Pelvic Exercises for Vaginal Delivery
The pelvic floor consists of a group of muscles, ligaments, and tissues that support the bladder, uterus, and rectum. During vaginal birth, these muscles can stretch up to 3x or even tear, leading to potential long-term issues such as urinary incontinence, pelvic organ prolapse, and sexual dysfunction.
To aid recovery and restore pelvic health, pelvic floor physical therapy (PT) and exercises are critical in the postnatal period. This blog explores the importance of pelvic exercises for vaginal delivery and what you can do immediately after vaginal birth based on recommendations from a pelvic floor physical therapist.
Why Focus on Pelvic Floor Recovery?
After a vaginal birth, the pelvic floor muscles may be weakened, stretched, or damaged. These muscles, which help control urination, defecation, support the pelvic organs, and can be strained by the pressures of labor and delivery.
The pelvic floor may also experience trauma if there was perineal tearing, an episiotomy, use of forceps, or if the baby was larger in size. As a result, many new mothers experience symptoms such as:
Urinary incontinence: Leaking urine during sneezing, coughing, or physical activity.
Pelvic organ prolapse: A sensation of pelvic pressure or bulging due to organs like the bladder or uterus descending into the vaginal canal.
Pain during sex: Due to scar tissue or weakened muscles.
Low back and pelvic pain: These can persist if the pelvic floor muscles aren't functioning well.
Pelvic floor exercises, often introduced through pelvic floor physical therapy, are essential for restoring muscle strength and coordination, improving urinary and bowel control, and reducing discomfort.
The Role of Pelvic Floor Physical Therapy
Pelvic floor physical therapy focuses on rehabilitation of the pelvic floor muscles using exercises, manual therapy, and education.
The goal is to improve strength, flexibility, and coordination of these muscles to restore their pre-pregnancy function and prevent future complications. Studies from the last decade have highlighted the importance of pelvic floor PT in preventing and treating common postpartum issues.
A 2018 systematic review published in the International Urogynecology Journal found that pelvic floor exercises significantly reduced the incidence of postpartum urinary incontinence.
Another study in the American Journal of Obstetrics and Gynecology (2020) confirmed that early pelvic floor rehabilitation, especially starting in the first six weeks post-delivery, can alleviate pain and prevent long-term pelvic floor dysfunction.
Pelvic Exercises for Vaginal Birth
The timing and type of exercises you do post-birth depend on individual recovery and any complications you may have experienced during labor. It's important to consult with your healthcare provider or a pelvic floor physical therapist before beginning any exercises.
In general, pelvic floor exercises can be safely started after vaginal delivery as early as the first few days postpartum for breathing and coordination, provided there are no complications like significant tearing or infection. More intense activations can wait until a couple of weeks postpartum.
Here’s a research-based progression of pelvic floor exercises to incorporate into your postpartum recovery after a vaginal birth:
1. Pelvic Floor Breathing Exercises
Pelvic floor breathing exercises are a gentle way to start engaging the pelvic muscles without placing too much strain on your body in the early days after birth.
How to do it:
Lie on your back with your knees bent and feet flat on the floor.
Breathe in deeply through your nose, allowing your belly to expand.
As you exhale, gently draw your pelvic floor muscles upward (as though you’re trying to stop the flow of urine). Try to hold for 3-4 seconds as you exhale, then relax.
Repeat for 2-3 minutes 2x per day, focusing on deep, controlled breathing.
This exercise helps with the initial awareness and activation of the pelvic floor muscles, which can help combat any postpartum pelvic floor weakness.
2. Pelvic Floor Muscle Activation
Pelvic floor muscle activation is one of the most important exercises to help regain strength and improve bladder control after childbirth. These exercises target the pelvic floor muscles, allowing them to contract and strengthen over time.
How to do it:
Identify your pelvic floor muscles by contracting “up and in” like when trying to stop urination.
Contract these muscles as if you're stopping the flow of urine, holding the contraction while engaging the core and breathing normally.
This should be done when you are transitioning in positions, getting up and down from chair/couch, picking something off the floor, getting in and out of the car, lifting baby, etc.
Studies have shown that regular pelvic floor muscle activation can significantly improve urinary incontinence, even within the first few weeks postpartum. This exercise is also helpful for reducing the risk of pelvic organ prolapse, and it encourages proper muscle engagement to support overall pelvic health.
3. Bridges
The bridge exercise strengthens the pelvic floor as well as the glutes, hamstrings, and lower back—areas that often become weakened during pregnancy and childbirth.
How to do it:
Lie on your back with your knees bent and feet flat on the floor, hip-width apart.
Tighten your abdominal muscles and gently squeeze your pelvic floor muscles.
As you exhale, lift your hips towards the ceiling while keeping your shoulders and feet on the ground.
Hold for a few seconds before slowly lowering your hips back to the floor.
Repeat 3 sets of 10-12 times, focusing on pelvic floor engagement throughout.
This exercise also helps to activate the deep core muscles, which can aid in postpartum recovery.
4. Pelvic Tilts
Pelvic tilts can be helpful for strengthening the pelvic floor and abdominal muscles, and they also improve spinal mobility.
How to do it:
Lie on your back with your knees bent and feet flat on the floor.
Tighten your lower abdominal muscles, and slowly tilt your pelvis upward so your lower back flattens against the floor.
Hold the position for a few seconds and then relax.
Repeat for 10-15 reps, focusing on gently engaging the pelvic floor as you tilt your pelvis.
This movement can help restore balance to the pelvis and encourage optimal positioning of the pelvic floor muscles.
5. Core Strengthening (Modified Planks)
Once you feel ready and your pelvic floor is recovering, you can begin to strengthen your core muscles. A strong core will support pelvic floor health.
How to do it:
Start in a modified plank position (on your knees rather than your toes and on an elevated surface).
Engage your pelvic floor and abdominal muscles as you hold the position for 10-20 seconds.
Gradually increase the duration as your strength improves.
Repeat 5-10 times.
Keep an eye out for any coning or doming
This exercise supports both your pelvic floor and your overall body posture.
When to Seek Professional Help
While pelvic floor exercises are essential for postpartum recovery, some women may experience complications that make self-directed exercise difficult. If you experience any of the following, it’s important to consult with a pelvic floor physical therapist or healthcare provider:
Inability to control urine or feces, or a constant feeling of urgency.
Difficulty performing pelvic floor exercises or a sense of pelvic heaviness or bulging.
Persistent pain during sex or difficulty achieving orgasm.
Pain or discomfort that doesn’t improve after a few weeks.
A pelvic floor therapist can assess your individual needs and tailor an exercise program to address your specific symptoms and recovery goals.
Conclusion
Pelvic floor recovery is a critical aspect of postnatal care. By engaging in pelvic floor exercises, new mothers can experience a quicker recovery, better bladder control, and a reduced risk of long-term pelvic dysfunction.
Early intervention with pelvic floor physical therapy, starting within the first few days after vaginal birth, is an effective strategy to restore strength and prevent complications. By incorporating simple and research-supported exercises, mothers can take charge of their pelvic health and enjoy a smoother recovery as they transition into motherhood.
If you're postpartum, always consult with your healthcare provider or a certified pelvic floor therapist before starting any exercise regimen to ensure your approach is safe and effective for your individual recovery needs.
Looking for pelvic floor physical therapy in Jacksonville Beach, FL?
If you’re looking for personalized, one-on-one sessions to address your postpartum pelvic health concerns or you are looking to get back into workouts after having a baby and don’t know where to start, we provide pelvic health physical therapy services to women in the Jacksonville Beach area.
If you’re looking for providers who will listen to you and help you get to the root cause of your pelvic concerns, we’ve got you. We’re here to help you if you’re experiencing pelvic pain, pelvic heaviness, leaking, or are pregnant/postpartum and want to continue safely working out/running/lifting during your pregnancy and get back to your sport after birth.
Get started today by booking a discovery call.