Train before the baby
A Cochrane review of 11 trials found that training during pregnancy lowers the risk of leaks in late pregnancy by 22%. Here is how to start, and when to check first.
Pregnancy puts 9 months of growing load on your pelvic floor. Then birth stretches it.
You can train for that, the way you would train for a long hike.
What the evidence shows
A Cochrane review pooled 11 trials and 3,307 pregnant women.[1]
Women who did pelvic floor training during pregnancy were 22% less likely to report leaks in late pregnancy. The authors rate the evidence as moderate quality.
Timing matters
The same review found weaker results for blanket training programs offered to every woman after birth.[1]
So my advice: start during pregnancy, while your pelvic floor is still building toward the big day.
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How to train during pregnancy
The basics match any Kegel:
- Lift on the out-breath, as if holding in gas.
- Let go fully on the in-breath.
- 8 lifts, 3 times a day.[2]
What changes with the bump:
- Positions. As your belly grows, train sitting, lying on your side, or on hands and knees.
- Effort. Gentle to firm. Breathe through every rep.
- The let-go. It matters even more now. For a vaginal birth, your pelvic floor needs to soften and stretch. Practice the let-go as carefully as the lift.
After birth
If you gave birth in the last 6 weeks, or had a cesarean, check with your doctor before you train. Then start gently, with the let-go first, and rebuild the lift over the following weeks.
A Postpartum program is coming to the app. Class Notes subscribers hear first, the day it opens.
Your pelvic floor will carry your baby for 9 months. Give it 5 minutes a day.
Quick answers
Are Kegels safe during pregnancy?
For most pregnant women, yes. Check with your doctor first if you have bleeding, placenta problems or a risk of preterm labor, recent pelvic or belly surgery, pelvic pain or pain with sex, or a bulge at the vaginal opening.
Do pelvic floor exercises in pregnancy prevent leaks?
They lower the risk. In a Cochrane review of 11 trials and 3,307 women, those who trained during pregnancy were 22% less likely to report leaks in late pregnancy (moderate-quality evidence).
When can I start pelvic floor exercises after birth?
When your doctor clears you, and later after a cesarean. Start gently, with the let-go first, then rebuild the lift over the following weeks.
Written by Dr. Dana Kivlin, DO, board-certified urologist. Updated . Every number links to its source below. This letter teaches; your own doctor diagnoses. How we write
Sources
- Woodley SJ, et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews, 2020. cochranelibrary.com
- NICE guideline NG123. Urinary incontinence and pelvic organ prolapse in women: management, 2019. nice.org.uk
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