Pelvic floor exercises

The pelvic floor muscle group is like a hammock stretched across the base of the pelvis. There are three openings in the muscle – the anus (back passage), vagina (birth canal) and urethra (bladder outlet).

Sit comfortably or lie on your side
Imagine that you are trying to stop yourself passing urine and ‘wind’, by drawing the area ‘upwards and forwards’ from bowel to bladder, then let go. Start this ‘squeezing and lifting’ movement gently at first. Next ‘squeeze and lift’ and try to hold for a few seconds (breathe normally –don’t hold your breath and ensure your buttocks and thighs are relaxed!). This is a ‘slow hold’.

Rest for a moment and then repeat four times if you can.

Now try squeezing the pelvic floor muscles quickly five times, with a little rest between each squeeze. This exercise helps your muscles react quickly when you cough or sneeze. Try five ‘slow hold’ squeezes, followed by five ‘quick’ squeezes at least four times a day. As your muscles get stronger, try holding the ‘slow’ holds for longer.

Don’t stop and start your flow of urine – this can interfere with normal bladder function.

Use the NHS-approved ‘Squeezy’ App available on all smart phones/mobile devices to help remind you to complete exercises using the exercise plan described above.

Getting back to normal

• Do your pelvic floor exercises regularly. The hardest part is remembering to do them – a good time could be every time you feed your baby or wash your hands.
• Tighten your pelvic floor when you do any activity that requires effort – e.g. cough, sneeze or lift. The reflex that makes you do this naturally can stop working after having a baby. Regular practice protects your pelvic floor and helps to train it to work automatically again.
• Avoid heavy lifting where possible – e.g. vacuuming, wet washing, car seats.
• Avoid sit ups and high impact exercise for at least 3 months after the birth – it can take the pelvic floor this long or more to return to its previous pre-natal strength.
• Drink at least 1.5 – 2 litres of fluid a day, which is about six to eight drinks. If you are breast-feeding or it is very hot you should maintain good hydration by drinking according to your thirst and ensuring that you have lightly coloured urine.
• Avoid constipation – it puts pressure on the pelvic floor.
• Once your pelvic floor muscles are back to full strength, you will need to do one set of ‘fast’ and ‘slow’ exercises every day to keep them strong. Aim for 10 fast and 10 slow holds for 10 seconds.

Are you at risk of developing pelvic floor problems?

• Did you have urinary leakage in pregnancy?
• Did you struggle with continence – bladder or bowel post-natally?
• Does/ did your mother have continence or prolapse problems?
• Did you have a large baby (over 4kgs) or an instrumental (forceps/ventouse) delivery?
• Did you have a very long or very fast ‘pushing’ (second) stage of labour?
• Do you suffer regularly from constipation?