There are several muscles that reinforce the pelvic floor, also called the pelvic diaphragm. These muscles support the pelvic organs including the bladder, intestines, and uterus. Keeping them toned and strong during pregnancy and post-partum helps prevent bladder incontinence, as well as prolapses of the uterus and bladder (a condition in which these organs can bulge into your vagina), and can be an aid in childbirth.
One of the most important pelvic floor muscles, the pubococcygeus (PC) muscle directly aids in urinary control and childbirth, and contracts during orgasm. During childbirth, having a strong PC muscle can help to position the baby’s head properly during labor, and aids in the pushing phase of delivery. A weak pelvic floor can be caused by pregnancy, childbirth, being overweight, and aging, and can lead to problems such as stress incontinence, along with prolapsed pelvic organs and pelvic pain.
So you may be thinking, I have to do strengthening exercise with yoga, add in cardiovascular exercise, and now I have to exercise my pelvic muscles too? Isn’t yoga or pilates enough to take care of all of that “down there?” The answer is no. Yoga and pilates are not enough. It is imperative to do certain exercises designed specifically to strengthen the pelvic floor, called Kegel exercises. Understanding where your PC muscle is, how it works, and doing your Kegels can make or break your labor and delivery.
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How to do Kegel exercises:
It’s not easy to identify your pelvic floor muscles, and then learn how to contract and relax them. It will take a bit of practice and may feel odd when you are first starting out. While it may be uncomfortable learning to find and contract the proper muscles, you should quickly be able to perform the exercises easily.
1. Finding the right muscle:
This is where you may feel a bit uncomfortable, but once you get this part, the rest is a breeze. There are a couple of different ways to do this, and you can choose the one that suits you best. The first way is to insert one clean finger into your vagina and try to squeeze the muscles around your finger. You should feel your vagina tighten and the surrounding muscles move upward. Afterward, relax your muscles, and you should notice the pelvic floor muscles return back where they started. The second way is a bit more tricky, and should not be done on a regular basis as it could lead to a urinary tract infection from contracting your pelvic floor muscles with a full bladder. With this method, you will attempt to stop the flow of urine when you urinate. The muscles that contract when you try to stop are the correct muscles.
2. Start slow and build up:
When I first started doing Kegel exercises, I couldn’t contract the muscle for very long, maybe a second or two. When you are first starting out, just practice contracting and relaxing every second, for 50 to 100 times. Do this three times daily. This is the basic exercise. It’s actually quite easy to do, and you can do it while you are doing routine tasks–watching TV, reading, driving to work, checking email….you get the picture.
Once you’ve got this down pat, it’s time to move to some heavy duty Kegels. Once you start building those muscles, you will be able to hold the contraction for a longer period of time. When this happens, focus on building the amount of time you contract the muscles. You can picture your PC muscle as an elevator, and each contraction makes the “elevator”(your muscles) move up another “floor.” Each second you tighten the muscle means the muscle is contracted up higher and tighter. Try to do this for five seconds (or move the “elevator” up “five floors”). The good news is you won’t need to do as many. You will only need to do this 15 to 20 times three times daily. As your muscle gets even stronger, you can do this for 10 seconds, and then you will only need to practice it 10 times three times daily.
I am very much into centering or focusing, and this can apply to Kegels as well. When you are working on perfecting your technique, there are a few things to do (or not do). First, don’t hold your breath. With the beginning exercise, just nice even breathing. When you get more advanced, try to focus on breathing in with contracting and breathing out with relaxing. Also, when you are doing the exercise, make a mental picture in your head of how your muscles are strengthening, and imagine how you are going to use those muscles to push the baby out during delivery.
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4. Keep doing it.
The great thing about this exercise is that it can be done right after the baby is born, and should continue on. Another great thing about Kegel exercises is that they work. The downside is that if you stop doing them, the muscles quickly become weak again, and you have all of those negative side effects of weakened pelvic floor muscles. I’ve delivered eight babies, and I’ve been jokingly told that my uterus must be ready to fall out. I can guarantee you that is not the case, and certainly won’t be if I have anything to do about it.