Looking after your pelvic floor during and after your pregnancy

Looking after your pelvic floor during and after your pregnancy

It’s important for all women to look after their pelvic floor, but especially during pregnancy and after their baby is born. This special group of muscles work much like a supportive  sling and hold the   uterus, bowel, and bladder in their correct position. The pelvic floor muscles also support the urethra, rectum and vagina.  

Pregnancy is a time of hormonal overload.  One of the main hormones is progesterone, also known as the ‘softening’ hormone. Its role is to loosen the woman’s muscles and ligaments so she can more easily give birth. Although this is beneficial, there’s a negative side to that softening as well, especially after the baby is born. This is when many women experience problems regaining the tone in their pelvic floor and develop incontinence (weeing involuntarily). 

Having heavy babies, a long second (pushing) stage, multiple babies and being gaining a lot of weight during pregnancy adds to the likelihood of having pelvic floor problems.

Pelvic floor exercises in pregnancy

Start doing pelvic floor exercises from early in your pregnancy – with practice and repetition you’ll become better at them and they won’t be so challenging.  Doing a pelvic floor exercise program will also help your muscles recover more quickly after your baby is born. They will also reduce the risk of prolapse and incontinence (involuntary wetting), which affects one in three women who’ve ever had a baby.

Another name for pelvic floor exercises is Kegel’s which target the pelvic floor.  Try to do these daily, after you’ve gone to the toilet and you’re not rushed. You can find your pelvic floor by sitting on the toilet and starting to wee.  Once the wee is flowing, concentrate on stopping the flow and you’ll feel your muscles lift.  These are your pelvic floor muscles. Just be mindful that stopping and starting can increase the risk of developing a urinary tract infection. It’s not something you should do routinely.

How to do pelvic floor exercises

  • Close your eyes and focus on the muscles which are supporting your vagina, anus and urethra and then tighten them. If you’re doing this right, you’ll feel a pulling and lifting sensation.
  • Sit up straight and relax your shoulders. Imagine an invisible thread running from your head, through your spine and into your bottom. Concentrate on your rectum and lift and squeeze upwards and inwards.  Now, extend this tightening to  the front as though you were trying to stop weeing.
  • Lift and squeeze your pelvic floor and count how long you can hold for. Aim for 3 seconds at the start and then build up to 10 seconds as you get stronger.
  • Keep breathing and also concentrate on keeping your shoulders, buttocks, thighs, hands and feet relaxed.  
  • Rest your pelvic floor muscles for the same amount of time as you held the lift. Be patient, this can take time.
  • Aim for 3-5 holds in one set and build up to 10 over time. Repeat 3 sets each day. 

Nurture your pelvic floor

Just like when you start any other exercise program, it will take time and practice to feel any results. Be patient with yourself.  For at least the first 6-8 weeks, you’re unlikely to feel much difference to your pelvic floor strength and tone. 

  • Avoid straining and pushing when you go to the toilet. Eat a healthy and nutritious diet to avoid becoming constipated.
  • Try not to lift anything heavy, especially if you’ve got a weak pelvic floor. It’s easy to strain the back and pelvic floor muscles, especially when progesterone levels are high.
  • When you’re about to cough, sneeze or laugh, tighten your pelvic floor first. This will help to ‘brace’ your pelvic floor.

Speak with a physiotherapist who has a special interest in pregnancy and women’s health if you have incontinence or any pelvic floor problems.

Written for Belly Bandit by Jane Barry, Midwife and Child Health Nurse – April 2022

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