Pelvic Floor Exercises – for Pregnancy and Beyond
All pregnant women should do pelvic floor exercises and continue them even after birth, to maintain proper function. At FitMama, the focus is on making you your strongest self, before, during and after childbirth, and pelvic floor exercises are a crucial step towards achieving this goal!
Pelvic floor exercises are very safe to perform during pregnancy and very effective in preventing incontinence and preparing your body for labor. They strengthen your pelvic muscles, which are exposed to great strain during childbirth, and reduce the risk of complications.
Your pelvic floor is a series of muscles located at the base of your pelvis. They make up part of the deep inner core, along with the TVA, diaphragm, and multifidus muscle, forming the deep core unit that requires retraining postpartum.
These muscles are responsible for holding up all of your organs, and have the openings of the anus, vagina and urethra coming through.
There’s a twofold purpose in discussing the pelvic floor here. This first is to equip you with the knowledge to strengthen muscle power and stability in your pelvic floor. The second is to boost complete recovery after childbirth, as these muscles are directly related to incontinence and uterine prolapse.
The pelvic floor muscles are naturally anticipatory muscles that fire when triggered by movement. Due to so much IAP when you get pregnant and as your baby grows, this natural firing of the PF doesn’t happen with the same strength, and the neural connections between the brain and the deep core start to weaken.
If you are not doing core breathing while pregnant, these pathways can start to disengage more and more, to the point where the firing doesn’t occur and pelvic floor dysfunction sets in. Couple that with the weight of a baby, fluid, body fat, placenta, plus your organs.
Your pelvic floor weakens to the point where you could just cough postpartum and get a prolapse (bladder or uterus falling through the pelvic floor), or pee in your pants!
I recommend exercising throughout pregnancy, if that’s safe for you.
Comfortable cardiovascular exercises as well as full-body strengthening moves are best, focusing mostly on squats, and upper body, particularly the back (especially upper due to the demands of pregnancy and then holding baby, feeding, rocking, etc.).
Keeping your glutes strong and functioning can also help tremendously, as can hip flexibility, foam rolling (if you are familiar with what to do), and lots of stretching in the chest to open that area up (it’s usually tight due to posture and activities of daily living).
I do recommend using the Epi-No, a device inserted into the vagina to help prep the muscles for having a baby through the canal. Studies have shown less tearing and need for stitches after vaginal births with it. The device also allows you to connect with those deep muscles and as well as prepare mentally for the birth event.
Kegels are only a part of the pregnancy puzzle. Most to-be moms are doing Kegels wrong which is why I recommend seeing a pelvic health phsyio, or having your OB or midwife check if you are doing them right by actually feeling your pelvic floor.
Since most people are focused just on the tightening aspect of Kegels, they forget to do the important relaxation phase of a full contraction. It’s like just doing the top part of a bicep curl, which leads to hypertonic (too tight) muscles that don’t fully relax, and this can lead to long and non-progressive labors.
It is the key to learning the core breathing techniques . I teach because it allows for full relaxation of the pelvic floor, which is intimately connected to a full inhale into the upper abdomen and engaging the diaphragm.
The consequences are serious to say the least. Quality of life is greatly affected if you need to pee all the time and cannot hold it, or if you sneeze and pee, just leak during exercise or even all the time. As we age, it’s one of the leading reasons that older adults are placed in nursing homes – their kids do not want to deal with it!
Back pain is another serious consequence. When we are dealing with babies and small children, living in chronic pain is far from the ideal. Prolapse is a very serious consequence, which can require surgery more than once. It can not only be uncomfortable and embarrassing, but can also lead to a major quality of life issues.
Painful sex can often be another sign of pelvic floor dysfunction, but you do not need to live with any of these problems. Go see your pelvic health physiotherapist and take care of yourself when you’re pregnant and postpartum. You will thank yourself for it for years down the road!
Don’t do abdominal moves during pregnancy, or do anything else that causes more IAP, like bearing down, planking, holding your breath or sucking in at your belly button. Do not do crunches or all the contraindicated moves listed either (on other page or above – link to it?).
Take the time to heal pp, by following FitMama’s instructions regarding no stairs, waiting to walk, and taking your rehab seriously.
Using imagery can help with exercises for pelvic floor muscles, and I talk about the “blueberry” in my core breathing instructions.
You will be stronger than before you had kids!