Kegels
A common exercise recommendation when someone is pregnant is to do kegels. If you complain of leaking or any sort of pelvic floor issue, both medical providers and mom groups alike will probably recommend doing some kegels. The issue is obviously weakness.
“Do 500 kegels a day.”
“Do them at every stop light.”
“Hold it for as long as you can.”
Why? Because we want a strong pelvic floor for birth. And, if you are having issues, it’s because you’re weak! Right?? Maybe not.
Hey there… before we continue, I have one question! Are you feeling anxious or overwhelmed about your upcoming childbirth experience?
Our Childbirth Education Course is here to help you feel more confident and prepared for the big day.
With our expert guidance and support, you’ll learn everything from breathing techniques and pain management strategies to postpartum recovery tips and newborn care. Plus, you’ll be part of a supportive community of fellow moms-to-be who are all on the same journey.
Don’t let fear hold you back from the birth experience you deserve. Enroll in our course today and let us help you achieve your best childbirth experience yet!
Ok, let’s continue…
Let’s first define strength and consider range of motion.
Strength can be defined as the amount of force that can be withstood. But, it’s important to note that we can have varying strength throughout a range of motion. You may notice while doing a squat, that it’s easier at certain points on the ascent, but there are a few “sticky” points that your movement slows or you may find yourself failing the movement.
Another thing to consider is the range of motion that we train in. Let’s say I barely squatted below parallel. If I tried to squat below parallel with the same weight, I may find that I am bailing at the bottom of the movement. This could be because I have not trained in that range of motion, so I am not conditioned to perform there.
If we only contracted our pelvic floor at the top of a movement (think only doing quarter squats), we may find issues when our pelvic floor needed to move outside that range of motion (such as when you jump or sneeze). When we sneeze or jump, the pelvic floor lowers in response to the increase in downward pressure. Then the pelvic floor recoils and contracts upwards to prevent leakage and protect the pelvic organs. But, this would be moving it outside of our trained range of motion, and we may find the recoil is uncoordinated or nonresponsive. This could cause leaking!
Now let’s consider pregnancy and having a strong pelvic floor
While our pelvic floor does need to be strong to support our pelvic organs during pregnancy, we also want it to be supple and have the ability to relax and release to make way for baby during birth. Our uterus grows 40x the size from pre-pregnancy; our mass increases; baby is growing; we have more fluid from an increased blood volume… so our pelvic floor has a lot more to support during pregnancy. We want it to be strong enough to support our organs as the foundation of our core.
Kegels may help to increase max contractile strength at the peak of a pelvic floor contraction. But, strength in only one portion of the entire range of motion may not be functional or even helpful during pregnancy (or for overall pelvic health). Kegels may be helpful, but would only recommend them under the guidance of a pelvic floor physical therapist. Kegels may actually make issues you are having worse, especially if you have a tight or clenched pelvic floor.
Our in house pelvic floor physical therapists offer group pelvic floor wellness sessions both in person and virtually!
Our pelvic floor needs to be able to respond to changing demand and movement. When we walk, jump, sneeze… we want our pelvic floor to be able to respond to these changes appropriately. This means, we need our pelvic floor to MOVE.
Pelvic floor considerations for birth!
On one end of the spectrum is the contraction, the other end is the stretching. And in between we have relaxation. Our pelvic floor needs to be able to contraction or shorten; lengthen and stretch; and also relax! This is incredibly important for birth.
We need some tension in our pelvic floor to help with fetal head positioning. Enough tension helps baby to tuck their chin, and present smaller to the vaginal opening. But, too much tension, especially uneven tension, could cause the baby’s head to tilt sideways. Too much tension could also make it more challenging for baby to descend through the pelvic floor for a vaginal birth.
Now, while we need SOME tension, we really need a lot of relaxation and stretching!! Baby is working to descend through the pelvic floor to be born. Our pelvic floor does not need to push your baby out (it’s on the bottom of the path baby is exiting), but rather it needs to just move out of the way.
Some helpful methods to relax the pelvic floor during labor include:
Deep inhales to feel the perineum expand, followed by exhales to relax as much as possible;
Supported positions, that allow the legs and glutes to relax;
Feet supported, as tippy toes can clench the pelvic floor;
Jaw release or myofasical massage, as jaw tension can clench the pelvic floor.
The blanket recommendation for every pregnant person to do kegels is not helpful, nor will it improve birth outcomes. In may more likely cause more issues during both pregnancy and birth, since the focus is not on overall function and coordination of the pelvic floor with the rest of the system. If you are having issues, working with a pelvic floor physical therapist can be incredibly beneficial. You may find kegels are helpful, or you may find another method is more appropriate for you.
We break down the pelvic floor, to include relaxation techniques, in our childbirth education course and fitness education courses!