Postnatal pelvic floor exercise program

Why strengthen the pelvic floor?

Your pelvic floor muscles start from your pubic bone at the front, and go all the way to your tailbone at the back, extending between your two sit bones and helps to support your pelvic organs, the bladder, uterus and bowel. These muscles help to keep you continent with its muscle tone and closing mechanisms around the urethra and bowel, and also links in with our deep abdominal muscles which help to support your pelvis and spine. Your pelvic floor muscles can also improve vaginal tone for sexual function.

“We recommend an assessment by a women’s health physiotherapist around 6-8 weeks after giving birth,” Kate says. “Your physiotherapist can ensure you are doing pelvic floor contractions correctly and help you to strengthen your body safely and comfortably. We know that about half of women cannot effectively contract their pelvic floor muscles when provided written or verbal instruction alone. Furthermore, around 1 in 4 women will actually use a technique that strains the pelvic floor and can weaken it further – so it is important to undergo a professional assessment.”

Pelvic floor exercises, when done correctly, are effective in treating and preventing incontinence and prolapse issues. This is particularly important as you return to more formal exercise, and also to ensure you have the strength to manage carrying babies and lifting prams, without getting a sore back or pelvis, or developing pelvic floor issues.

Postnatal pelvic floor exercises

Pelvic floor exercises can be done in any position. Kate suggests that when you begin you may find it easier to activate your pelvic floor muscles while lying on your back or side. As you progress they can be done in sitting and standing positions.

1. Relax all of your external muscles around the pelvis, buttocks, and legs.
2. Squeeze inwards around the urethra, as if you are holding on or stopping the flow of urine, and at the same time, squeeze in around the vagina and the back passage as though you are holding on to some wind. While squeezing, lift your muscles upwards towards your belly button so that the pelvic floor contraction feels like a “squeeze and lift” movement.
3. Hold each contraction for as long as you comfortably can. This may be for just a flicker or a second initially, building up to a 10-second hold.
4. Fully relax your pelvic floor muscles after each contraction.
5. Repeat in sets of 5-10 exercises, three times throughout the day.

It takes around 4-6 months of this level of exercising to strengthen your pelvic floor muscles to their full potential postpartum. Throughout the exercises check that you keep your body still on the outside and that you are breathing normally. When it comes to pelvic floor exercises, quality is more important than quantity, so start with a good technique and build up the number of exercises you do as your muscles get stronger.

Quick flicks

Kate also recommends that you practice activating your pelvic floor quickly with rapid on/off flicks. This can help when you need to sneeze or cough so that you can quickly switch your pelvic floor muscles ‘‘on’ to protect yourself from leakage or strain.

Start with just five of these quick flicks at once, and then work your way up to 10 repetitions.

For an assessment of your pelvic floor muscles and for personal instruction on completing your pelvic floor exercises, book an appointment with a Women’s Health Physio.