Pregnancy & Kegel Exercises

What is a Kegel Exercise?

It is a simple exercise of the pelvic floor muscle (PFM) for the purpose of increasing muscle strength.  Your PFM supports your uterus, bladder and bowel.

Why is it Important?

During pregnancy, the PFM naturally releases some to help prepare for the delivery of the baby.  As your uterus grows, it strains the surrounding muscles and ligaments.  If your muscle is already weak, you may experience trouble with leaking urine, known as urinary incontinence (UI).  Urinary incontinence can occur during pregnancy, postpartum, and even years laters.  Kegel exercises can prevent or lessen urinary leaking, but they can do a whole lot more!  Pregnant women can benefit greatly from strong pelvic floor muscles.  A strong PFM can help make childbirth easier, specifically during the pushing stage of labor.  Kegels teach a woman how to both contract and relax their muscle.  Relaxing the PFM during childbirth as the baby moves through the birth canal can also help reduce tearing.  During postpartum, kegels can aid in circulation to the genital region which can help speed healing of episiotomies and hemorrhoids.  Kegel exercises can also help women tone up their vaginal muscles thereby making sexual intercourse more pleasurable for them as well as their partner.

How to do a Kegel Exercise?

First you need to learn to identify the PFM.  You need to draw up or squeeze the muscle around your vagina.  Do not use your inner thighs, stomach, or buttocks to help you squeeze.  Do not bear down like having a bowel movement, rather; pull up your muscle like you are trying to draw something up inside you.  Do not hold your breath.  You can identify the correct muscles by trying to stop your urine stream.  Stopping your urine midstream is only to be done to teach you to identify the correct muscles.  It is not advisable to make it a habit of performing kegels whil urinating.  Habitually interrupting your urine flow can lead to incomplete emptying of the bladder which can increase your risk of urinary tract infection.

Once you have identified the correct muscles, you will squeeze (contract) and relax your PFM several times in a row. Try to squeeze for a slow count of 5 seconds and then relax for 10 seconds.  This is one kegel.  Start by doing 3-4 kegels in a row three times/day.  Gradually increase the amount of kegels you are doing by one each week until you can do ten kegels in a row, three times a day or 30 kegels per day on most days of the week.  Women, who are more physically active such as joggers, golfers, tennis players, etc., need to gradually build up the amount of seconds they are squeezing as well.  They should build up to a ten second squeeze and ten second rest cycle as they get stronger.  More active women should also aim for 40-60 kegels most days of the week.  All women should also learn to do quick kegels most days of the week.  All women should also learn to do quick kegels by rapidly tightening and relaxing your muscles several times in a row.  Doing quick kegels or "quick flicks" can especially help women whose muscles are too weak initially to do longer contractions or to help women control strong urges to go to the bathroom so they can make it in time.

Important Considerations

Developing new muscle strength does not occur overnight, it takes time.  It may take a few weeks for your PFM to "feel stronger."  Do not get discouraged!  Do not give up!  You can do these simple exercises anywhere.  No one can see you doing them.  You can do them standing at your kitchen sink while doing dishes, or at the red light while driving, or in bed at night before going to sleep.

• Kegel exercise can prevent pelvic support problems (falling organs) or prolapses of the uterus, bladder, and bowel through the vaginal opening.  Some women have a genetic predisposition to weak connective tissues and pelvic support issues.  Kegels can help but sometimes medical intervention or surgery may be needed.  Be sure to see your doctor if you experience a feeling of pelvic heaviness or aching in the lower pelvic area, or you feel a bulge in your vaginal area.
• Increasing abdominal pressure or heavy straining such as with chronic coughing (smokers, asthma, COPD), chronic constipation, strenuous activities (gymnastics, jogging), obesity, multiple pregnancies and complicated deliveries, or heavy lifting can put women at risk for weak or damaged PFM.  This can lead to urinary incontinence and pelvic organ prolapse problems.  Kegel exercises are a must for these high risk groups.
• Learn to use your PFM in activities of daily living and it will stay strong and healthy like any other muscle.  All women should contract their PFM when they cough, sneeze, or lift heavy objects.  If, for example, you leak urine with a strong belly laugh, learn to contract your PFM when you laugh.
• During pregnancy, if you develop urinary incontinence, please let your physician know.  Sometimes UI can be a sign of infection and needs to be evaluated.

For more information, please call the Elkhart General Women's Health Center Urinary Continence Program at (574) 523-2751 or (866) 637-3863.