diet
- 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:
- Put your thumb into your vagina.
- Squeeze the muscles around your vagina - you should feel a squeeze around your fingers.
- Press your thumb towards your anus - you should feel a sensation in your rectum (back passage).
- Move your thumb to the left and right and pull in the muscles around your anus - you should feel your pelvic floor muscle working.