Pelvic floor muscle exercises immediately after childbirth

Pelvic floor muscle exercises are recommended worldwide to prevent pelvic floor problems such as leakage of urine and loss of stool. Also, better support for the organs in the small pelvis (the bladder, uterus and bowel) can help alleviate some of the problems of prolapse and heaviness in the vagina.

Pelvic floor muscle exercises may be resumed immediately after childbirth. The exercises will not aggravate any pain you may feel or swelling in the pubic area and labia. Even women who have been cut, torn and stitched up may start exercising. We know this from scientific research!
But this restarting of the exercises does not come easily to everyone.

Your pelvic floor consists of muscles, but also ligaments, connective tissue, nerves and blood vessels. All these tissues are therefore under pressure during pregnancy and possibly also during a vaginal birth.

What problems can you expect when starting exercises immediately after giving birth?
  • You may hardly feel how to tighten your muscles.
  • You may be able to tighten them briefly, but you will feel them release immediately. As if you can only make a short blinking movement with your muscles.
  • You may feel like you have to hold your breath and tighten all the muscles around that pelvic floor, but you can barely feel anything happening around the vagina and pee hole.
  • Maybe it will work once, but certainly not 10-12 times.
  • Maybe you doubt that you are doing it right?
All the above feelings are very common! Do not be discouraged.
Some golden tips when starting exercises after giving birth:

Focus first on control of the pelvic floor:

  1. Try to understand your muscles again; to control them; to feel them...
  2. Tense them up (as if you were peeing or holding back a breeze) and try to release them at your own pace.
  3. Always ensure that the muscles are well toned up and relaxed
  4. Correct stretching means making a closing and lifting movement with the muscles.
  5. Relax your abdominal muscles, buttocks and thighs
  6. Breathe calmly
  7. Do not tilt your pelvis

 Give yourself some time. Your pelvic floor has just undergone quite a challenge and the control (=mirroring) of these muscles may also be temporarily impaired by the stretching.

By the way, keep in mind that this also applies to women who give birth by caesarean section ; the pressure on the nerves and other tissues already builds up during pregnancy!

In order to avoid common mistakes and to clear up any doubts about these exercises, it is best to have these attempts checked by a pelvic floor therapist. We know that more than half of all women who have recently given birth fail to tighten their muscles correctly during their first attempts. But after a few tips, more than 90% of women will get over it quickly!

Don't give up, after a few days your feeling in the muscles will already start to recover.

Practise lying down, sitting down and standing up.
Preferably daily, in 3 sets of 12 repetitions, "tighten briefly and powerfully and release gently".
Aim for 5 minutes a day.
Make a habit of your daily exercises up to 6 months postpartum.

This information is also covered in The Pelvic Floor's "infographic" on pelvic floor rehabilitation, which will be shared on this platform soon.
Like, follow and support us. Be sure to check out all the additional tips included.

Good luck,
Hedwig Neels, PhD, Pelvic floor physiotherapist.
Prof. Dr. Alexandra Vermandel, PhD, Pelvic floor physiotherapist, Coordinator Klein Bekkenkliniek UZA 

Neelset al, Common Errors Made in Attempt to Contract the Pelvic Floor Muscles in Women Early After Delivery: A Prospective Observational Study. Ejog, 2017 DOI: 10.1016/j.ejogrb.2017.11.019
Vermandel et al, Pelvic Floor Awareness andthe Positive Effect of Verbal Instructions in 958 Women Early Postdelivery.IUJO, 2015 DOI: 10.1007/s00192-014-2483-x


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