Pushing your baby through your pelvis and into the world is demanding not only on you, but also on your pelvic muscles as they stretch to new proportions during the process. Not only do pelvic floor muscles play an important role during delivery, but when they work correctly, they hold your uterus, bladder and rectum in place, as well as help to keep urine from leaking when you cough or laugh — a skill set you’re only likely to notice when it’s gone.
Fortunately, there’s one exercise that can help prevent some problems with your pelvic muscles after birth: Kegels.
What are Kegel exercises?
Named after gynecologist Arnold Kegel, Kegel exercises engage and strengthen your pelvic floor, which is a group of muscles and ligaments that sit like a sling between your hips. Your pelvic floor muscles support your bladder, uterus and other organs and control the flow of urine, gas and feces.[1]
The goal of a Kegel is to contract and then relax the pelvic floor muscles for short periods of time. It's best to aim for several short sets a few times a day (more on that below).
Are Kegel exercises beneficial during pregnancy?
As your baby grows inside your uterus during pregnancy, your pelvic floor muscles have to support more and more weight, which can be taxing on them. Research has shown that regularly doing Kegels before, during and after pregnancy can help strengthen your pelvic floor muscles and may help decrease the odds of pelvic floor issues such as incontinence.[2]
When you finally go into labor, these muscles will stretch even more to make room for baby to pass through. Doing Kegel exercises while pregnant (and postpartum!) may help avoid future problems.
Here's how you'll benefit from adding them to your routine:[3]
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- Better bladder control. Up to an estimated third of women experience postpartum loss of bladder control, and doing Kegels can help prevent and treat urinary incontinence. If you notice occasional urine leaking — when you cough, lift or exercise — this could be because your over-burdened pelvic floor muscles aren’t able to fully support your bladder the way they usually do.
- Lower risk of fecal incontinence. Women with third or fourth degree tears are more at risk for postpartum fecal incontinence. Kegels may help prevent this.
- Slow the progression of POP. Pelvic organ prolapse (POP) occurs when one or more pelvic organs descend into the vagina from their normal positions. Regularly doing Kegels may help prevent prolapse from worsening.[4]
- More enjoyable sex. And as if that's not enough, Kegels may help boost your sexual health and pleasure and help you reach orgasm more easily.[5]
While Kegel exercises can be hugely beneficial during pregnancy and postpartum, it's also important to remember that some people could actually benefit from "reverse Kegels," which means relaxing your pelvic floor instead of contracting.[6] When in doubt, a pelvic floor physical therapist can help assess your specific symptoms and suggest the best routine for you.
How to correctly do Kegel exercises
Kegel exercises are fast and free, and once you know how to do them, you can do them just about anywhere — when you’re stuck at a red light, waiting in line or watching TV. Here's how:
1. Find your pelvic floor muscles
Before you begin, you'll want to make sure you're engaging the right muscles. Kegels feel as though you are holding back gas or urine. The muscles you’re tightening to do this are the same ones you’ll want to contract when you do a Kegel. (But once you find them, don’t engage those muscles while you’re urinating — this can actually lead to urinary incontinence, urinary tract infections and other problems.)[7]
If you’re still not sure you’ve found the right muscles, put a clean finger in your vagina. If you’re doing a Kegel correctly, the vagina should contract around your finger and lift your finger upward towards your head. Just try not to hold your breath, and avoid clenching your thighs, stomach or butt muscles at the same time.
Still having trouble? Don’t hesitate to ask your health care practitioner or a pelvic floor physical therapist to coach you next time you’re having a pelvic exam.[8]
2. Practice Kegel exercises
Once you’ve located your pelvic floor muscles, here’s the recommended Kegel routine:[9]
- Tighten the muscles for three to five seconds, and then relax them for as many seconds. Relaxing is as important as contracting. Begin with one set of ten squeezes per day.
- Start contracting and relaxing the muscles tight for longer — working up to 10 seconds at a time — and doing more repetitions as it becomes easier.
- Try to work up to 3 sets of 20 repetitions daily.
Don’t get frustrated if you’re nowhere close to that goal when you start. Quality is much more important than doing a bunch of Kegels incorrectly. And remember, these are muscles like any other in your body. With time and consistent, mindful work, they can only get stronger.
When to do Kegel exercises during pregnancy and postpartum
It’s never too early to start doing Kegels, but the earlier and more regularly you practice them throughout pregnancy, the greater the benefits.
However, as you enter the third trimester, it becomes more important to focus on learning to relax your pelvic floor as labor nears. Your pelvic floor muscles need to fully relax and stretch so they can make way for your little one to exit. To do this, sit comfortably, take a few breaths and try visualizations such as picturing a flower gently opening.
After you’ve delivered, you can restart your Kegel routine. Make it a habit to do them regularly — while, say, you’re feeding your baby — to stimulate circulation, promote healing and improve muscle tone. Don’t worry if you can’t feel yourself doing them initially — the perineum may be somewhat numb and your muscles have been lengthened and are more difficult to contract early on.
Just remember that it's a good idea to discuss your symptoms with your practitioner and a pelvic floor physical therapist to make sure Kegels are the right exercise for your specific symptoms after giving birth (since some people could benefit from relaxing the pelvic floor instead of contracting it).
How long should you keep doing Kegels? If you want to keep your pelvic muscles in shape, many health care practitioners recommend making them a regular, lifelong habit.
How to make Kegel exercises fun
If you’re having trouble remembering to do your daily Kegels, or they just seem like a drag, there’s no better way to mix business with pleasure than performing Kegels during sex — which can double the pleasure for you and your partner. Your partner can also use his or her clean fingers to check whether you’re tightening the right muscles.
If you’re looking for ways to make Kegels more fun on your own, try a smartphone app. A number of options send you daily reminders, track your exercise habits and even provide musical routines for your pelvic floor workouts.
There are also devices known as vaginal exercisers that claim to help you isolate the pelvic floor muscles or work them for you. Some are shaped like cones and are held in place in your vagina by your tightened muscles. Others provide electrical stimulation to the muscles. While they could be helpful for some women, they could also introduce bacteria into the vagina — so skip them if you’re pregnant or recovering from childbirth, and check with your doctor first before trying one for the first time.
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