7 Ways to Exercise the Pelvic Floor During Pregnancy and Postpartum

Before you got pregnant, you may not have thought much about your pelvic floor—aka that group of muscles and tissues in your pelvis supporting your bladder, bowels and reproductive organs. But now that sneezing too hard makes you pee a little, you might be wondering if you should get a bit more acquainted with the group of muscles involved. The good news is that strengthening your pelvic floor in pregnancy and postpartum has tons of benefits (aside from helping prevent those accidental leaks), like relief for aches and pains, a potentially smoother labor experience and a quicker postpartum recovery.

“My pelvic floor was strong already because I’ve done Pilates for years, but I didn’t want to just rely on strength: Birth needs softness too,” says Melody M., a mom of two in Texas. “I wanted my pelvic floor to be able to release, not just grip. I knew I’d need that awareness during labor and for healing after.”

Larissa Rodriguez, MD, urology department chair at Weill Cornell Medicine specializing in urogynecology and pelvic floor conditions, says carrying baby puts a huge strain on your pelvic floor. “Just like any other muscle in your body, you need to exercise it to keep it healthy,” she adds.

Here’s what to know about strengthening your pelvic floor during pregnancy and postpartum, including expert-recommended pelvic floor exercises.

Key Takeaways

• Pregnancy is a big stressor on your pelvic floor, so regularly performing pelvic floor exercises while pregnant and postpartum can help you avoid side effects like urinary incontinence and back pain.
• Pelvic floor exercises during pregnancy and postpartum include cat-cow, bridge, child’s pose, happy baby and more.
• Symptoms of a weak pelvic floor include urinary incontinence, pelvic pain or pressure, difficulty emptying your bladder, and leaking when sneezing, laughing or coughing.
• Most women’s pelvic floor symptoms gradually improve after pregnancy, but if your symptoms linger, get worse or are accompanied by urinary tract infections (UTIs) or signs of pelvic organ prolapse, speak to your provider right away.

Best Pelvic Floor Exercises for Pregnancy

Here are a few of the best pelvic floor exercises while pregnant, according to experts:

Cat-cow

This popular yoga pose is a favorite of Tessa Ladd, OTR/L, an occupational therapist specializing in pelvic floor dysfunction at Orlando Health Advanced Rehabilitation Institute in Florida. Get on all fours, then inhale as you look up and tilt your pelvis forward, sticking your bottom up (cow). As you exhale, bring your head and neck to look downward and reverse your pelvic tilt so that you’re tucking your bottom under (cat). This helps stretch and lengthen the muscles and tissues around your sitz bones, aka the curved bones on either side of the base of your pelvis.

Bridge

Ladd also recommends doing bridges, a simple exercise that strengthens your pelvic floor, glutes and core. Lie on your back with your knees bent and your feet flat on the floor. Gently tuck your pelvis so you’re not arching your back off the floor, then:

• Exhale as you push your feet into the floor to lift your hips and bottom
• Maintain that lift for the length of your exhale, then return to your starting position
• Take a deep inhale while you’re resting on your back, then repeat the movement

If you’re more than 20 weeks pregnant (or just uncomfortable lying on your back), Ladd says you can prop yourself up with a few pillows so you’re not totally supine.

Child’s pose

Grace Prete, DPT, a pelvic floor therapist with the Gyn & Sexual Medicine Collective in Chicago, recommends this classic yoga pose—particularly during the third trimester—to open up and relax your pelvic floor in preparation for birth.

Kneel on the floor, then lean back so your bottom is resting on your heels. Slowly spread your knees apart to make room for your belly, then lean forward onto your elbows or extend your arms all the way out in front of you. Hold the stretch, resting with your chest on the floor. If needed, lean onto a stability ball or stack of pillows for support instead of lowering all the way down to the floor.

Butterfly

Another hip opening exercise, butterfly pose may be even more effective than kegel exercises at strengthening the pelvic floor. Sit up straight against a wall or the edge of a pillow for stability and support. Bend your knees and bring the soles of your feet together; support your feet with your hands, placing them under your toes or ankles. Keep your spine tall, your chest open, and your shoulders down and back. Hold the pose for your preferred length of time while remembering to breathe deeply.

Yoga squat

Squats are great for opening the hips, but they can be tricky to pull off during pregnancy. Yoga squats are a modified way to get the benefits of a squat without the instability, and both Prete and Ladd recommend this type of deep squatting as pelvic floor exercises for pregnant women.

Start by standing with your feet wider than hip-width and your toes pointing out slightly. Bend your knees to move into the squat position, lowering your hips to the floor. Bring your hands together in front of your body, then use your elbows to gently press your knees apart and open your hips. Hold the pose for your preferred length of time while remembering to breathe deeply.

Happy baby

The happy baby pose is a great way to relax your pelvic floor, and you can easily modify it for your comfort depending on how far along you are. If you can, lie on your back and draw your knees up to your chest. Hold your feet or ankles with your hands and gently stretch your legs apart wider than your body. Relax your shoulders and keep your chest open. Hold the stretch while you breathe, then slowly release back to your starting position. If you can’t lie on your back, you can also do happy baby on your side.

Transversus abdominis breathing

It may sound a bit complicated, but this breathing exercise targeting the deepest layer of your abdominal muscles is easy to do. Ladd says you can practice it in several different positions, including on your side, back, while sitting or on all fours.

• Inhale and allow your stomach, rib cage, back and pelvic floor to expand
• Exhale while engaging your deep core muscles, tensing and pulling your abdomen inward and upward

Liesse J., a mom of one in California, says she practiced transversus abdominis breathing in several different positions and credits it with helping her stay strong long-term. “I think it aided in my recovery from pregnancy and a C-section delivery, and now, one year postpartum, my core feels very strong,” she says. “I can easily carry my 25-pound baby around all day.”

Benefits of Exercising the Pelvic Floor in Pregnancy

Pelvic floor exercises during pregnancy have many different benefits, including strengthening, stretching and improving the pelvic floor muscles’ ability to adapt to our various movements during daily life, says Prete. “We need power and strength for fast movements, including coughing, sneezing and laughing, [but] we also need endurance to support baby while upright,” she says.

Studies have shown that doing pelvic floor exercises in pregnancy can:

• Reduce urinary incontinence
• Reduce the risk of severe perineal tears during delivery
• Shorten the second stage of labor
• Improve symptoms of lower back and pelvic pain during pregnancy

You may benefit from pelvic floor exercises during pregnancy even more if you tailor them to the trimester you’re in, Prete says. During the first and second trimesters, exercises should focus on strengthening the pelvic floor to prepare for the increased demands of supporting a growing baby, while in the third trimester, exercises should focus on relaxing the pelvic floor and opening the hips to help prepare the birth canal for childbirth and prevent musculoskeletal injuries during delivery.

Katherine W., a mom of one in Colorado, says she started her pregnancy with kegels but eventually shifted her focus from strengthening her pelvic floor to relaxing it as she neared her due date: “Learning to relax my pelvic floor, breathe into a flexible state and release the urge to tense up was a key part of my labor prep,” she says.

How to Strengthen the Pelvic Floor Postpartum

Strengthening the pelvic floor is just as important postpartum as in pregnancy—but you may have to change up your strategy. “After having a baby—a C-section or vaginal birth—the pelvic floor frequently tightens up and becomes stiff because of the trauma,” Prete says, adding that tight muscles are also weak muscles and shouldn’t be exercised too aggressively.

Jess R., a mom of two in New Jersey, says she learned this the hard way. After experiencing round ligament pain and lower back pain during pregnancy that lingered postpartum, she realized the source of her pain was a weak pelvic floor. Unfortunately, she was only making things worse with intense pelvic floor exercises during her postpartum workouts. “What I learned from working with my pelvic floor therapist was that in addition to focusing on tightening your pelvic floor muscles, you also need to focus on the inverse—relaxing your pelvic floor muscles,” she says. “This creates a balance that helps you avoid unnecessary pain and tightness in your pelvis, hips and lower back.”

Follow these instructions from Prete to start gently reincorporating pelvic floor work into your postpartum routine:

• Make sure you can fully relax the perineal area with deep belly breaths.
• Practice squeezing and holding for 10 seconds before releasing.
• Once you can do that without tiring out, you can start doing pelvic floor contractions—exercises like squats, lunges and leg presses paired with deep breathing and deep core activation.
• To do a pelvic floor contraction, start with a deep belly breath at the start of your chosen movement (like a lunge), then while performing and completing your movement, exhale as if you were blowing through a straw while sucking in your core and pelvic floor.

When to Seek Help

If you’re experiencing symptoms of pelvic floor dysfunction—which include urinary frequency and urgency, urinary or fecal incontinence and leaking, constipation, lower back pain, pelvic pain, and painful sex—Ladd recommends visiting a pelvic floor therapist. (FYI, you may need a referral from your primary-care doctor or ob-gyn depending on where you live.)

That said, it’s normal to have some weakness in your pelvic floor during pregnancy and for a while after you deliver, says Rodriguez. For most women, milder symptoms like urinary incontinence gradually fade away in the first year postpartum.

If your symptoms aren’t getting any better, or are accompanied by recurrent urinary tract infections (UTIs) or symptoms of pelvic organ prolapse (like a feeling of pressure in the pelvis, and seeing or feeling a bulge in your vagina), Rodriguez says it’s time to see your healthcare provider.

Doing pelvic floor exercises while pregnant can help lessen urinary incontinence, relieve pain, reduce the risk of delivery complications like perineal tearing and improve your postpartum recovery. Postpartum, pelvic floor exercises are also important to help strengthen muscles that become weakened while giving birth. Start slowly, but be consistent—and you’ll be on your way to a stronger pelvic floor.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.