Pelvic floor exercises

During your pregnancy, the increasing weight of your growing baby places increased pressure on your pelvic floor.

The pelvic floor is made up of a combination of muscles, fascia and ligaments that lie across the base of the pelvis. These muscles support the pelvic organs especially when there is an increase in pressure in the abdomen such as when you cough, sneeze, lift, jump or laugh and the muscles prevent downward movement of the pelvic organs. The pelvic floor muscles surround your urethra, back passage (rectum) and vagina and prevent unwanted leakage of urine, wind and stool, providing bladder and bowel control. They also help to provide support for the pelvic organs including the bladder, bowel and uterus (womb) and help to improve sexual satisfaction by improving vaginal sensation.

How to strengthen your pelvic floor muscles:

Long squeezes

Squeeze the muscles surrounding your back passage (imagine yourself trying to stop passing wind) and then pull up the muscles around the front (imagine trying to stop passing urine).

Hold the squeeze for up to 10 seconds. To begin with, you may only be able to hold this for a few seconds, but with practice this should gradually build up to 10 seconds.
Don’t hold your breath and breathe normally throughout the exercise.
Relax fully after each contraction and then repeat up to 10 times. To begin with you may only be able to repeat this a couple of times but this should improve with practice.

Short squeezes

Squeeze the pelvic floor muscles quickly and immediately relax again - be sure to fully relax your muscles after each contraction.
Breathe normally throughout.
Repeat the short squeezes up to 10 times.

You should do your pelvic floor exercises at least 3 times per day. You may find it easier to start the exercises lying down or sitting down and progress to standing.

You can also practice a pelvic floor squeeze, known as ‘the knack’, throughout the day with daily activities such as lifting, coughing and sneezing.

To start with you may only be able to hold the long squeeze for a short time or only manage a few short squeezes but you can gradually increase them over 3 - 4 months as your muscles become stronger.

Practicing the exercises with a regular daily activity, feeding your baby or whenever you have a drink, for example, can be a good way of helping you to remember to do the exercises every day.

You can begin to perform pelvic floor exercises as soon as you feel comfortable following the birth of your baby (including after a caesarean birth). You can perform them lying, sitting or standing.

Pelvic floor exercises should be continued for the rest of your life to maintain the strength of the muscles and prevent symptoms such as urinary incontinence, bowel incontinence and pelvic organ prolapse.

For further information visit Pelvic Obstetric Gynaecological Physiotherapy (POGP): www.thepogp.co.uk and www.thepogp.co.uk/resources/booklets