Pregnancy Pelvic Floor Tips: What To Focus On Instead Of Kegels.
Most women have heard, “do your kegels!” - but few are actually told the whole story. Pelvic floor strength is not enough - flexibility, coordination, and overall body support are essential for birth and recovery. As a Pelvic Floor Therapist, I’m here to set the record straight and give you some practical tips to focus on, in order to help you optimize your pelvic health during pregnancy and for delivery.
The Problem With the Kegel-Only Approach
Kegels, also known as pelvic floor contraction, were named after Dr. Arnold Kegel in 1948, who first described this as a way of strengthening to prevent prolapse. The term has been thrown around and passed down through generations, but in fact, many people either don’t know what a kegel is or they don’t know how to do them correctly. A pelvic floor contraction, or Kegel, is when the pelvic floor muscles tighten and lift. These muscles can be found between your tailbone and pubic bone, and between your sit bones. The problem with doing a bunch of kegels during pregnancy (or at any other time of life for that matter) is that people don’t always need more tightening of their muscles. For many people, their pelvic floor muscles are plenty strong and adding further tightening can lead to overactivity, resulting in pelvic pain, difficulty giving birth, constipation, and urinary issues.
But what if your pelvic floor muscles are weak? - some people do in fact need strengthening, however, this should be done in a more functional way and not as an isolated exercise. This is where a pelvic floor evaluation can be so valuable - to determine exactly what it is that each person needs and also to help people learn how to do an exercise correctly.
Why Strengthening Outside of the Pelvis Matters
As I’ve already stated, it’s not all about pelvic floor strength. To maintain a strong and healthy pelvic floor, you must have support from the surrounding muscles - namely, your glutes, abdominals, and back muscles. These muscle groups must all work together. When there is weakness in one of these areas, the pelvic floor muscles will oftentimes work too hard to “pick up the slack.” Again, this can lead to overly-tensed pelvic floor muscles and make it harder for delivery. When your core, hips, and back muscles are all doing their jobs, your pelvic floor muscles come along for the ride automatically and aids in support. This is our goal throughout pregnancy - to maintain overall strength for pain-free mobility.
Focusing on movements such as squats, lunges, bridges, side lying leg lifts, are just some examples of exercises that can be helpful. As with anything, knowing how to properly perform these, and manage pressure well through breathing and posture, is essential. This is why many women seek out a pelvic floor therapy evaluation in their first or second trimesters - to be given specific things to focus on as they progress throughout their pregnancy.
The Importance of a Flexible, Relaxed Pelvic Floor
During a vaginal delivery, it’s the uterus that is actually pushing the baby out. Your pelvic floor muscles must be relaxed and flexible enough to move out of the way. THIS is way more important that being able to kegel or tighten. Imagine your pelvic floor muscles are a trampoline. A trampoline needs to be supportive but also have give to it. If your trampoline springs were very tight, there wouldn’t be much movement as you jump and this would not be so fun. Likewise, if your pelvic floor is too tight, it won’t relax and stretch easily. This can mean more significant tearing or increased difficulty delivering vaginally.
One way to ensure your pelvic floor is flexible is to ensure your hips are flexible. This is because your hips and pelvic floor share structures and influence one another. In fact, I have an entire blog post about that here.
Try some hip opener stretches, consider some deep breathing exercises, and focus on connecting to and relaxing your pelvic floor, for starters.
A Balanced Approach to Birth Prep
Many pelvic floor therapists like myself provide birth prep visits to teach women how to connect to these muscles and how to recognize if they’re contracting or relaxing. We combine a focus on pelvic floor relaxation and strength and support around your pelvis, as a way to keep you moving through pregnancy and prepare for delivery. I usually encourage people to look into pelvic floor therapy and birth prep for tailored strategies that work for them. Seeing a therapist earlier, in the second trimester, can set you up for a more comfortable pregnancy. Later in the third trimester, birth prep becomes an invaluable experience to rehearse for labor and delivery. If nothing else, I hope this opened your mind to considering more than a kegels-only approach to pelvic health during pregnancy.
Preparing your pelvic floor is one of the best gifts you can give yourself and your baby. If you’re ready to feel confident, strong, and prepared for birth, schedule your prenatal pelvic floor therapy session today.
I hope this information was helpful and maybe caused you to look at symptoms you have been ignoring. If you need help finding a pelvic floor therapist in Florida, we hope that you will consider us for either in-person or virtual appointments.
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