Updated October 22, 2024
We probably don’t need to tell you this, but pregnancy and childbirth certainly take a toll on your pelvic floor muscles. Yet, when we talk about postpartum “core recovery,” most people think primarily about their abdominal muscles. While your abs are certainly important, we cannot ignore the “floor of your core” — your pelvic floor. The pelvic floor muscles are perhaps the most neglected group of muscles in the body, but they are critical core muscles that have very important functions. Given the stress these muscles undergo during pregnancy and childbirth, proper recovery work is essential to build a strong and functional core. But no, it’s not about “just doing Kegels” as we so often hear.
Read on to learn:
- The structure and function of your pelvic floor muscles
- How pregnancy impacts your pelvic floor
- Pelvic floor recovery work: How to perform “PFAs”
- Why we don’t use the term “Kegels”
- Additional resources to support you
Understanding Your Pelvic Floor
Let’s begin by understanding a bit more about the structure and function of your pelvic floor muscles. Your pelvic floor consists of three layers of 14 different muscles that form a sling at the bottom of your core (or “floor of your core”).
Many people think of their pelvic floor muscles as just those “pee-stopping” muscles, but actually that is just the front of your pelvic floor. As you can see in the image below, the pelvic floor muscles have connection points in the front, back, and sides of your pelvis.
Together, the pelvic floor muscles are responsible for:
- Supporting your pelvic organs: uterus, bladder, rectum
- Helping to stabilize your spine and pelvic-hip region
- Controlling continence (making sure you pee when you want to, and don’t pee when you don’t want to)
- Aiding in sexual response and satisfaction
- Assisting in guiding the baby out during delivery
How Pregnancy Impacts Your Pelvic Floor
During pregnancy, the pelvic floor muscles are stressed with the added weight of your growing belly and uterus. In addition, the common pregnancy alignment shifts — especially the anterior tilt (or low back arch) caused by the growing belly — can accentuate pressure on these muscles.
Then, comes the added trauma of childbirth. In a vaginal birth, the pelvic floor muscles are responsible for helping to guide the baby out during delivery. However, if these muscles are weak or underactive, this could result in increased tearing. A C-section also traumatizes the pelvic floor muscles. During the procedure, the abdominal muscles are moved in order to pull the baby out. Because of how intricately connected the abdominal and pelvic floor muscles are, this major abdominal surgery also impacts the pelvic floor.
So, in summary, pregnancy alone puts a great deal of excess strain on the pelvic floor muscles. However, delivery certainly adds to it, and that’s why pelvic floor dysfunction is more common in the postpartum period.
Pelvic Floor Recovery Work: How to Perform “PFAs”
You can begin pelvic floor recovery work as soon as you feel comfortable following delivery. In fact, some studies show that gentle pelvic floor activations done within the first 24 hours after delivery can help increase blood flow to the area to expedite healing. Of course, depending on your delivery experience, let comfort be your guide.
When it comes to specific pelvic floor exercises, we teach exercises called PFAs (Pelvic Floor Activations).
Watch the video to learn how to perform these exercises. It takes you through a 4-step process to help you first find your pelvic floor muscles, then learn how to perform the two PFA variations: PFAs-Slow and PFAs-Fast.
Let’s review the 4 steps from the video:
- Step 1: Find your pelvic floor muscles: front, back, and sides
- Step 2: Practice moving them together (lifting up, then fully releasing)
- Step 3: Align this movement with your 360˚ Breathing. This is a PFA-Slow
- Step 4: Continue this same motion, but at a slightly faster tempo, not aligned with your breath (just breathe comfortably). This is a PFA-Fast
Practice both PFAs-Slow and PFAs-Fast because they target different muscle fibers:
- PFAs-Slow target the slow-twitch fibers that are responsible for supporting the pelvic organs and stabilizing the pelvic region
- PFAs-Fast target the fast-twitch fibers that help to resist unwanted leakage (urinary or fecal) – especially during sudden movements like coughing, laughing, sneezing, or impact exercise.
*Expert TIP*
One great way to get in your pelvic floor work is to align your PFA practice with an activity that you do daily to help you establish a habit. This way, your practice becomes routine — something you don’t have to try to remember (because remembering to shower and brush your teeth is challenging enough in the early postpartum days). If you’re in those earlier postpartum months, we recommend practicing your PFAs every time you sit down to feed your baby. Aligning your pelvic floor work with an activity like feeding your baby ensures you get in plenty of practice!
In terms of reps and sets, there is no specific rule on this. As one example, you could say 1 set = 3-5 PFAs-Slow + 8-10 PFAs Fast. Perform 2-3 sets at every feeding session.
Why don’t we use the term “Kegel”?
We do not use the term “Kegel” because these exercises have become synonymous with “squeezing the muscles used to stop the flow of urine.” After reading this article, hopefully you see that there are two issues with this description:
- Your “pee-stopping” muscles are only the front of your pelvic floor (this misses the back and sides).
- A focus on the contraction only can cause your pelvic floor muscles to go into a shortened (overly tight) state, which can actually lead to, or exacerbate, pelvic floor dysfunction. Like all other muscles in your body, your pelvic floor muscles must be worked through a full range of motion, which requires being able to lengthen them.
Want Additional Resources?
Want an easy-to-follow program that can help you heal and strengthen your deep core muscles after birth? Explore our 8-week Core Recovery Program delivered on the ProNatal Fitness app. It helps you rebuild your core from the inside out in less than 10 minutes a day — whether you gave birth a few weeks, or several years, ago. Looking for workouts too? Explore our Postpartum Workout Program, which includes the Core Recovery Program plus total body workouts, nutrition guidance, and other resources to support your recovery.
Are you a Health & Fitness Professional?
Are you interested in training pre & postnatal clients or supporting them better in your current line of work? Explore our ProNatal Professional Education & Certification to find courses, resources, and community to help you build your pre & postnatal fitness expertise.