Pelvic floor exercises

Even if you do no other exercise for the entire time you are pregnant, you should definitely make pelvic floor exercises a part of your daily routine – indeed, these should be continued for life.

Pelvic floor muscles surround the urethra, vagina and rectum and support, like a hammock, the bladder, uterus and bowel. They can be damaged by the weight of the uterus during pregnancy and by the passage of the baby during a vaginal birth.

Stretched or damaged pelvic floor muscles lead to stress incontinence during and after pregnancy – this is when urine is leaked when you cough, laugh, sneeze, jump or run. More severe urinary and faecal incontinence can also occur after labour.

Although Caesarean deliveries can limit the damage, the weight of the uterus during pregnancy still stretches and puts a strain on the muscles.

Postnatal problems are less prevalent among women who do regular pelvic floor exercises. Because of the drop in oestrogen levels (which exacerbates weakened pelvic floor muscles), one third of post-menopausal women suffer from incontinence. The reality is that the stronger your pelvic floor muscles are, not only during pregnancy but thereafter, the less likely you will be affected by these problems.

And strong pelvic floor muscles are good for your long-term sex life, too!

Pelvic floor exercises are quick and easy to do, regardless of where you happen to be. There are two types of exercise and you should aim to do both sets three or four times per day:

  • Slowly squeeze the muscles around the anus, vagina and urethra – as if stopping the passage of wind or urine. Hold for as long as you can (up to a maximum count of 10), making sure you are breathing normally throughout, then let go. Repeat 10 times.
  • Quickly queeze and release the pelvic floor muscles 10 times, but do not hold this time.
  • The contraction is internal – you should not see any movement in your leg, bottom or stomach muscles – but you should feel a ‘lift’ inside your lower body when you squeeze. It doesn’t matter if you can only hold for three seconds to start with; just try to increase the length of time you hold for as you continue to practise.However, it is important to exercise your muscles until they are tired and not to where they are comfortable. So, when you can hold a slow contraction for ten seconds, increase the length of the hold to 13 or 15 seconds and when you find 10 fast contractions easy, increase to 15.The best way of remembering to do pelvic floor exercises is to do them at a particular time, such as when you brush your teeth, so that the other activity becomes associated with them.In addition to these daily exercises, you can squeeze your pelvic floor muscles in the same way when you cough, sneeze, laugh or carry out an activity that is strenuous in order to help prevent leakage of urine.If you are not sure how to do the above exercises correctly, speak to your GP or midwife.This is an edited extract from One Born Every Minute: Expecting a Baby by Dr Penelope Law (Quadrille, £20). Text © 2013 Dr Penelope Law.