(English) Pelvic floor health during pregnancy and beyond

When your pelvic floor is strong and functioning as it should, you may not give it much thought. But that all changes when the muscles in your pelvic region aren’t working as expected. Often, this time comes during pregnancy and after childbirth. Your pelvic floor muscles have always supported the organs in your pelvic region, until your body starts to change. Then, you may notice you can’t hold your bladder like you used to—this is a sign of a weak pelvic floor.

In this guide, we’ll help answer some of your questions about pelvic floor health (including ones you didn’t even know you had). Keep reading to learn what happens to your pelvic floor during pregnancy, how to strengthen those muscles with pelvic floor exercises for women, and more.

What Is the Pelvic Floor?

The pelvic floor is made up of muscles and tissues that stabilize your core and support the organs in your pelvic area. For cisgender women, this would include your bladder, bowel, uterus, and vagina. These muscles have a very important job: They’re responsible for keeping your organs in place, and they’re involved in essential bodily functions, like peeing.

They also have an additional role during pregnancy. Throughout those nine plus months, the pelvic floor muscles help support your growing baby's weight. Then, during labor, they relax and stretch. If your pelvic floor is strong, you have better control of the muscles, which may make a vaginal delivery easier.

Understanding Pelvic Floor Weakness During and After Pregnancy

Pregnancy can put a lot of strain on your pelvic floor and weaken the muscles. If you have a weak pelvic floor, symptoms can include:

• Losing control of your bladder and peeing when you laugh, cough, or sneeze
• Needing to pee frequently and being unable to wait
• Having trouble controlling your bowel movements and when you pass gas
• Experiencing pelvic pain, including during sexual intercourse

Pelvic floor prolapse is also a condition that can be caused by weak pelvic floor muscles. However, it’s most common after menopause. It occurs when the organs in your pelvis are unsupported and start to either bulge into or protrude from your vagina.

What else can cause a weak pelvic floor?

Pregnancy and pelvic floor stretching during childbirth aren’t the only causes of weakness. Pelvic injuries and surgeries, straining to use the bathroom, and aging are all among the possible causes of pelvic floor dysfunction.

Can pelvic floor muscles be too tight?

More attention is paid to weak pelvic floor muscles than overly tight ones, but the latter is possible. For some people, childbirth can cause the muscles to tighten, which may result in:

• Being unable to pee or having to pee frequently
• Becoming constipated or struggling to have bowel movements
• Experiencing pelvic pain
• Having pain in your back and legs

If your muscles do become too tight, you can try pelvic floor relaxation exercises. Some common yoga poses, including happy baby and child’s pose, may help. Still, it’s possible you’ll need to retrain your muscles with physical therapy.

Pregnancy Tips for Pelvic Floor Health

There are a number of things you can do to keep your pelvic floor healthy both pre- and post-baby. Below, find some tips you can try to strengthen and maintain your muscles.

Try pelvic floor muscle exercises

Like other muscles, you can work out your pelvic floor—no dumbbells or fancy workout sets required. Rather, you’ll perform exercises called Kegels, where you repeatedly squeeze and relax your pelvic muscles. Doing Kegels can be beneficial for everyone, but there are quite a few benefits associated with pregnancy in particular. They can help with bladder control, supporting your baby in utero, pushing during labor, and perineal healing after the birth.

To perform pelvic floor muscle strengthening exercises, start by locating your pelvic muscles. Then, tighten them for a few seconds before releasing and relaxing the muscles. That is a Kegel, and you can do it while you sit, stand, or lay down (which means these exercises are super easy to fit into your daily routine).

You can build up strength over time by gradually increasing how long you hold your Kegels for and how many you do. A good place to start is with tightening for just three seconds at a time. From there, you can increase to holding for eight seconds and, eventually, 12. However, don’t try to jump straight to 12. Doing too much, too soon, can strain the muscles. As for how many prenatal pelvic floor exercises to do, the Cleveland Clinic recommends starting with eight Kegels three times per day.

Maintain good posture

Your posture is something you might not even realize is connected to your pelvic floor health. When you have bad posture, the stress on your muscles is not balanced correctly, and this can affect your pelvic floor.

Changing your posture may be easier said than done, but the first step is to become more aware of it. Pay attention to how you sit and stand. Your goal should be a neutral spine where you don’t tilt too far in any direction.

Avoid heavy lifting

Heavy lifting is generally considered an activity to avoid during pregnancy. But if you need another reason not to pump iron at the gym or carry new nursery furniture by yourself, lifting can also affect your pelvic floor muscles. Picking up something heavy puts tension on the pelvic floor and can strain those muscles.

Drink plenty of water

Unfortunately, constipation is a common digestive issue that women can experience during pregnancy. And it can further stress your pelvic floor muscles.

Because dehydration can cause constipation, making sure to drink enough water is helpful for prevention. You also may want to consider what else you drink. Some beverages, like coffee and soda, can be dehydrating. This is one more reason you might want to limit caffeinated beverages while pregnant.

If you do become constipated, we recommend consulting your doctor.

Post-Birth Pelvic Floor Care

With childbirth (and children), you can prepare and prepare, but things don’t always go to plan. The same is true of pelvic floor health. You can do your best to exercise your pelvic muscles during pregnancy, but they can still weaken, and you may still need a post-birth care plan. In fact, according to one study, the majority of women experience pelvic floor trauma during a vaginal delivery.

Here are some tips to keep in mind for after the birth.

Be patient with recovery

Your body goes through a lot during pregnancy and delivery, and it takes time to recover. If your pelvic floor muscles are weak after childbirth, don’t push yourself and expect them to snap back immediately. You need to give your body time to heal. This means you shouldn’t rush to immediately start doing intense pelvic floor exercises after birth—this can actually exacerbate the issue.

Start with gentle exercises

You’ll need to rebuild strength in your pelvic floor gradually with gentle exercises. Typically, it’s safe to start a few days after a vaginal delivery. You can check with your doctor to confirm you’re ready.

Pelvic tilt exercises are one option that can help strengthen your core. Lay down on the floor with your back flat and your knees bent. Then, tighten your abdominal muscles and lift your pelvis up. Hold for a few seconds, relax, and repeat.

You can also do Kegels, just like you would during your pregnancy. In postpartum, the Mayo Clinic recommends doing at least three sets of 10 each day.

Practice proper lifting techniques

After delivery, don’t rush back to heavy weightlifting. When you do need to lift something, make sure it’s not too heavy for you and that you know how to lift it properly. Here’s what to do:

1. Tense your pelvic floor muscles.
2. Bend from the hips.
3. Lift.

If you can, it’s safer to lift objects off of a higher surface, like a table or counter, rather than the floor.

Talk to an expert

For health-related concerns, your doctor should be the first person you consult. Pelvic floor weakness after childbirth is common, and they should be familiar with any issues you’re experiencing.

You can also speak with a specialized pelvic floor physical therapist. They can help you develop a plan with pelvic floor therapy exercises and address your concerns.

Maintaining Pelvic Floor Health Long-Term

After childbirth, problems associated with a weak pelvic floor, like incontinence, typically go away within weeks. But it is possible for them to persist.

Even once you strengthen your pelvic floor muscles, you won’t want to forget what you’ve learned here. It’s important to continue caring for your pelvic floor, and you don’t have to be pregnant or postpartum to benefit from Kegels.

In addition to Kegels and other pelvic floor exercises, staying active with regular physical activity can be good for your pelvic health. Plus, it’s good for your body in general. As always, consult with an expert before beginning any new routine.

What to remember about your pelvic floor

• It’s important to care for your pelvic floor both during and after pregnancy.
• This care shouldn’t stop a designated number of weeks or months after delivery—you want your pelvic floor muscles to stay strong always.
• You don’t need to wait until you experience signs of pelvic floor weakness to care about your pelvic health. It’s best to be proactive and add exercises to strengthen pelvic floor muscles to your routine now.
• Maintaining a healthy lifestyle can also be good for your pelvic floor and is great to do proactively.
• Don’t handle pelvic floor weakness or any related issues alone. You can work with your doctor or a pelvic floor specialist to get personalized guidance. This is especially important if it’s a persistent issue.

If you’re currently pregnant, caring for your pelvic floor will just be one part of a good care plan. Next, read our article on why you should be taking prenatal vitamins.