Beyond Kegels: 3 Tips for Improving Pelvic Floor Function in Pregnancy

Pregnancy can be an exciting, yet physically and emotionally challenging journey for women. It is important to honor and tune into these changes in your body. Some of these physical changes that accompany the growing baby will include increased fatigue, weight gain, and  low back/SI joint. The most common, yet least talked about symptoms include:

  • Leaking when you cough or sneeze (urinary incontinence)
  • Intense sudden urge to use the bathroom (stress incontinence)
  • Heaviness in the pelvis or “organs going to fall out” (organ prolapse)

Although we have accepted that these pelvic floor symptoms are “normal” to feel during pregnancy, expecting mothers can alleviate their symptoms through pelvic floor physical therapy. 

Here are 3 tips for all expecting mothers to get started on improving their pelvic floor health:

Get your pelvic floor strength and function tested.

Pelvic floor physical therapists (PTs) are trained to assess the pelvic floor both externally and internally. The internal exam is similar to an OB/GYN exam but the PT will be assessing your pelvic floor strength, tone, and its function. A pelvic floor PT will be able to provide the proper treatment plan which could include pelvic floor strengthening/release, postural work, manual therapy, and therapeutic exercise. Also, every mother is different and should be treated on an individual basis. Treating urinary incontinence can be different from treating pelvic pain, so make sure you see the proper professional!

Practice proper breathing.

Most women are told to practice Kegels to work on the pelvic floor, but proper breathing actually makes the exercise effective. It’s not just about flexing the muscles down there! To start off, simply inhale to fill the belly and exhale to draw the navel in slightly, as if you’re hugging your baby. 

Following proper breathing technique, you can start to incorporate the Kegel exercise. I like to cue pelvic floor contraction by telling patients to imagine there is an elevator at the bottom of their pelvic floor and that they are drawing it all the way up. Inhale, to fill the belly and relax the pelvic floor, and exhale to draw the pelvic floor muscles in and up. 

Stay active! 

Depending on your activity level prior to pregnancy, the goal is to maintain your cardiovascular fitness and strength. If you are starting out, work with a prenatal/postpartum fitness professional or physical therapist.  I like to recommend yoga and Pilates to my expecting patients of all fitness levels, as they are great low-impact exercises that allow you to focus on your breath and pelvic floor! 

Dr. Kathleen Castro, PT, DPT, CSCS, PMA®-CPT, BSPTS-1 Certified Therapist is the lead therapist for PhysioElements Physical Therapy in Greenwich, CT, and enjoys treating a diverse population of patients, especially the perinatal population in addition to children. She works to find the root of the problem and combines manual therapy, Pilates-based therapeutic exercise, and functional strength training in her treatment sessions to work her patients to reach their goals. As an avid Pilates practitioner and long-distance runner, Dr. Kat integrates her passion for fitness and wellness to support her patients and clientele in leading a healthy lifestyle for optimal health and longevity. Connect with Kat on MyNestwell.

This site does not provide medical advice, diagnosis or treatment and is not a substitute for medical care. does not employ any care provider nor is it responsible for the conduct of any care provider. Each individual is solely responsible for selecting an appropriate care provider for themselves and for complying with all applicable laws in connection with any employment relationship they establish. Your use of the site indicates your agreement to be bound by our Terms & Conditions and Privacy Policy.