Pelvic Floor Exercises
The pelvic floor consists of a 'hammock' of muscles and ligaments, resembling a figure of eight, and stretches from your pubic bone (at the front) to the bottom of your backbone. This holds your bladder, bowel and uterus in place, as well as helping to close the outlets of the bladder and bowel. The muscles also play a role in love-making - their contractions increase the pleasure for both you and your partner.
These muscles and ligaments come under strain during pregnancy and childbirth so it is important to maintain their strength by exercises. The weight of your baby during pregnancy places a strain on the muscles, but the hormone relaxin also softens and stretches them. If you have any strain or weakness in these muscles, you may leak urine - particularly when you cough, laugh, sneeze or exercise.
The importance of these exercises
Prolonged or repeated stretching of these muscles can result in permanent damage. If you ignore any weakness in your pelvic floor, you may develop conditions such as a prolapsed vagina, rectum, bladder or uterus. This is where the muscles fail to support the organs and start to 'drop', bulging into the vagina. This can result not only in urinary incontinence but also in lack of control over bowel movements. Surgery may be necessary to repair this.
When to start the exercises
There is no reason why you should not start doing these exercises as soon as you find out that you are pregnant. It is important to continue these exercises, not only during your pregnancy but also after the baby is born, in order to help yourself to regain the muscle tone. Do not leave it until after the birth because you will not be able to feel the muscles as well as you can now. All women should do these exercises throughout their lives to guard against stress incontinence (involuntary leakage of urine).
How to do these exercises
Sit comfortably, with your back straight and knees relaxed and held slightly apart.
- Imagine that you are trying to avoid breaking wind, or that you are 'holding on' to a desperate need to open your bowels. As you squeeze the muscles around your back passage you should feel the muscles move. Do not lift your buttocks or move your legs.
- Imagine that you are sitting on the toilet to pass urine. Clench the muscles that you would use to stop the stream of urine and imagine drawing them up, like an elevator rising.
- Imagine that you are trying to grip a tampon in the vagina using your pelvic floor muscles.
In each case, relax the muscles quickly and then repeat the exercise. Try to combine the three exercises. Pull up the muscles quickly several times and then do the exercises again slowly. Think about the position of the different muscles and how they feel. Imagine the muscles as an elevator - rising three floors and stopping at each one. When they are on the top floor, lower them in stages, stopping at each floor! Repeat the exercises ten times, five times per day.
Check that you are doing the exercises properly by putting a finger into your vagina and feeling the muscles tighten as you clench. Develop an awareness of how your muscles feel when they are relaxed. This is important in the second stage of labour, when you are pushing out your baby. Tighten the muscles of your pelvic floor as you breathe in and then with each outward breath, slowly relax the muscles as much as possible.
Try to associate the exercise with another activity, for example when you have a drink or after you have passed water. It does not matter what position you are in - you could be standing, sitting, squatting or lying down. The great thing about these exercises is that you can do them anywhere and at anytime and no one else will be any the wiser about what you are doing!