Pelvic Floor Exercise during Pregnancy

One of the two groups of muscles that bear the most stress during pregnancy is the pelvic floor muscle. Pregnancy and childbirth weaken the pelvic floor. This is because having a baby puts enormous pressure on these muscles since the muscles have to cope with the weighty uterus and the vaginal stretching that takes place during delivery. No doubt Kegel exercise is most important after delivery to allow the muscles to heal and get back to the pre-pregnancy state, getting into the habit of doing pelvic floor exercises while pregnant will ensure familiarity with the routine.

It is therefore beneficial to become accustomed to this exercise during pregnancy i.e. contracting and relaxing your pelvic floor muscles every day so that you don't have to spend time learning post delivery. Once you have got a knack for it you can practice it standing, or sitting for a few minutes several times a day everyday.

What are Pelvic Floor Muscles

The pelvis protects the internal organs it contains i.e. the bladder, uterus and lower bowel. Between the legs lie several muscles which support these organs. A strong pelvic floor lends support to the pregnant uterus, helps push baby out during labor and eventually aid these muscles into shape post birth. Conversely a weak pelvic floor may give rise to stress incontinence (leaking drops of urine when you cough, laugh or sneeze) towards the end of a pregnancy and after childbirth. When these muscles weaken, supporting the contents of the pelvis is removed leading to embarrassing moments. Apart from stress incontinence, a weakened pelvic floor muscle can cause the more severe problem of prolapsed uterus (uterus starts to sag down into the vagina).

How are Pelvic Exercises Performed

• Pelvic floor exercises are also known as Kegel exercises and they need to be performed at the earliest after your baby is born, even following a Cesarean birth. There is the classic form and some variations to that form as well.
• The classic/basic form: Breathe normally and sit or stand upright. Without moving your body, squeeze and lift/pull the vagina then the urethra area, and then the anal sphincter muscles upwards. You should feel them lifting towards your belly button. All three areas are to be considered as a single unit; hold the contraction for a count of 5. Then slowly relax the muscles and you should feel a ‘drop’ between your legs, indicating you have successfully contracted your pelvic floor muscles.
• You may also vary this exercise i.e. not hold the contraction for a few seconds. Instead, you may contract and release the muscles in a fast motion as if you are switching on and shutting off a switch. Repeat this at least 10 times.
• Another variation is the sitting form. Do the steps as outlined in the basic form. Then place your elbows on your knees and lean forward. Repeat the pelvic floor exercise but this time you will feel the movement concentrated around the urethra and vagina and less around the anal region. By alternating between upright and leaning versions, you are able to feel the sensation in isolated areas of the pelvic floor.

Incorrect forms for pelvic floor exercises

Following suggest that the exercise is being carried out incorrectly:

• Contracting the abdominals
• Tensing the buttocks
• Gripping with the leg muscles
• Tensing shoulders
• Tensing your facial muscles, especially the brow area
• Holding your breath as you work your pelvic floor

Remember, toned pelvic muscles are the best cover you can hope for against future problems. That should suffice in getting you started. During pregnancy do a total of 25 contractions a day in sets of 5 contractions each time, and don’t be too concerned if you are not able to hold the contractions (2 seconds is not too bad at this stage). You can do them while you are waiting in a queue, stuck at the traffic lights, waiting on the phone or when downloading websites. Basically you don’t have to set time aside and therefore feel stressed just thinking how you are going to fit Kegel into your busy schedule.