5 Pelvic Floor Exercises for Pregnancy

While every pregnancy and birth experience is unique, one universal truth exists for everyone regardless of your age, fitness level, or birth plan: pregnancy pushes your pelvic floor to its limits.

As you might already know, your pelvic floor is a group of muscles located at the base of your pelvis. These muscles are attached to your tailbone, pubic bone, and sit bones. They surround your vaginal, anal, and urethral openings and they form a bowl at the bottom of the pelvis. As with all muscle groups, their job is to contract and relax; but because of their location, when they contract, they work to hold in urine, gas, and bowel movements, they support and uplift your internal organs including the bladder, uterus and rectum, and they stabilize your pelvic joints for walking and movement. When they relax, they allow you to pass a bowel movement, empty your bladder, insert a tampon, engage in penetrative sex, and deliver a baby.

Few muscles have more responsibilities or work harder or more often than the pelvic floor, pregnant or not. But in pregnancy, your body undergoes many dramatic changes that will push your pelvic floor to do even more. As your hormones shift, your ligaments become less rigid and joints more flexible, as your baby grows, your body must carry around much more weight, and as it becomes more awkward and challenging to move around and perform your everyday tasks, your muscles, especially your pelvic floor, need to work that much harder in order to provide stability during these movements.

Not everyone experiences pelvic floor dysfunction in pregnancy, but with all these changes, it is not uncommon for the pelvic floor to drop the ball at least once in a while: 70% of women report incontinence, 40% will report difficulty passing bowel movements, and 1 in 5 women will experience pelvic girdle pain (pain in one or more pelvic joint) during pregnancy. Having a strong and well coordinated pelvic floor during and, ideally, before pregnancy, is the best way to prepare your body for these changes and avoid dysfunction altogether.

Working with a pelvic floor physical therapist during pregnancy is a great way to learn about your body's abilities and potential limitations, learn strategies to prevent small issues from becoming larger ones, and also learn how to best prepare your pelvic floor for the demands of pregnancy, delivery and postpartum. But until you're able to set up that appointment, here are 5 exercises that you can start today to support a strong and healthy pelvic floor at any and every stage of pregnancy.

Pelvic Floor Exercises for Pregnant Women

1. Kegel Coordination Practice

Most people can feel themselves turn the pelvic floor muscle all the way on (i.e. a kegel or contraction), but can you feel yourself turn them all the way back off, too? It can be a challenging sensation to tap into because you aren't actively doing anything: you're just allowing gravity to pull your pelvic floor towards the ground as you release your hold on the muscle. If this feels frustratingly difficult, then keep practicing or consider reaching out to a pelvic floor PT to help guide you through this. And if this feels easy, take a moment to see if you can allow your pelvic floor to drop even further. Quality really is more important than quantity when it comes to kegels.

How to coordinate kegels with your breath:

Stand with feet hip distance apart.

1. Inhale deeply, allowing air to fill the bottom of your lungs. Feel your lower abdomen, your low back, and your pelvic floor gently stretch outwards with your breath.
2. As you exhale, contract your pelvic floor muscles in a kegel, feeling your pelvic floor lift up and in and your belly button move towards your spine.
3. Relax your pelvic floor during the next inhale.

Tip: Once this feels easy, try to contract and relax your pelvic floor muscles while breathing normally.

2. Diaphragmatic Breathing

A muscle works well when it has access to its full range of motion. Maintaining the function and range of motion of your diaphragm in pregnancy is a great way to keep your pelvic floor muscle's function and range of motion in check, as well! Try to keep your chest and ribs still during this exercise so that your diaphragm is challenged to do all the work of breathing. As you inhale, practice feeling your abdomen expand outward and downwards into your pelvis. With each inhale, imagine your pelvic floor lengthening like the bottom of a balloon as it inflates with air. As you exhale, allow your abdomen to gently recoil back towards your spine.

How to breath with your diaphragm:

Lie flat on your back in a comfortable position.

1. Place your hands beneath your ribs and on the sides of your belly.
2. Inhale, feeling your abdomen expand outward and into your hands, your pelvis, and your back as your lungs fill with air. Imagine your pelvic floor lengthening like the bottom of a balloon as it inflates with air.
3. Exhale, allowing your abdomen to gently recoil back towards your spine.

Tip: Try to keep your chest still — place a hand on your chest to help you see how much movement is happening there throughout this exercise.

3. Belly Lifts

Your transversus abdominis muscle of the core attaches along the top rim of your pelvis while your pelvic floor attaches along the bottom rim of your pelvis. These two muscles work together all of the time to stabilize your pelvis. If you allow your core to become weaker or more lazy in pregnancy, then that just leaves more work for your pelvic floor to take on. Give your pelvic floor some support by keeping the abdominal muscles of your core strong and supportive throughout your pregnancy.

How to do belly lifts:

Start on your hands and knees with your hands under your shoulders and knees under your hips.

1. Inhale, filling your belly with air and relaxing your it towards the ground.
2. Exhale, as you pull your belly button up and in towards your spine.

Tip: Keep your back flat and unmoving for the duration of the movement. Your belly is the only thing that moves.

4. Deep Squat Stretch

Maintain the flexibility of your pelvic floor and hip muscles by moving your body into this extreme position. This should not be painful, so consider beginning by lowering your pelvis onto a stool or box, and as you feel you can move into a deeper stretch, move to a yoga block or pillows. What is most important is that you bring yourself into a position that feels like a good stretch and then practice releasing your pelvic floor more fully in that position.

How to do a deep squat stretch:

Stand with your feet hip-distance apart and your toes angled slightly outward.

1. Draw your belly button in toward your spine to stabilize your back and pelvis.
2. Lower into a deep squat, allowing your knees to rotate outward and away from your center. For added stability, place a yoga block under your hips or hold onto a stable surface like a door jam or banister.
3. Hold this pose and breathe, relaxing the muscles in your abdomen, pelvic floor, and the surrounding areas.
4. Engage your lower abdominal muscles and squeeze your glutes to return to standing.

5. Light Cardio

Your pelvic floor activates every time you move. So building a daily routine of regular movement or exercise is a great way to build and maintain strength, endurance and good muscle tone. If you aren't already exercising, consider reaching out to a physical therapist for more targeted advice based on your environment, interests, and needs. But research supports even just walking in pregnancy because of the many health benefits that regular movement brings to you and your baby.

If you aren't already exercising, here are some general tips for beginning a walking program in pregnancy:

1. Try walking for 5 minutes (avoiding hills, if possible) 1-3 times a day.
2. If you do not have symptoms during or after your walks, try to increase your walking time or frequency a little each day (consider increasing to four 5-minute walks a day or maybe two 8-minute walks, for example).
3. Continue to gradually increase your distance or time walking until you can walk up to 30 minutes in a row 1-2 times a day without any symptoms (pain, pressure, heaviness, bleeding, incontinence, etc).

Before beginning any exercise, speak with your medical provider to learn if you have any specific conditions that may impact your ability to exercise or if you should take any precautions before beginning an exercise routine. Depending on your situation, your doctor may recommend that you work with a physical therapist who specializes in pregnancy and the pelvic floor before beginning any new exercise. Origin physical therapists are ready to work with you wherever you are in your pregnancy, whether you are 36 weeks and still jogging or 16 weeks and recovering from months of nausea, vomiting, and bedrest, our team is ready to meet you where you are to help you reach your goals and prepare your pelvic floor for the journey ahead.