Pelvic floor health: an alternative to kegels for expecting moms

What exactly is my pelvic floor?

Your pelvic floor is a set of muscles and ligaments that stretch from your pubic bone to your tailbone, supporting your bladder, bowel, and uterus. It’s the bottom part of what people often refer to as your core. A strong pelvic floor can improve your sexual function and pleasure, minimize backaches, and reduce your risk of peeing when you sneeze or laugh 🙃

The pelvic floor muscles work particularly hard during pregnancy, as they’re supporting the extra weight from your baby and enlarged uterus. At the same time, your hormones soften these muscles and surrounding ligaments so they can stretch out of the way during labor to make room for your baby to exit. All of these changes can leave your pelvic floor in need of some TLC—both during and after your pregnancy.

What to do instead of kegels

Kegels are a common recommendation during pregnancy for strengthening the pelvic floor, but strengthening may not be what your pelvic floor needs. If it’s holding too much tension or lacking muscular coordination, kegels could do your pelvic floor more harm than good. Instead, try diaphragmatic breathing which improves the flexibility and mobility of your pelvic floor muscles, and is good for everyone. 

Here’s how to do it: 

Many of the breaths we take as adults are shallow and don’t use our full lung capacity. These “chest breaths” happen without any conscious direction from us. Diaphragmatic breathing, on the other hand, is deep and intentional. 

1. Take a slow, deep breath with one hand on your stomach and the other on your chest. As you breathe in, direct the air into your lower belly. The hand on your stomach should rise as you do this, while the one on your chest stays put. This may take a few tries, but you’ll figure it out ❤️
2. As you exhale, contract your core muscles to push all of the air out. It can help to imagine that your core is like a tree trunk with rings on the inside. Try to bring those rings together towards your midline. As you do this, the hand on your stomach will return to its starting position, while the one on your chest continues to stay still.
3. Repeat, counting to 4 as you breathe in, and 4 as you breathe out. 

Practice this breathing method a few times a day—2 to 5 minutes per session is plenty. To make it a habit, see if you can work it into a routine or pattern you already have. For example, you could practice each time you log onto your computer, brush your teeth, or sit at a stoplight.

Meet the expert

Natalia Avelar, DPT, PRPC, is a pelvic floor physical therapist and owner of Peace Pelvic Health, a specialty physical therapy practice specializing in treating pelvic and orthopedic conditions.