Pelvic floor exercises

What is the pelvic floor?

Your pelvic floor is a group of muscles which support your bladder, uterus and bowel. These muscles form a ‘sling’ which attaches to your pubic bone at the front and your tailbone at the back. Your urethra, vagina and anus pass through the pelvic floor. A strong pelvic floor helps you to maintain good bladder and bowel control. Your pelvic floor is also important for good sexual function.

The pelvic floor has an extra job during pregnancy — to support your growing baby. During labour and birth, your pelvic floor muscles need to relax and stretch to allow your baby to be born.

Why should I do pelvic floor exercises?

Pelvic floor exercises are important at all stages of life to prevent bladder and bowel problems, such as incontinence and prolapse, and improve sexual function.

In pregnancy, hormonal changes cause your muscles to soften and stretch more easily. These changes, along with the weight of your growing baby, put extra strain on the pelvic floor. This can increase the chance of suffering from bladder or bowel problems during pregnancy and after birth.

Around 1 out of 3 women develop some form of incontinence after having a baby, but with pelvic floor training during and after pregnancy, your pelvic floor is more likely to return to normal after birth. Women with a strong pelvic floor are also less likely to have bladder or bowel problems both during and after pregnancy.

How do I do pelvic floor exercises?

The first step is to find out how to activate your pelvic floor muscles. Sit or lie down with your thighs, buttocks and stomach muscles relaxed, and squeeze the muscles around your anus (back passage) as if you are trying to stop passing wind. Squeeze and relax these muscles a few times to get used to the sensation. Make sure your buttocks remain relaxed and that you are breathing normally.

You can also try to stop the stream of urine when you are on the toilet emptying your bladder. This can help you learn how to squeeze and relax your pelvic floor, but it’s important not to stop and start your urine stream too often (no more than once a week), as this can make it difficult to empty your bladder properly.

Some women find it difficult to feel or voluntarily squeeze their pelvic floor muscles. If you are struggling, ask for advice from a physiotherapist or continence nurse.

Use the service finder tool to help you find a physiotherapist or continence nurse near you.

How to perform pelvic floor exercises

• Squeeze your pelvic floor muscles. You should feel the muscles around your anus and vagina lifting up inside.
• Hold them as tightly as you can while counting to 8, or as long as you can.
• Relax your muscles. You should feel them let go and relax, and rest for around 8 seconds.
• Repeat the exercise as many times as you can.
• Make sure your thighs and buttocks stay relaxed while you do the exercises, and that you aren’t holding your breath.

Aim to do 3 sets of 8 to 12 squeezes every day. You can try to do sets in different positions including lying down, sitting or standing

When is the best time to do pelvic floor exercises?

You can do pelvic floor exercises any time of the day. You can do them anywhere, and in any position.

Aim to do pelvic floor exercises every day. It can be helpful to link them with a regular activity, such as waiting for the kettle to boil, standing in a queue or sitting at a red traffic light — any time when you are relaxed and can focus on strengthening your pelvic floor.

Remember to actively squeeze your pelvic floor when you cough, sneeze or lift heavy objects. This will help you to strengthen your pelvic floor and to reduce the chance of urine leaks (stress incontinence).

Will my pelvic floor muscles get stronger after my baby is born?

Your body needs time to recover after birthing your baby. This includes your pelvic floor and the other muscles and nerves in your pelvic area, which may have been stretched during your baby’s birth. Women who birth a large baby (over 4kg), push for a long time or have an assisted birth may need more time to recover.

Weak pelvic floor muscles, or problems with bladder or bowel control, may get better in the first 6 months after birth even without help. Regular pelvic floor muscle training, along with the right advice if needed, can help you recover faster.

Most women can start gentle pelvic floor exercises within 24 hours after birth, even if they have stitches after an episiotomy or swelling. Pelvic floor exercises can even improve circulation in the area and help you to heal faster.

If you are still struggling with bladder or bowel problems 6 months after birthing your baby, it’s a good idea to visit your doctor or physiotherapist for an assessment.

Who can I talk to for advice and information?

Your doctor can give you advice and information about pelvic floor exercises and any medical problems, such as incontinence, which might be caused by a weak pelvic floor.

Your doctor may also refer you to a physiotherapist or continence nurse who can give you further advice.

Visit the Continence Foundation of Australia website for more information and resources. You can also contact the National Continence Helpline for information and advice.