Pelvic Floor Prep: Training Before Birth
SaveYes — pelvic floor training is worthwhile in pregnancy, and the full skill is two-sided. Kegels strengthen the muscles and can lower urine leaking later, while learning to relax and lengthen them supports pushing at birth. Starting before delivery reduces incontinence for many, and a pelvic physical therapist can teach both halves.
Last updated: July 2026
Should you do kegels during pregnancy?
Pelvic floor training is worthwhile for most pregnancies because these muscles carry real load as the baby grows. The pelvic floor is a hammock of muscle that supports the bladder, uterus, and bowel, and pregnancy stretches and strains it over roughly 40 weeks.
A large Cochrane review found that people who trained these muscles before birth were about one-third — roughly 30 percent — less likely to report urine leaking in late pregnancy and the early postpartum period 1Ref 1Woodley SJ, Lawrenson P, Boyle R, et al. (2020).Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women.Cochrane review found continent women who did pelvic floor muscle training before birth were about one-third less likely to report urinary incontinence in late pregnancy and the early postpartum period. NICE antenatal guidance also endorses pelvic floor exercises during pregnancy 2Ref 2National Institute for Health and Care Excellence (2024).Antenatal care (NG201).NICE antenatal care guidance endorses pelvic floor exercises during pregnancy. Building the habit now tends to pay off during recovery, when the same muscles are healing and re-learning their job.
How do you actually do a kegel?
A kegel is a squeeze-and-lift of the muscles you would use to stop the flow of urine or hold back gas. A common approach is to draw those muscles up and in, hold for a few seconds, then fully release, repeating in short sets through the day — quality of the lift and the release both count 1Ref 1Woodley SJ, Lawrenson P, Boyle R, et al. (2020).Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women.Cochrane review found continent women who did pelvic floor muscle training before birth were about one-third less likely to report urinary incontinence in late pregnancy and the early postpartum period.
Breathing normally rather than bearing down keeps the effort in the right muscles. Many people unknowingly recruit the belly, buttocks, or thighs instead, which is why feedback from a pelvic floor specialist can be valuable. The release phase — letting go completely between reps — is as important as the squeeze.
Why does relaxation matter as much as strength?
Relaxation — the ability to release and lengthen the pelvic floor — is the half of prep most advice skips. During birth, these muscles need to yield and stretch so the baby can pass, and a floor that is only ever tightened can become overactive and tense.
Learning to fully let go, sometimes called down-training, supports pushing and may ease perineal strain, and perineal massage in the final weeks is a related skill some clinicians suggest to help the tissue stretch. A floor that both contracts well and relaxes well is more functional than one trained only to grip. This balance also supports comfort during sex and can ease the lower back pain that pelvic tension sometimes feeds.
How does pelvic floor care change over a lifetime?
Pelvic floor needs shift across the reproductive years and beyond. In adolescence, most people never think about these muscles; pregnancy and birth put them under their biggest test; and around the perimenopausal transition, thinning tissue can make leaking or urgency more likely again.
Pelvic floor training also reduces urine leaking outside of pregnancy, so the skill started now keeps paying off, according to a Cochrane review 3Ref 3Dumoulin C, Cacciari LP, Hay-Smith EJC (2018).Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women.Cochrane review found pelvic floor muscle training is effective for reducing urinary incontinence in women outside of pregnancy. It carries through recovery after a c-section or vaginal birth and into midlife, and the 150 minutes of weekly activity that supports overall health complements pelvic work. Symptoms that persist at any stage deserve attention rather than quiet acceptance.
When pelvic floor symptoms need a clinician
Some pelvic symptoms point to a problem that training alone will not fix. A heavy, bulging, or dragging sensation in the vagina, leaking that soaks through protection, pain during sex, or an inability to feel any contraction at all are all reasons to ask for a pelvic floor physical therapy referral 3Ref 3Dumoulin C, Cacciari LP, Hay-Smith EJC (2018).Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women.Cochrane review found pelvic floor muscle training is effective for reducing urinary incontinence in women outside of pregnancy.
New pelvic pain, or a floor so tense it hurts, also warrants assessment rather than more squeezing. A pelvic physical therapist can check whether the muscles need strengthening, relaxing, or both, and build a plan around your birth. Gale can help you gather what to bring to that visit.
Common questions
Related
Say it back
How would you explain this to someone you love?
Two or three sentences, just as you’d say it. Gale reflects back what you focused on — a mirror, not a quiz.
Pelvic floor red flags in pregnancy
- —A heavy, bulging, or dragging feeling in the vagina is a reason to ask your clinician about a pelvic floor referral
- —Urine or stool leaking that soaks through protection is a reason to seek pelvic floor physical therapy review
- —Pelvic floor exercises that consistently cause pain are a reason to stop and check technique with a specialist
- —Any vaginal bleeding or leaking of fluid is a reason to contact your prenatal clinician promptly
This article is general health education, not medical advice. Whether and how to train your pelvic floor in pregnancy is best guided by an obstetric clinician, midwife, or pelvic floor physical therapist who can assess your muscles directly.
References
- 1.Woodley SJ, Lawrenson P, Boyle R, et al. (2020). Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD007471.pub4 ✓Cochrane review found continent women who did pelvic floor muscle training before birth were about one-third less likely to report urinary incontinence in late pregnancy and the early postpartum period
- 2.National Institute for Health and Care Excellence (2024). Antenatal care (NG201). National Institute for Health and Care Excellence (NICE). link ✓NICE antenatal care guidance endorses pelvic floor exercises during pregnancy
- 3.Dumoulin C, Cacciari LP, Hay-Smith EJC (2018). Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD005654.pub4 ✓Cochrane review found pelvic floor muscle training is effective for reducing urinary incontinence in women outside of pregnancy
3 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — every citation independently verified. Editorial policy