It’s not said nearly enough, but the way a pregnant woman’s body adapts to create and grow a tiny human is nothing less than amazing. And much of this strength and stability is thanks to the pelvic floor.
The pelvic floor refers to a group of muscles that, according to Heather Jeffcoat, DPT, orthopedic and abdominopelvic health physical therapist, work together to control big-time essential functions like bladder and bowel control, sexual function and core stability.
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In other words, your pelvic floor is really, really important. And pregnancy puts a massive strain on these muscles. “While your body is heroic in its ability to carry and birth a baby, the changes that pregnancy and childbirth put your body through can push your pelvic floor to its limit,” says pelvic floor physical therapist Dr. Ashley Rawlins, PT, DPT. “Fifty-eight percent of individuals who gave birth vaginally and 43% of those who had a Cesarean birth report symptoms of pelvic floor dysfunction.”
So taking care of your pelvic floor before, during and after pregnancy is a must. Here’s what three experts want you to know about pelvic floor exercises and why getting started right after birth can help you avoid problems down the road.
When to start pelvic floor exercises after birth? Immediately
Dr. Rawlins shares that rest and recovery are priorities for the first six to eight weeks postpartum (or per your OB-GYN’s recommendations), but you can start gentle pelvic floor exercises right after birth. “By reconnecting with this area of your body, you are encouraging healing blood flow in the area, minimizing swelling and can support your posture while protecting healing tissues,” she shares.
Erin Low, postpartum health expert and personal trainer, encourages new moms to take the time to heal after having a baby. “Gentle breathwork that integrates the pelvic floor is safe to do immediately post-delivery as long as it feels nurturing,” she shares. “In fact, it can be a tool to aid healing and calm the nervous system.”
Pelvic floor exercises are so much more than Kegels
Kegels—a contraction of the pelvic floor muscles—are usually the only pelvic floor exercise mamas hear about during pregnancy (if any), but they aren’t enough.
“Performing ‘Kegels,’ or pelvic floor muscle contractions, are often over-prescribed at the same time as they underdeliver,” Dr. Jeffcoat shares. “We need to reframe this ‘pelvic floor exercise’ the same way we think of all exercise—it’s a combination of strengthening, flexibility, local joint mobility work, breathwork, coordination and functional training.”
Simply performing Kegels is like going to the gym and doing nothing but bicep curls every single day. Your arms will get stronger but also overworked, and the rest of the body won’t adapt. “The pelvic floor is not designed to work in isolation. It is part of an integrated system of muscles that works in coordination with all the muscles of breathing,” explains Low.
In other words, strengthening the pelvic floor muscles using Kegels can be helpful, but true postpartum healing comes from a holistic approach and not just one exercise.
What pelvic floor exercises can you start right away?
All three experts wish pelvic floor physical therapy was part of the normal standard of care after having a baby. Dr. Jeffcoat explains that unlike other developed countries like France, women in the US usually aren’t given the option (although the Academy of Pelvic Health Physical Therapy is working to change this).
In the meantime, Dr. Rawlins suggests a few postpartum pelvic floor exercises you can start right away. “As you rest and recover, alternate between engaging and relaxing your pelvic floor muscles 10 times, several times throughout the day,” she says.
She also recommends gentle activation of the abdominal muscles within those first few weeks. “Belly lifts are a great way to do this. Starting on your hands and knees, inhale, then exhale as you draw your belly button up towards your head and back towards your spine. Repeat 10 times, at least once a day.”
How to know if your pelvic floor needs more support
Pregnancy increases the risk of pelvic floor dysfunction for anyone, no matter what type of birth you had. Unfortunately, many mamas have pelvic floor dysfunction symptoms but don’t seek help. According to Dr. Jeffcoat, research suggests that nearly 9 out of 10 women experience sexual pain after delivery.
Things will feel off in the early day (hello, first postpartum trip to the bathroom), but you should see improvements. “While there are many symptoms that are normal in the early days post-delivery, ongoing urinary or fecal incontinence, pelvic pain (with intercourse or otherwise) and visible separation and inability to activate the abdominal muscles are all reasons to seek professional support.”
But there is support available, but it may mean advocating for yourself to ask your doctor for a referral. “A pelvic floor PT can also help you move ergonomically as you care for your baby to prevent or relieve pain, learn helpful breast/chestfeeding techniques, and sleep more comfortably,” Dr. Rawlins says. “When you’re ready, they can support you in returning safely to work, sex and exercise.”
Remember this, mama: You don’t need to “bounce back” immediately
We’ve all seen that woman on Instagram jumping back into her workout routine two days after delivery, but please resist the urge to compare. “Your postpartum body is wonderfully resilient, but it does need time to heal,” Dr. Rawlins shares. “If you jump back into exercise too quickly or intensely after birth, you’ll not only interrupt your recovery process, it’s likely that you’ll end up with new injuries and dysfunction that could impact you negatively for months or even years.”
Low also reminds mamas to take their time. “It took your body nearly a year to create and support a new life. It deserves time to properly heal so you can go back to doing the things you love with inner strength and confidence.”