Strengthening Your Pelvic Floor During Pregnancy

Last week we talked about the benefits of core training during pregnancy. This week we’re going to talk about how you can specifically focus on strengthening your pelvic floor during pregnancy.

Pregnancy is a transformative journey, but it can also bring about certain challenges, including issues related to the pelvic floor. The pelvic floor plays a crucial role in supporting the bladder, uterus, and bowel (among many other things!), and it undergoes significant changes during pregnancy. The pelvic floor muscles have a lot of responsibilities, including continence, elimination, the sensation of urgency, organ support, respiration, circulation and immunity. During pregnancy, these muscles are taxed to their max, which can compromise their function.

In order to prevent fatigue of the pelvic floor muscles (resulting in loss of function) during pregnancy, pelvic floor strengthening is very important. The strength of your pelvic floor needs to continually increase as your uterus grows, in order to counteract the pressure and stretching that is happening during pregnancy. Check out the first post in this series to learn more about how your core adapts during pregnancy.

In this post, we will explore the limitations of traditional exercises such as Kegels in addressing pelvic floor issues during pregnancy and then we will discuss a holistic approach to strengthening the pelvic floor.

Remember, it’s about more than your pelvic floor.

It’s about how the pelvic floor relates to the rest of your body and how that changes during pregnancy. How you breathe and posture yourself throughout your day will either make pregnancy harder or easier on your body. Besides targeted pelvic floor strengthening, awareness of breathing and posture is key during pregnancy. Empowering yourself with the knowledge about how your core health and core function are impacted by daily posture, breathing mechanics, lifting techniques, and exercise routines is a game changer in pregnancy. These aspects can have a significant impact on how much pressure is put on your pelvic floor during pregnancy, and how it supports you post partum.

Belly breathing during pregnancy

It’s common to be told to do belly breathing while lifting, moving, or squatting during pregnancy, but contrary to this misconception, belly breathing may actually exert additional and unnecessary pressure on the pelvic floor muscles during pregnancy. Belly breathing results in relaxation of the pelvic floor muscles. It’s great to practice belly breathing when you are laying on your back or on your side. Those are postures where it’s safe and functional for your pelvic floor to completely relax. However, belly breathing while standing upright, lifting, moving, squatting, or exercising is not functional because we don’t want the pelvic floor muscles to relax during those activities or in those situations. We want the pelvic floor muscles to be activated through breathing when you are upright and against gravity - to support your organs and spine. If you belly breathe during activity or when you are upright, your pelvic floor muscles will turn off, the pelvic fascia will become overloaded and pelvic floor dysfunction could result.

Leaking during pregnancy is NOT NORMAL.

Leaking (also known as urinary incontinence) during pregnancy is a sign of pelvic floor dysfunction. Although leaking is a common symptom experienced during pregnancy, it is NOT NORMAL. During pregnancy, the pelvic floor is challenged to its max. It is asked to support an ever growing uterus, without rest, for 10 months. If the pelvic floor is weak going into pregnancy, this task can overwork and fatigue the pelvic floor muscles, and lead to pelvic floor muscle spasm. When the pelvic floor gets overworked, instead of just relaxing, it gets locked in a contracted position (also known as muscle spasm). When the pelvic floor is in a spasm, it cant contract or relax - it essentially “freezes”. This leads to further weakness of the pelvic floor muscles, and loss of function. The most common symptom of pelvic floor muscle spasm (aka pelvic floor dysfunction) is leaking.

Leaking can occur with coughing, laughing, sneezing, or exercising (also known as stress incontinence); or it can occur with urgency on the way to the bathroom (also known as urge incontinence). Leaking can also come and go during pregnancy, where you have it for a while then it goes away, and then might return again. Leaking is an indication that the pelvic floor is not functioning properly and reason to seek further assessment. Dehydration, constipation, pelvic or spinal mis-alignment, or too much intra-abdominal pressure can lead to leaking. Increasing your water intake, resolving constipation, and practicing proper core training to correct spinal and pelvic alignment and reduce pressure in your abdomen can resolve leaking during pregnancy.

Why kegels aren’t enough during pregnancy

Many women are told to perform Kegels throughout their pregnancy, as a way to prevent and treat the symptoms of pelvic floor dysfunction (like leaking). But Kegels are not the answer. Kegels isolate a very small percentage of your voluntary pelvic floor muscles. In fact, if you tuned into our core series last month, you’ll know that your pelvic floor muscles are almost entirely involuntary. So performing voluntary contractions of your pelvic floor muscles (Kegels) is not an effective way to strengthen your pelvic floor during pregnancy. 

In fact, performing too many Kegels during pregnancy can actually cause more harm than good. Since the pressure in your abdomen is continuously increasing over the course of pregnancy, your pelvic floor muscles will tend to become tighter in response to this (also know as pelvic floor muscle spasm). Kegels will make pelvic floor muscle spasm worse, and can actually lead to more symptoms of pelvic floor dysfunction. Instead of relying on isolated Kegel exercises, a holistic approach to core and pelvic floor muscle activation is much more effective. 

So if Kegels aren’t the answer to pelvic floor strengthening during pregnancy, then what is?

The best pelvic floor training for pregnancy

The best way to strengthen the pelvic floor during pregnancy is by triggering a reflexive activation of the pelvic floor through breathing. Specific breathing patterns that reduce the pressure in your abdomen and unload your pelvic floor by lifting and centering your uterus is what creates the environment in your body ideal for strengthening your pelvic floor. You can learn exactly how to do this with The Core Recovery Method®. 

Resolving any spinal and pelvic imbalances can also improve pelvic floor muscle activation during pregnancy. Stretching, rolling, self trigger point release, self massage, glute strengthening and hypopressive training are all very effective techniques to balance the spine, pelvis and pelvic floor. You can learn these techniques with the The Core Recovery Method® as well. 

True pelvic floor strengthening during pregnancy needs to involve the whole body and have a heavy focus on posture. Since your pelvic floor is the base of your core and supports all of your organs, uterus, spine, and hips, you cannot just isolate it with Kegels and expect to see functional improvement. The pelvic floor is an integral part of all body movements and functions - including digestion, elimination, circulation, respiration, immunity, and hormonal regulation. All of these functions need to be taken into consideration when strengthening the pelvic floor during pregnancy. 

Taking care of your pelvic floor during pregnancy is crucial for maintaining optimal health and well-being during pregnancy. By adopting a holistic approach, and engaging in appropriate exercises, you can strengthen your pelvic floor muscles, reduce the risk of common pregnancy-related conditions, and speed up postpartum recovery.

Looking for a simple, safe, and effective exercise protocol for pregnancy?

You can learn more about the core during pregnancy through The Core Recovery Method® online program. The Core Recovery Method® provides a simple way to learn essential core breathing techniques and create a regular practice for yourself in the comfort of your own home. This program will empower you with the knowledge necessary to understand where core dysfunction comes from, how to heal it, and how to prevent it during pregnancy. You will learn therapeutic techniques that optimize core function during pregnancy and prepare your body for delivery. The Core Recovery Method® online program also guides you step by step through the post partum journey, and gives you all the tools necessary to safely and effectively rehab your core after pregnancy.