The BEST Pelvic Floor + Core Exercises for Pregnancy and Childbirth

The pelvic floor is truly the foundation of your pregnancy and your body. Not only does the pelvic floor support your internal organs but helps provide strength and stability to move pain-free. With the added pressures from pregnancy, it’s more important than ever to have a strong, yet flexible pelvic floor to support your baby, your body, and to have a healthy labor and birth.

During and after pregnancy, many women notice they may leak urine more easily, have pain with intercourse, or have a heaviness “down there” that wasn’t there before. These are all symptoms of pelvic floor weakness (or tightness).

Thankfully, research shows that pelvic floor training can not only prevent but reverse incontinence, dyspareunia, and prolapse. And potentially decrease likelihood of perineal injury during birth.

And while it would be nice if we could just Google a few exercises, there’s a lot of misinformation out there. In fact, studies show that 30% of women are performing their pelvic floor exercises wrong, which can actually worsen pelvic floor symptoms and increase the risk of incontinence and prolapse!

But the good news is, the best exercises to train your pelvic floor aren’t difficult or overly time-consuming, they just need to be taught and practiced correctly in order for them to work.

I remember going into labor with my first baby…

Thinking I knew what I needed to know. I was a practicing physical therapist (though not a pelvic specialist at the time) so knew a thing or two about exercise. But I didn't know what a beating my pelvic floor would take. And even though I had read all the pregnancy books I could get my hands on, taken classes, and had my postpartum kit, birthing ball, and baby things ready, I wish I'd had the tools and strategies to target and prep my pelvic floor muscles for birth. Cause I struggled with pelvic floor pain for 6 months after having my baby before realizing it was treatable and wasn’t going to go away on its own. Thankfully, I was able to reverse the issue with some simple self-treatment techniques.

Now I know I should have specifically trained my pelvic floor and core muscles with targeted exercises to both lengthen and strengthen all 3 layers of muscles of the pelvic floor (not just the perineum). Training the entire pelvic floor is vital so the muscles can stretch when they need to and squeeze when it matters - like when you can’t get to the bathroom soon enough!

Three babies (and natural births) later, I can definitely attest that training the pelvic floor and core makes all the difference in the world in preventing (and reversing) problems and recovering faster after birth.

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Training the muscles of the pelvic floor and core during pregnancy is key to not only helping prevent or relieve pain and symptoms during pregnancy, but is key to a smoother birth and recovery process.

There's a lot more awareness these days about the importance of pelvic therapy AFTER birth. You probably have heard how in France it's standard of care for all postpartum women to have pelvic training.

That's awesome! Very important!

But what about pelvic floor+core training BEFORE birth?
Wouldn't it make sense to train before a major physical event rather than just hope you don't get injured and plan on rehabbing afterward if you do?

Not to mention how much it can help to relieve common pregnancy pain like symphysis pubis, SI Joint pain, back pain, and urinary leakage during and after pregnancy.

Pelvic Floor Muscle Training During and After Pregnancy is Research-Backed

Studies show women who follow a professionally-prescribed pelvic floor muscle training program during pregnancy may have less perineal tearing, pain, incontinence, length of labor, and better recovery…

One study showed an almost 33% reduction in episiotomies and over 10% reduction in perineal tearing by practicing targeted pelvic floor exercises. There were also significantly fewer 3rd and 4th degree tears and less perineal pain after birth in the group that followed the exercise program.

A review of the literature investigating pelvic floor muscle training found a significant reduction in the duration of the second stage of labor, as well as a reduced incidence of urinary incontinence with a prescribed pelvic floor muscle training program.

And although up to 45% of pregnant and postpartum women experience incontinence, another study demonstrated the effectiveness of pelvic floor muscle training to prevent or resolve incontinence in pregnant and postpartum women. In both pregnancy and postpartum, regular pelvic floor muscle training not only reduced the frequency and intensity of urinary incontinence, but also showed significant improvement in quality of life.

In addition, women who were continent (not experiencing leaks or urgency) and practiced pelvic floor muscle training as a preventive tool were 62% less likely to experience urinary incontinence in late pregnancy and have a 29% lower risk of urinary incontinence 3-6 months postpartum.

The Best Exercises and Strategies to Protect and Prepare Your Pelvic Floor + Core For Birth

If you’re wondering what the best exercises are to prepare for birth and improve recovery, there are many that can be helpful, some a waste of time, and some possibly harmful depending on your individual muscle tension, postural patterns, breathing habits, and other lifestyle considerations. Specifically,

A great pelvic floor program will follow these strategies:

Breathing and relaxation - making sure you can not just contract, but relax the pelvic floor. (psst - you MUST be sure you have good pelvic floor mobility before working on exercises that encourage tightening the pelvic floor muscles. Many pelvic floor issues have more to do with a too tight pelvic floor than not being able to tighten the muscles enough.)
Postural alignment education and practice to ensure your daily habits aren’t contributing to pelvic floor tightness or laxity
Stretching and trigger point release for pelvic floor, hips, glutes, low back, adductors/abductors to balance out the tissue length (which will affect the strength of your pelvic floor activation) - check out this resource for a step-by-step in how to test for and release pelvic floor tension
Exercises to practice coordination of the pelvic floor with the deep core, abs, and diaphragm
Exercises in multiple positions (no more “do kegels every time you’re sitting at a stoplight” please) to strengthen and tone your pelvic floor and core for everyday life (the pelvic floor should be dynamic, not static)

**But pelvic floor and core health isn’t just about doing exercises (and may not even include Kegels!!!)**

The most important determinants of pelvic and core health are lifestyle, daily habits, nutrition, breathing mechanics, and postural alignment to support the health of the pelvic floor, hormones, and whole body. Without those key pieces, exercises really aren’t going to do you a lot of good.

Think about it, if you only do exercises for, say 20 minutes per day, and the rest of the time you’re practicing poor biomechanics, nutrition, or breathing, 20 minutes of exercise is not going to offset the other 15+ hours (taking out 8 hours for sleep) you’re using your pelvic floor. If you think about it, that 20 minutes is only 2% of your daily time. Pretty sure that’s not going to be as effective as if you’re practicing good pelvic floor and core mechanics and other lifestyle habits 24/7.

Need more targeted strategies? Here’s where to start…

Take our free Pelvic Health Quiz to get a baseline of your pelvic health starting now.
Think you might have pelvic floor tension? Grab the Strong, Supple Pelvic Floor Ebook to learn how to test for PF muscle tension and what to do about it.
Check out my Pelvic Floor + Core Exercises for Pregnancy online course for comprehensive exercises and strategies to prepare your pelvic floor and core for your beautiful birth and recovery. (Already delivered? Congrats! This course is especially good for recovery after baby’s birth as well!)