Pelvic Floor Exercises During Pregnancy

Pelvic floor exercises are one of those things almost every pregnant woman is told to do and relatively few do consistently. The advice arrives early, usually without much explanation of why it matters or how to do it correctly, and it tends to get deprioritised behind everything else pregnancy demands.

The reality is that pelvic floor exercises take less than five minutes a day, can be done anywhere, require no equipment, and make a measurable difference to birth outcomes, recovery, and long-term continence. They are one of the highest-return habits you can build during pregnancy. Here's what you need to know to actually do them.

What the pelvic floor is and what it does

The pelvic floor is a group of muscles and connective tissue that forms the base of the pelvis, stretching like a hammock between your pubic bone at the front and your tailbone at the back. These muscles support your bladder, bowel, and uterus, control the openings of the urethra, vagina, and anus, and play a role in sexual function and core stability.

During pregnancy, the pelvic floor is under sustained increased load. The growing weight of your baby, uterus, placenta, and amniotic fluid places downward pressure on these muscles for months. The hormone relaxin, which loosens ligaments and joints in preparation for birth, also affects the connective tissue of the pelvic floor, reducing its natural tension. By the third trimester, the pelvic floor of most women is working considerably harder than it was before pregnancy.

During a vaginal birth, the pelvic floor stretches significantly to allow your baby to pass through. The degree to which it recovers after birth is influenced by its strength and flexibility beforehand — which is why exercising it during pregnancy rather than waiting until after birth matters.

Why pelvic floor exercises during pregnancy matter

Stress urinary incontinence — leaking urine when you cough, sneeze, laugh, or exercise — affects a significant proportion of pregnant and postpartum women. It is not an inevitable consequence of pregnancy or birth. A strong, well-conditioned pelvic floor significantly reduces the likelihood of developing it during pregnancy and speeds recovery if it occurs postpartum.

Birth outcomes. Research supports pelvic floor muscle training during pregnancy as contributing to shorter active pushing phases in labour and reduced rates of perineal tearing. A pelvic floor that is both strong and flexible — able to contract effectively and also relax and lengthen — is better equipped to work with the birth process rather than against it.

Postpartum recovery. Pelvic floor rehabilitation after birth is considerably easier when the muscles have been regularly exercised during pregnancy. Women who have built a consistent pelvic floor habit before birth typically find it easier to reconnect with and rebuild those muscles in the postpartum period.

Prolapse prevention. Pelvic organ prolapse — where the bladder, bowel, or uterus descends into or outside the vaginal canal — is a long-term consequence of pelvic floor weakness that affects a significant number of women who have given birth. Building pelvic floor strength during and after pregnancy is one of the most effective preventive measures available.

How to find your pelvic floor muscles

Before you can exercise your pelvic floor, you need to be confident you're contracting the right muscles. This is where most women go wrong — either contracting the wrong muscles, bearing down instead of lifting, or holding their breath.

The most reliable way to find your pelvic floor is to imagine you are trying to stop the flow of urine midstream, or trying to prevent passing wind. The sensation is an internal lift and squeeze rather than a visible movement. Your buttocks, thighs, and abdominal muscles should remain relaxed throughout. If you're tensing those areas, you're recruiting the wrong muscles.

Breathing normally throughout each exercise is important. Holding your breath increases intra-abdominal pressure, which works against the pelvic floor lift rather than supporting it.

If you're unsure whether you're finding the right muscles, or if you have any pelvic floor symptoms including leaking, heaviness, or pelvic pain, a women's health physiotherapist can assess your pelvic floor directly and give you personalised guidance. This is worth doing at any point during pregnancy and is covered by Medicare with a GP referral in many circumstances.

The two types of pelvic floor exercise

Effective pelvic floor training involves two distinct types of contraction, both of which serve different functions.

Slow, sustained contractions build endurance — the ability of the pelvic floor to maintain support over time. These are the contractions that matter most for preventing leakage with everyday activities and for supporting the downward pressure of pregnancy.

To perform a slow contraction: lift and squeeze your pelvic floor, hold for up to ten seconds while breathing normally, then release fully and rest for the same amount of time before repeating. Work up to ten repetitions per set. If you can't hold for ten seconds initially, hold for as long as you can and gradually build up over weeks.

Quick contractions build the fast-twitch muscle response that responds to sudden increases in abdominal pressure — the kind that happens when you cough, sneeze, or laugh. These are shorter, sharper lifts and releases rather than sustained holds.

To perform a quick contraction: lift your pelvic floor quickly and firmly, hold for one second, then release fully. The release is as important as the contraction — a pelvic floor that can't fully relax is as problematic as one that can't contract. Aim for ten quick contractions per set.

How often and when

The Continence Foundation of Australia recommends doing pelvic floor exercises three times per day during pregnancy. Each session should include both slow and quick contractions, taking around three to five minutes in total.

The most effective strategy is habit stacking — attaching your pelvic floor exercises to something you already do consistently. Common triggers that work well include every time you sit down to eat, every time you brush your teeth, and every time you stop at a red light. The exercises are invisible, silent, and require no equipment, which means they can be done anywhere.

Consistency over weeks and months is what produces results. A perfect session done occasionally is less effective than a modest session done every day.

One important note on relaxing as well as contracting

A common misconception is that pelvic floor training is only about strengthening. For birth in particular, the ability of the pelvic floor to relax and lengthen is just as important as its ability to contract. A pelvic floor that is too tight or that cannot fully release creates its own set of problems, including increased perineal tearing during birth and difficulty with penetration and tampon use.

If you notice that you find the release phase of exercises difficult, or if you experience any pelvic pain, tailbone pain, or discomfort during intercourse during pregnancy, mention this to your midwife or GP and ask for a referral to a women's health physiotherapist. Pelvic floor tension is treatable and getting it assessed before birth rather than after is considerably more useful.

Pelvic floor exercises after birth

The postpartum period is when pelvic floor rehabilitation becomes critical. Regardless of whether you had a vaginal birth or caesarean, your pelvic floor needs attention after birth. For caesarean births, the months of pregnancy load still affect the pelvic floor even without a vaginal delivery.

Begin gentle pelvic floor contractions as soon as you feel comfortable after birth — even the first day if possible. Start with short, gentle contractions rather than attempting sustained holds immediately. Gradually build back toward your pregnancy routine over the following weeks.

A postnatal check with a women's health physiotherapist at around six weeks after birth is one of the most useful investments you can make in your long-term pelvic health. Many women are cleared for exercise at their six-week GP check without their pelvic floor being specifically assessed — a physiotherapist provides a more detailed evaluation and a personalised return-to-exercise plan.