Your pelvic floor is a web of muscles, ligaments and tissues that stretches across your pelvic bones. It does the important job of supporting your pelvic organs, which include your:

• womb (uterus)
• vagina
• bladder
• bowels

There are gaps in your pelvic floor for your urethra, vagina and anal passage to pass through:

The muscles in your pelvic floor become stretched during pregnancy and birth. The weight of your baby, hormones that loosen your tissues, and the efforts of labour all put pressure on this part of your body.

When your pelvic floor is weakened or damaged, you may leak wee (stress incontinence), wind and, more rarely, poo (faecal incontinence).

Daily pelvic floor exercises help you to regain control of your bladder and bowel after your baby’s birth.

Having a well-toned pelvic floor also enhances feeling in your vagina, making sex and orgasm more satisfying.

If your pelvic floor is badly weakened, perhaps after several pregnancies, your pelvic organs may slip down in your pelvis. This is called pelvic organ prolapse.

Prolapse gives you a dragging feeling in your vagina, because your womb, bowel and bladder push against the walls of your vagina.

The strength of your pelvic floor decreases as you get older, so you are more likely to have problems later in life than straight after the birth. Protecting yourself against prolapse in years to come is another good reason to do your pelvic floor exercises every day.

Ask your midwife or doctor to refer you to a women’s health physiotherapist if you have prolapse symptoms after giving birth. Your physio can give you specialist help to retrain and improve your pelvic floor.

When can I start doing my pelvic floor exercises again?

You can start your pelvic floor exercises as soon as you feel comfortable after having your baby. It may be the last thing on your mind, but it will really benefit you.

Bear in mind that you use your pelvic floor automatically every time you sneeze or cough. So it’s perfectly safe to start exercising it as soon as you can.

You may not be able to feel your pelvic floor at first, because the nerves in that area stretched as you pushed your baby out. Even if you can’t feel anything happening, you will still be doing yourself some good.

Doing your exercises will:

• Prevent and treat stress incontinence.
• Improve the circulation of blood to your perineum, which will help to reduce any swelling and bruising you may have.
• Rebuild strength in your pelvic floor.

If you didn’t get into the habit of doing your exercises during pregnancy or after your baby’s birth, it’s never too late to start. You can still get all the benefits of exercising if you start today.

How should I do pelvic floor exercises?

Start exercising your pelvic floor muscles when you’re lying on your back, or on your side. Or you may find it easier to do your exercises in a relaxing bath to begin with.

Breathe in, and as you breathe out, gently squeeze your pelvic floor muscles. Try not to pull in your tummy muscles. Just focus on pulling your pelvic floor muscles up and in, as if you’re trying not to wee or pass wind.

Hold the squeeze for four seconds or five seconds, at first, while you continue to breathe in and out as normal.

If you are tightening your upper tummy muscles (above your belly button) or your buttocks, you’re trying too hard

Once you’ve got the knack, hold each pelvic floor squeeze for between eight seconds and 10 seconds, while breathing normally.

If you lose control of your breathing mid-squeeze, stop, and start again. Once you can do the holds for 10 seconds, try to do five quick squeezes in a row. Quick squeezes help you to tighten the muscles when you cough, sneeze, laugh or lift something.

You should feel your muscles letting go at the end of each squeeze. If you don’t, you may have allowed your muscles to relax before reaching the end of your count. If this is the case, reduce the count until you can feel your muscles letting go, and build up from there.

Slowly build up to 10 squeezes for 10 seconds, followed by 10 quick squeezes, three times a day. Try to tighten the muscles as hard as you can, but keep breathing through it.

You may not feel much, or even anything, when doing your exercises in the first few days. But your efforts will pay off over time. It can take between six weeks and 12 weeks for your muscles to strengthen noticeably, so keep going.

Do I still need to do my exercises if I’ve had a caesarean?

Yes. Being pregnant can overload your pelvic floor, however you gave birth.

You’ll probably find it easier to do your exercises than a mum who had a vaginal birth, as your pelvic floor will not feel as sore, and your muscles are likely to be stronger. Unless you had a long time in labour before the birth, your nerves won’t have been affected.

Wait for your midwife to remove your catheter before trying any pelvic floor squeezes.

What is an over-active pelvic floor?

An over-active pelvic floor can happen when you’re constantly contracting your pelvic floor muscles without realising it. This can be caused by tension due to pain or damage to your tissues. Having tears, stitches, an episiotomy, or pelvic girdle pain, can all lead to your pelvic floor muscles becoming overly tight.

If you are sore during the first few weeks, you may squeeze in your pelvic floor muscles in response to the pain. If you hold your muscles too tight for too long, it can cause a range of problems that don’t get better.

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