Pelvic floor care during and after pregnancy

Anatomical drawing of a woman's pelvic floor musclesA woman's pelvic floor muscles support her bladder, uterus (womb) and bowel and stretch like a hammock from her tailbone to pubic bone, and from one side to the other. They play an important role in bladder and bowel control and sexual function.

The urethra (front passage), vagina (birth canal) and anus (back passage) pass through the pelvic floor muscles.

Factors that weaken the pelvic floor include:

  • pregnancy and childbirth
  • continual straining to empty your bowels or bladder
  • persistent heavy lifting
  • a chronic cough (smoker’s cough, chronic bronchitis, asthma)
  • being overweight and a lack of general fitness
  • changes in hormone levels during menopause.

Signs of weak pelvic floor muscles include:

  • accidently leaking urine or faeces when coughing, sneezing, laughing or exercising
  • rushing to the toilet because you can’t hold on
  • difficulty controlling bowel movements or wind
  • difficulty emptying your bladder or bowel
  • a prolapse (dragging, heaviness or a vaginal bulge)
  • lack of sexual sensation.

Exercising your pelvic floor muscle on a regular basis can help manage or prevent these problems. By strengthening your pelvic floor muscles and improving their stamina, they can then work hard and for longer and are more able to coordinate their action with other muscles working at the same time.

Learning about your pelvic floor muscles
Pelvic floor exercises

All women should do these exercises throughout their life, not just when they are pregnant. To do this exercise correctly you need to hold and lift the muscles around your anus, vagina and urethra together, then relax the muscles.

  1. Sit or lie down comfortably with the muscles of your thighs, bottom and abdomen relaxed. Remember to keep breathing normally.
  2. Tighten the muscles around the anus (back passage) like you are stopping wind, then tighten the muscles around your vagina as a ‘squeeze and lift’ movement and tighten the muscles around your urethra (front passage) as if you are stopping the flow of urine, and then relax.

Don’t worry if one part feels stronger than the others at the beginning, you will get better with practice.

Slow and sustained exercise for endurance

  1. Squeeze and lift all passages gently, hold initially for 2–3 seconds.
  2. Rest for 5 seconds.
  3. Repeat 4–5 times for one set.
  4. Do 2–3 sets per day, if possible. Concentrate on doing these exercises carefully and correctly.

Once you feel comfortable with these exercises, gradually increase your hold time by one second each week. Regular practice will strengthen the muscles, so eventually with practice you should be able to hold for up to 10 seconds or longer, and walk, talk and do other activities at the same time.

If you are doing these exercises during your pregnancy, the exercises will become harder to do and you may find yourself holding for a shorter period of time. This is normal as baby gets heavier, and your hold time will increase after pregnancy. If you can’t feel the muscles working keep trying.

Quick and short exercise

This exercise can help to reduce urinary leakage when you cough.

  1. Squeeze and lift all passages strongly.
  2. Let go and rest for 3 seconds, then repeat 3 times.
  3. Increase by 1 repetition daily until you are doing 10 repetitions. Do at least 3 sets of 10 repetitions each day

It’s important you gradually build up each exercise and don’t:

  • bear down or push
  • hold your breath
  • overwork your muscles.

Set reminders to do these exercises

You can do these exercises during daily activities such as working in the kitchen, brushing your teeth or having a shower.

Other ways to remind yourself to do your pelvic floor exercises include:

  • download an app such as the 'Squeezy NHS Pelvic Floor App'
  • put reminders in your phone
  • put sticky notes around the house
  • link your pelvic floor to a daily activity, such as brushing your teeth or waiting for the kettle to boil.
See how to do pelvic floor exercises

During pregnancy

After pregnancy

Learn more about physiotherapy during pregnancy

Find out more