Many of us know Kegels as the dreaded exercise our doctor tells us to do while standing in line at the store or sitting at a red light, but these pelvic floor exercises have a valuable place in your daily to-do list during pregnancy.
Named after gynecologist Arnold Kegel, these exercises can strengthen the pelvic floor muscles, which stretch during pregnancy and childbirth. If done correctly, Kegels can minimize stretching and make the muscles in your pelvic and vaginal area strong.
Sherry A. Ross, MD, an OB-GYN at Providence Saint John’s Health Center, says your doctor may suggest a regular Kegel routine during pregnancy — which makes sense, especially since you need these muscles strong to assist during labor and to help minimize postpartum incontinence.
If this is your first baby, you may not understand the critical role these muscles play after childbirth. But once you hit the postpartum stage, you’ll soon discover the importance of your pelvic floor muscles.
Not only do they support the reproductive organs and control bladder and bowel function, Ross says strong pelvic floor muscles can also help delay or prevent pelvic organ prolapse and other related symptoms.
And if done correctly and repeatedly, she also points out that you can avoid symptoms such as stress and urge incontinence that can result from childbirth as well as plain ol’ aging.
Ideally, your pelvic floor is active — both contracting and releasing —throughout all daily activities, from sitting to standing to recruitment during exercise.
But once you understand how to find your pelvic floor muscles and the steps to perform a Kegel, you can do these exercises anywhere and without anyone even knowing.
To identify your pelvic floor muscles, Ross says to follow these steps:
- Go to the bathroom.
- While urinating, stop the flow midstream and hold it for 3 seconds.
- Relax, allowing the flow of urine to continue.
- Repeat. While it may take a few tries to find the right muscles to tighten or squeeze, if you stick with it, you’ll be busting out multiple sets of Kegels in no time.
Now that you know how to identify these important muscles, it’s time to learn how to incorporate Kegel exercises into your daily routine.
The thing to remember, as with all muscles, says Heather Jeffcoat, DPT, the owner of FeminaPT.com, is they need to be able to contract well but also relax and lengthen. “This is especially important as the pelvic floor needs to lengthen during pregnancy and vaginal delivery,” she adds.
When doing Kegels, Jeffcoat says to perform them from the back to the front, meaning, from the anus towards the vagina. If done correctly, Jeffcoat says you will also feel a gentle contraction with flattening of your lower abs.
“The number of Kegels you should do to maintain your fitness level varies and depends on factors such as rehabilitating from an injury, dealing with stress incontinence or prolapse, or pelvic pain,” Jeffcoat says.
If there are no symptoms of pelvic floor dysfunction, Jeffcoat recommends the following protocol:
- Contract or tighten the muscles for 3 seconds.
- Rest for 3 seconds.
- Do 2 sets of 10 to 15 every other day.
- Alternate with quick contractions of 2 sets of 10 to 15 on the other days.
If remembering to contract these powerhouse muscles is a problem, Jeffcoat says there are Bluetooth enabled devices that can give you feedback. “In my office, we recommend using the Attain, which provides visual feedback plus pelvic floor muscle electrical stimulation to assist with your pelvic floor contractions,” she adds.
Kegels are a pelvic floor muscle contraction, so like any muscle in your body, you should be attentive to strengthening them throughout your lifespan.
For many women, doing Kegels during pregnancy is a safe and effective way to keep the pelvic floor muscles strong. However, Jeffcoat says if you are experiencing pelvic, abdominal, hip, or back pain, doing Kegels may be one factor feeding into your pain cycle.
“Examples of pelvic and abdominal pain that should give a woman pause to consider the appropriateness of Kegels are if they have symptoms such as bladder pain (painful bladder syndrome or interstitial cystitis), vulvodynia, vestibulodynia, vaginismus, dyspareunia or painful intercourse, urinary urgency and/or frequency, endometriosis, or constipation,” she explains.
If you are experiencing any of these conditions, Jeffcoat strongly recommends getting an evaluation by a pelvic floor physical therapist who can help direct a woman’s plan of care.
The benefits of Kegel exercises, says Jamie Lipeles, DO, an OB-GYN and founder of Marina OB-GYN in Marina Del Rey, include:
- stronger pelvic floor muscles
- better control of the urinary bladder
- better control of avoiding rectal incontinence
- a tighter vagina, which can lead to more pleasurable sex
Additionally, Jeffcoat says what many people don’t know is that Kegel exercises can also help with postural support. “This extra support is essential in reducing other symptoms such as back pain,” she explains.
While most women will benefit from Kegels during pregnancy, Jeffcoat says if you continually contract your pelvic floor, which she sees a lot in her avid Pilates clientele, you may experience adverse symptoms such as pelvic or abdominal pain. “We must be able to contract but also release and lengthen our muscles for optimal function.”
Although it is recommended to start doing Kegel exercises at a young age, Lipeles says the most critical time is during pregnancy and after delivery — for both vaginal delivery and cesarean section.
But if you’re dealing with any conditions that may make Kegel’s contraindicated, it’s best to talk to an expert.
“The best way to answer whether Kegels should be done or not during pregnancy is by having your pelvic floor muscles evaluated, and taking an honest look at any symptoms that they are experiencing and discussing that with their physician or physical therapist,” explains Jeffcoat.
If there are any symptoms of pain, she says the typical answer is to discontinue Kegels until further evaluated by your provider.
Performing Kegel exercises during pregnancy is an effective way to strengthen the pelvic floor muscles and help prevent incontinence, pelvic organ prolapse, and assist with labor and delivery.
If you have questions about the correct way to perform a Kegel, or you are experiencing pain while doing them, consult your doctor or pelvic floor physical therapist.
Remember to focus on the muscle contraction as well as the release, so you’ll be optimally prepared to usher your baby into the world.