Despite how much your pelvic floor does for you, most people don’t think too much about these muscles.
The pelvic floor consists of several layers of muscles and connective tissues that sit in your pelvis. This system is responsible for many important bodily functions, including supporting your pelvic organs, controlling your bathroom habits, regulating abdominal pressure, and stabilizing your spine and trunk as you go about your day. The pelvic floor is even involved in sexual function and orgasm.
Although you might not think of it very often (if at all), your pelvic floor should be top of mind during pregnancy. Both men and women can experience pelvic floor issues, but they’re often associated with pregnancy and childbirth.
Caring for your pelvic floor during pregnancy doesn’t require intensive workouts. But research suggests that knowing how to strengthen and relax your pelvic floor can go a long way towards helping prevent post-pregnancy pelvic floor dysfunction.[1]
For more about the pelvic floor, how you can care for it while pregnant and simple exercises to try, read on.
How does pregnancy affect the pelvic floor?
During pregnancy, the pelvic floor muscles have to support more weight as your baby grows.[2] In addition to carrying the weight of your little one, these muscles stretch to accommodate her growing size. Hormonal changes help increase the laxity of your muscles and connective tissue, but even still, over the course of 40 weeks, this is a lot of work for the pelvic floor.
Childbirth (whether you give birth vaginally or via C-section) can also do a number on these muscles: Research shows that your pelvic floor tissues can stretch more than three times their normal length during a vaginal birth.[3] While a C-section causes different stresses to this area, the pelvic floor is still impacted by cesarean deliveries in addition to the stressors of pregnancy.
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Pelvic floor exercises for pregnancy
You might 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 know how to relax the pelvic floor for pelvic floor health.
Many pelvic floor experts recommend preparing your pelvic floor to rise to the occasion of pregnancy and childbirth with both strengthening and relaxation exercises such as the ones below. But if you have questions or are experiencing any unusual symptoms, reach out to your OB/GYN, who may recommend you see a pelvic floor physical therapist for a more personalized routine.
To strengthen the pelvic floor during pregnancy
Early on in pregnancy and through the second trimester, most experts recommend focusing on building strength and endurance in the pelvic floor. This helps keep your pelvic floor strong as your baby grows, which can help you adapt to the increasing stress on these muscles throughout your pregnancy.
To do this, perform pelvic floor contractions (aka Kegels) regularly. You can work them into an exercise routine you are already doing. For example, if you normally lift weights, think about contracting your pelvic floor on the exhale as you perform a bicep curl.
You can also add pelvic floor work to your warm-up or cool-down, such as by performing 10 to 20 contractions before and after a walk or bike ride.
Make sure you are performing a full pelvic floor contraction and release whenever you do Kegels. Try this:
- Sit comfortably on the floor with your knees bent.
- Take a deep inhale, feeling your ribs expand.
- On the exhale, 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. Another visual to try: Think about trying to pick up and hold a blueberry with your vaginal opening. These visualizations can be helpful to make sure you’re contracting the entire muscle group in a coordinated way.
To relax the pelvic floor in preparation for labor
As you enter the third trimester, it becomes more important to focus on learning to relax your pelvic floor as labor nears. Your pelvic floor muscles need to fully relax and stretch so they can make way for your little one to exit!
It may seem silly 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. Here, visualizations may also be helpful:
- Begin by sitting comfortably and taking a few deep breaths, feeling your ribs expand.
- Then, on an inhale, picture a flower gently opening.
- See if you can feel your pelvic floor relaxing and opening as you do this. As you did with contractions, repeat for 10 to 20 breaths.
You can work this into an exercise routine or do anytime you think of it.
When to talk to your doctor about pelvic floor concerns during pregnancy
Some women experience symptoms of pelvic floor dysfunction during pregnancy or postpartum. This could include pelvic organ prolapse or bladder issues such as leaking urine. You should speak with your practitioner about any concerning symptoms you notice at any point during your pregnancy.
Still, you don’t have to wait to see a pelvic floor physical therapist until you're postpartum or experiencing a troubling symptom. In fact, a pelvic floor physical therapist may help you learn how to perform contractions correctly and help get ahead of any issues as your pregnancy progresses.[4]
Working with a pelvic floor PT during pregnancy may even help you prepare for labor: Some PTs offer special sessions or education around labor positions and pushing practice to help you know what to expect and practice for the big day. Your doctor may be able to refer you to someone or you can book a session on your own.
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