Working on your pelvic floor during pregnancy

By Agata Krupa, specialist in urogynecology and obstetrics.

Pregnancy and childbirth are two important stages in our life as women, mainly because it means creating or expanding our family, but also it plays a key role in our health, because our body changes significantly. All these changes affect the pelvic floor muscles and can cause urinary incontinence, lumbo-pelvic stability problems or anorectal dysfunction. For these reasons, prevention is essential. It is very important to exercise the pelvic floor muscles to have a healthy pregnancy and a good recovery after childbirth.

How can we exercise our pelvic floor muscles correctly during pregnancy? We must tone the pelvic floor muscles, so that they can support the weight of the baby without weakening. At the same time, we must make it more flexible. This is important because during labour the pelvic floor and perineum needs to be very elastic to avoid hypertonia.

In this post we will talk about exercises to prepare the pelvic floor for childbirth. That is, how to tone and make more flexible the pelvic floor muscles during pregnancy to minimize the risk of suffering subsequent problems.

KEGEL EXERCISES AS PREPARATION FOR CHILDBIRTH

It is recommended to combine the following exercises during pregnancy as physical preparation:

  • Light exercise (such as walking or swimming)
  • Toning up the postural muscles: practice exercises that keep a good alignment of the pelvis and spine (Pilates, Yoga).
  • Kegel exercises to maintain the pelvic floor strong and healthy. You will find exercise routines adapted to your vital moment in B-wom. Remember that all the exercises and content are personalized!

It is recommended to do the Kegel exercises during the first stage of pregnancy, since week 12. As they do not require intense physical activity all women can do them easily. Even in case of having contraindications to practice sports during pregnancy, since Kegel exercises can be done while lying down.

If you have never exercised your pelvic floor muscles, you can practice isolated contractions during the first two months of pregnancy. In a comfortable position (it is recommended to lie on your back), and with several positions for the legs (bent, stretched or crossed), contract the pelvic floor muscles for 5 seconds and then relax for 5 more seconds. In B-wom app you will find personalized exercises for you. Download the app!

How can you do the contractions? Remember that you need to focus on activating the muscles that are around your vagina and not the rectus abdominis. Therefore, the contraction should be around 80% of your maximum strength. Throughout pregnancy you can add this pelvic floor exercises to your daily exercises. For example, when you do the cat exercise: contract the perineum when rounding your back and relax it when extending the spine.

COMBINE THE KEGEL EXERCISES WITH RELAXATION

Doing too many toning exercises of the pelvic floor may make dilation and the stage of expulsion during labor harder. That is why Kegel exercises should be combined with other relaxation techniques that make the pelvic floor more flexible.

The aim is to find balance between toning (Kegel) and flexibility (relaxation) so that the pelvic floor muscles are strong enough to hold the compression of the fetus’ head during labor and flexible enough to withstand overstretching and avoid tears or an episiotomy.

We propose you to do a series of Kegel exercises daily (remember the 5 seconds of contraction + 5 seconds of relaxation), and during the first 6 months there must be more repetitions (up to 30), to then reduce the amount in the 3 final months to a maximum of 20 in a series.

For relaxation techniques we propose you:

  • Perineal massage: a massage technique that helps the elasticization and relaxation of the perineum and the pelvic floor musculature in order to avoid episiotomy during childbirth.
  • Movements of the pelvis on the fitball ball, massaging the area of the perineum
  • Stretching of the entire inner thighs
  • Abdominal breathing
  • Relaxation during the ‘frog’ position.
  • Always maintain a good alignment of the pelvis (neutral)


AVOID CONSTIPATION AND CORRECT YOUR POSTURE IN THE TOILET

Constipation is very common during pregnancy and has very harmful consequences on the pelvic floor muscles (damaged by the abdomen pressure increase). Therefore, to maintain a good pelvic health it is important to improve this aspect.

How? Improving your posture: try to sit in the toilet with your feet on a stool to facilitate defecation, raise the knees so that the sphincter of the anus is relaxed. In B-wom we can also help you achieve this goal with different exercises and habits.

As you see, working the pelvic floor for a specific goal such as pregnancy requires specific knowledge. It’s not as simple as “doing Kegels.” It is important for you to do some research, because with small habits and daily practices you can improve your well-being during pregnancy, your experience in childbirth and your health in the postpartum.

 

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