Basic pelvic floor exercises maintain muscle tone in the pelvis and promote recovery after pregnancy and delivery.
Practicing these exercises will help you feel connected to what happens inside your body, as well as increase your strength and resistance to prevent problems related to this area.
It’s also recommended to carry out these exercises during pregnancy and after delivery, at which time they’ll help you avoid urinary incontinence.
If you’re interested in practicing any of them, it’s important to speak with your doctor in order to receive any pertinent warnings, guidance or recommendations.
1. Butterflies
This simple exercise opens the pelvis and keeps the lower back flexible. You can practice it during all stages of pregnancy.
To do this, you must sit on the floor and connect the soles of your feet.
Next, push your legs up and down until you feel the stretch. You can even have your partner participate by adding some resistance to get a deeper stretch.
2. Bridge
To perform this second exercise, you should lie on the floor on your back with your knees bent and your feet flat on the floor, separated at the width of your hips.
Next, inhale, contract the pelvic floor and lift your hips in the air. Hold for 10 seconds.
Finally, lower your hips and release your pelvic floor. Ideally, do 10 repetitions.
3. Pelvic incline
This third exercise is very gentle and can even be done when rest has been recommended by your doctor.
In fact, you can do it from the first day of pregnancy to the moment of labor.
It consists of lying on your back with your feet on the floor and your knees bent. Your hands should be next to your hips and act as firm anchors.
If you try to place your hand under your back, you’ll see that it slides easily underneath, since there is an area that isn’t touching the floor.
To do this exercise, press this part against the floor for ten-second intervals. It may be repeated up to eight times, always maintaining normal breathing.
If after 30 weeks you want to try to turn the baby, you should do these inclines when you feel the baby move.
The child may be trying to obtain a better position for delivery, and you can facilitate this process through pelvic inclines.
It is advisable to perform the exercise three times a day for a total of 20 minutes per day when you arrive in the third trimester.
Basic pelvic floor exercises are recommended during pregnancy and after delivery, at which time they’ll help you avoid urinary incontinence.
4. Forward inclines
To counteract all the time we spend reclining each day, it’s important to lean forward. Whether leaning on counters, tables or people, anything works.
In these cases, an exercise ball can be a great ally for pregnant moms who wish to carry out this exercise. It’s helpful not only before delivery, but during it.
Place the arms and upper body on the exercise ball and turn around while the pelvis moves in the air.
This way you’ll be able to prepare the lower part of the body for natural labor.
5. Inverse forward inclines
This movement helps to loosen the lower uterine ligaments.
Due to poor posture and a sedentary lifestyle, the uterus may writhe and become tight. This leaves less space for the baby to be in optimal position.
To practice it, you should kneel on the edge of a sofa or bed and slowly lower your hands and forearm to the floor. You can use a stool or call your partner for help if you need it.
Next, let your head hang freely and keep your chin tucked.
Flatten your back and hold the position for 30 seconds before raising your hands back up. Then, get up again to a kneeling position, using a stool or a helper.
You can do this one to three times per day.
Keep in mind that you shouldn’t practice this exercise if you have abdominal or uterine cramps, have high blood pressure or feel excessive movement from the baby.
6. Elevator
This last pelvic floor exercise strengthens the muscles. In this exercise, the lower back and arms are involved, and therefore it tones and strengthens the area.
To do it, lie on your back with your knees bent and your feet flat on the floor. Next, inhale and lift your hips while tightening your pelvic floor.
Finally, continue to breathe, hold your hips up for about 10 seconds and lower your hips while releasing the pelvic floor. You must perform 10 repetitions to complete the exercise.
These 6 basic pelvic floor exercises that we’ve shown you provide innumerable benefits for moms. Try them and make a very important contribution to your well-being during pregnancy.
Scenario one: Urinary urge incontinence
You’re standing in line to buy your groceries and all of a sudden you get this uncontrollable urge to pee. Oh shoot — what can you do? You’re nowhere near the washroom and all the food is on the conveyer already. You hope and pray that you can control the urge until you get to the bathroom. Then — oh no — you let a little out! You’re a grown woman, not a toddler. You wonder, shouldn’t you be able to control this urge? Your friends say, “Thats normal, you had a baby!”
Scenario two: Urinary stress incontinence
You’re getting ready for an exercise class and you go to pee before the class — just in case. It’s a tough class, so you drink a lot of water. Halfway through, your instructor yells out, “Okay, now let’s do some squat jacks!” (It’s a jumping jack into a squat.) Oh no, you think. You start to do the exercise and yes, you guessed it — you leak a little pee!
Both these scenarios are very common in women who have given birth, and it doesn’t even have to be a vaginal delivery either, C-section mamas suffer too. The downward pressure during the 40+ weeks of pregnancy causes a weakening and/or tightening of the pelvic floor, teamed with poor alignment and improper breathing techniques. The core muscles start to shut down and malfunction (so to speak), which leads to urinary leakage. Now this is just a brief explanation on the subject, there are many more causes other than poor alignment and poor breathing techniques. My main aim here is to enlighten you and tell you that you DON’T have to suffer, it CAN be fixed (or symptoms reduced, depending on the severity of damage). You don’t have to leak when you cough, sneeze, squat or jump!
It wasn’t until well into motherhood that I realized I was having issues. I was so focused on being a good mother (and dealing with an injury) that I ignored the symptoms and brushed it off thinking it’s okay, it’s normal, lots of women are incontinent. IT ISN’T NORMAL! It’s common, but NOT normal. Hopefully I am reaching you early into your journey, but if I haven’t, that’s okay — it can be treated years later.
Step One: Physiotherapy
Book an appointment to see a pelvic floor physiotherapist. There are so many talented therapists in Canada that can help to figure out the WHY behind your incontinence. Google your province’s physiotherapist’s association to find someone near you. I recommend all women go visit a physio regardless of If they are incontinent, it can reveal a lot about your pelvic health and prevent any future occurrences.
Step Two: Belly Breathing
While you wait for your appointment (some physiotherapists have a long wait list), learn how to do a belly breathe, also known as diaphragmatic breathing.
Start sitting on a ball or lying on your side, take a few deep breaths into your belly whilst trying not to let your ribcage rise or fall. Inhale through your nose while your belly moves out, and exhale through your mouth (pursed lips) as your belly draws back in. Once you have mastered breathing into your belly, try incorporating your pelvic floor. On the inhale, feel your pelvic floor soften and drop down (do NOT push it down) and your belly move out. Then, on the exhale, imagine you are scooping something up off the floor, lifting your pelvic floor up off the ball and pulling your belly up and in. Focus on your breath every day and do 10 deep belly-breaths every morning and every night. This can be introduced as early as one week postpartum, as long as you feel comfortable and don’t feel any discomfort.
This is the foundation to everything — when exercising, you need to use this breath to move. When you are doing the hardest part of the exercise (usually the lift/pull/push), you need to exhale and lift the pelvic floor (e.g. inhale as you lower into a squat, exhale as to lift out of a squat).
Step Three: Exercises
Follow these exercises and focus on proper postural alignment throughout the day. Complete 10 repetitions of each exercise, three times round. Try to remember to do them every day. I tend to do them first thing before I get out of bed so I know they have been done for the day.
Bent leg heel slide — x 10 per leg
Side-lying bent leg lift — x 10 per side
Side-lying clam — x 10 per side
Butterfly — x 10 (Focus on fully relaxing at the bottom of the move and lift using your glutes — specifically gluteus medias, the outer glute muscle — rather than your hip flexors.)
All-fours toe tap — x 10 per leg
Happy workouts, mamas! And don’t forget to consult with a medical professional before beginning any exercise regime.
It’s a well known fact a woman’s body changes as she goes through pregnancy.
As your baby grows, your body stretches and your pelvic floor is weakened – which can lead to various problems. But despite the embarrassing symptoms – including leaking urine when coughing and sneezing – women are suffering in silence.
Wanting to help women, the Us Mums Hull team, run by Hull City Council‘s Healthy Lifestyles Team have held the city’s first ever pelvic health workshop to try and reduce the stigma around the problems women are facing.
It is just one of several workshops, events, walks and exercise sessions the team – which is funded by Sport England – is holding throughout the city in an attempt to help women keep fit, active and social during pregnancy and beyond.
Diane Mawer, Clinical Lead for physiotherapy in obstetrics talks to mums in the pelvic health workshop(Image: Joanna Lovell)
Leila Lapse-Berga from Us Mums said: “Pelvic health is so important and hasn’t been spoken about enough. We at Us Mums think we are in a good position to talk about that.
“Many women say to us they would like to do exercises, but they don’t know how, and they don’t want to openly talk about it.
“We have seen how pelvic floor related issues can affect a woman’s mental and physical health, yet we can help to fix it.
“So after a mum came to me in one of our sessions and told me her problems, we decided to launch these workshops to try and get women talking about it.”
During the free session, which was held at Hull Arena, Diane Mawer, clinical lead for physiotherapy in obstetrics, based at Hull Women and Children’s Hospital, talked to new mums about everything they need to know about their pelvic floor. Here’s what she had to say.
What is the pelvic floor?
The pelvic floor refers to the muscles at the bottom of the pelvis. They are the muscles responsible for holding things up in the pelvis. (The uterus, bladder and rectum). These muscles help with sexual function, bowel functions, wee functions and birth.
When women get pregnant, it’s often the first time we think about our pelvic floor, as our body changes.
When is a good time to start exercising your pelvic floor?
Leanne James, 36 who runs My Baby Can Dance workshops with her newborn attended the pelvic health workshop(Image: Joanna Lovell)
During pregnancy. Women who exercise their pelvic floor during pregnancy have a stronger pelvic floor then those who don’t.
What can I do to strengthen my pelvic floor?
Exercise
We allow women 24 hours off after birth to rest the muscle, but after this time, women should start exercising their pelvic floor.
We want women to start using these muscles again and not be afraid of it being sore or hurting. It may take a while before it starts to feel better, but that doesn’t mean the exercises aren’t working.
Rest
Women are told after they’ve had a baby to rest, and there is a very good reason for this, your pelvic floor needs to recover.
Your pelvic floor objects if you push it too hard, so think about what you are doing, are you on your feet, taking long walks, doing the vacuuming too soon? If you don’t give it a chance to recover, this is when you risk a prolapse.
Diet
If you’re not eating properly, this can affect your pelvic floor.
Women need to look at their diet and fluids intake. For example, too many fizzy drinks and drinks with caffeine will irritate your bladder.
Also, being constipated will weaken your pelvic floor.”
How do I exercise my pelvic floor?
You need to be thinking about squeezing and lifting, as if you are desperate for a wee.
You are squeezing and lifting inside, and holding this for up to ten seconds. You need to keep breathing whilst doing this.
I try to pull up slowly and smoothly and bring it down smoothly and slowly. Others think about bringing it up in a lift, and up and up again.
These exercises are for your slow twitch fibres, they are going to help stop you from going to the toilet so often, and women should do three groups of ten a day.
You also need to exercise your fast switch fibres – these are the ones to work to stop you leaking when you cough, sneeze and lift things.
With these you need to squeeze up and let go, and also do three groups of ten of these aswell.
Women need to do these at the front, middle and back. To make it easier to do the back women should stand with their feet facing inwards.
What can happen if my pelvic floor doesn’t work properly?
Urinary Incontinence (UI)
Urinary incontinence is a sign of a weak pelvic floor(Image: Getty Images)
This is known as an involuntary loss of urine. It is distressing and socially disruptive. Many women delay health treatment for this for many years due to being embarrassed.
Many women believe it is “inevitable” after childbirth, and not be aware there are treatment options. It has been estimated that UI affects more than 20 per cent of people aged 40 and over, equivalent to five million people in the UK.
A common form of problem is where women can’t even sneeze or cough without leaking urine. The reflex which stops you leaking, which closes the bladder neck, isn’t always under control when women have just had a baby.
Pelvic Organ Prolapse
The pelvic floor holds in place the uterus, bladder and rectum. If these support structures are weakened by over-stretching, the pelvic organs can bulge (prolapse) from their natural position into the vagina. Sometimes a prolapse may be large enough to protrude outside the vagina.
Prolapse is very common. It can cause a feeling of heaviness, and can cause bladder and bowel problems, and sexual activity may be affected.
Almost 50 per cent of women over the age of 50 suffer a prolapse. This is when the back passage and uterus sag down through the pelvic floor.
This can be temporary and is usually because women have done too much. It is correctable by doing pelvic floor exercises.
Urgency
Women will get that feeling of ‘I need to go to the loo now’, and they won’t be able to hold it. We can retrain our bladders though and solve this problem.
Frequency
Women with weak pelvic floors will find themselves going to the toilet too often. Going often in pregnancy is normal, but it’s not normal to go so often once the baby is born.
Common questions answered by Diane Mawer
Diane Mawer, Clinical Lead for physiotherapy in obstetrics talks to mums in the pelvic health workshop(Image: Joanna Lovell)
Q) “I’m an older mum, struggling with my pelvic floor, even though I’ve done my exercises. Is there anything else I can try? I had my baby five weeks ago.
A) “You could pull up every time you cough and sneeze, or bend over to help make it stronger. You could also look at your diet, are you drinking too many fizzy drinks, and alcohol can also irritate your bladder. But five weeks is not a long time. Women put pressure – society doesn’t help because we see women exercising and ‘getting back out there’ very soon after having a baby. But actually you do need to rest your pelvic floor after birth.
Q) What can I do if I’ve got a problem with my pelvic floor?
A) “You can ask your GP to refer you via the incontinence service to women’s health physio.
Q) Do pelvic floor over-the-counter devices work?
A) We are all looking for a quick fix, but I would suggest doing the exercises first.
Q) How long will it take to see an improvement?
A) Women should expect to see a difference quite quickly. If you are looking to see improvements, see if you can hold the squeeze for a bit longer. But like everything, you’ve got to keep doing it.
Q) How can I remember to do my exercises?
A) There are apps you can download that ping when it’s time to exercise. But actually I find it best to get into a routine. For example you might do it when you’re sat crawling in traffic, I personally do it when I’m waiting in a queue in a shop. It’s not a massive commitment, and when you get feedback that it’s working, you know they are working and so it becomes as familiar as cleaning your teeth. The point is, we can do these exercises wherever we want, without anyone even knowing we’re doing them.
Researchers say despite the high failure rate, most women report feeling better after the surgeries. Experts note there are alternatives to the procedures, too.
In the United States, one in three women experience pelvic floor disorders.It’s a common ailment and so are surgical procedures to treat it.According to a recent study in the Journal of the American Medical Association (JAMA), failure rates for two procedures used to treat the disorder were equally high, coming in at more than 60 percent.Despite this high failure rate, more than half of the women surveyed still reported a better quality of life after the procedure.Pelvic floor disorders can cause incontinence and painful intercourse. They can also cause pelvic organs to bulge into the vaginal canal.The procedure can improve quality of life but is often a temporary fix.As part of the study, researchers surveyed nearly 300 women to learn more about their quality of life five years after surgery. Their median age was 57 years old.The research team examined sacrospinous ligament fixation (SSLF) and ligament vaginal vault suspension (ULS) — two procedures commonly used to treat the disorders.These surgeries do not involve using synthetic mesh, which has been linked to complications and have produced extensive lawsuits.Of women who had SSLF, 70 percent reported a failure at 5 years, while 61 percent of women who had ULS reported failure at the same time.After 5 years, about 12 percent of ULS patients and 8 percent of SSLF patients were treated again.“This was surprising to us,” said Dr. J. Eric Jelovsek, a lead study author and a researcher from Duke University. “That failure rate was higher than we expected. But that does not necessarily align with how patients feel and we don’t know why that is.”The trial also looked at the impacts of pelvic muscle floor training and behavioral therapy to see if they could improve outcomes. Neither helped.
Jelovsek said one explanation is that the researchers defined “failure” too stringently. He called for more research to find out the best way to define failure or success.
The results suggest that neither procedure might work as well in the long term as surgeons once thought, Jelovsek said.
Unlike Jelovsek, Dr. Charles Ascher-Walsh, director of gynecology and urogynecology in the Division of Obstetrics, Gynecology, and Reproductive Science at the Icahn School of Medicine at Mount Sinai in New York, said he wasn’t surprised by the results.
“Both of the procedures in this study are vaginal procedures which have been shown to be inferior to the abdominal surgeries for prolapse, as far as prolapse of the top of the vagina is concerned,” he told Healthline.
Ascher-Walsh said doctors know that the classical procedure to fix prolapse of the front and back walls of the vagina have high recurrence rates.
Most patients would not be symptomatic with a drop in the prolapse to one-third of the vaginal length, so the percentages described would include many women who were not aware of the “failure.”
Looking ahead
Linda Brubaker, a co-author and professor of pelvic medicine and reconstructive surgery at University of California San Diego, said that there are treatments available for prolapse other than those used.
Advancements on the horizon include better efforts to prevent prolapse and understand why it happens, Brubaker noted.
True prolapse repair involves suspending the vaginal apex instead of using mesh, Brubaker told Healthline.
The procedure that involves suturing the apex (or top portion) of your vaginal wall to pelvis ligaments, as was done in the two types of surgeries studied.
Dr. Erin Duecy, an associate professor of obstetrics, gynecology, and urology at the University of Rochester Medical Center in New York, said that suturing the apex to ligaments provides the support in place of weakened pelvic tissues.
It is also known as a native-tissue repair, as the woman’s own tissues and sutures are used for the repair rather than placing a mesh.
“The days of simply removing the uterus and hoping for the best should be behind us now,” Brubaker added.
Pelvic floor physical therapy is another treatment.
Rachel Gelman, DPT, a therapist at Pelvic Health and Rehabilitation Center in San Francisco, said that therapy has been shown to help reduce symptoms relating to pelvic organ prolapse.
“It is less invasive and more cost effective than surgery,” she told Healthline.
Gelman said the physical therapy can also help patients who need surgery by preparing them for the process and helping them to recover.
Women should not discredit the help that prolapse surgery can provide, Duecy told Healthline.
They should be counseled that prolapse can recur, either in the same area of the vagina where the repair was performed or in a different area.
“We should not consider surgery a definitive cure for prolapse, but a way of managing it and improving [a] women’s quality of life,” Duecy added.
