Your pelvic floor explained

Pilates is a good way of making you mindful of your pelvic floor

Crucial in so many ways, but often misunderstood. Kate Freud talks us through the key facts

Particularly after childbirth, the pelvic floor is something that most women agree weighs heavily on their conscience – it’s something we know we should be doing something about but very few of us do. And with associated problems including urinary or fecal incontinence and reduced sensitivity during sex, it’s definitely an area that deserves a little more TLC. So what is our pelvic floor, why does it get put under pressure during pregnancy and childbirth, and how can we get it back to its pre-baby best?

Well, your pelvic floor is a hammock-shaped set of muscles found between your legs that runs from your pubic bone at the front to the bottom of your spine at the back. These muscles hold all of your pelvic organs in place – the vagina, uterus, bladder and bowel – and work with the bladder in a very clever way to give you control when you go to the toilet. When your bladder tightens to pass urine, your pelvic floor muscles relax, hence why when you tighten your pelvic floor muscles you can stop your stream of urine mid-flow.

Why is it affected by pregnancy and childbirth?

During pregnancy and childbirth, and later due to ageing, the pelvic floor gets put under a tremendous amount of pressure. These muscles are like a trampoline, but when they have had a lot of weight – such as a baby – weighing down on them for a long time, the muscles and connective tissue become overstretched and weakened, and the trampoline doesn’t bounce back in the same way any more. The physical strain of childbirth itself can also damage the pelvic floor.

What are the effects of a weak pelvic floor?

Having a weak pelvic floor can lead to a variety of problems including urinary (leaking wee when you cough, sneeze, laugh or exercise) and fecal incontinence because you can no longer squeeze the muscles and the sphincters at the bottom of your bladder. This kind of stress incontinence affects up to a third of new mums. Many women also complain of finding sex less satisfying, because of less sensitivity in the vagina.

 How to do kegel exercises help? 

Though it’s recommend to do pelvic floor exercises throughout your pregnancy, it is never too late to start.

Begin by identifying the correct muscles. You can do this by stopping urination midstream. When you have found them, you can do the exercises in any position, though many women find it easiest when lying down.

Pretend you are zipping up these muscles from your bottom through to your vagina. Once you have tightened the muscles, hold the contraction for five seconds, and then release for five seconds. Try and do this five times in a row. With practice you will be able to work up to keeping the muscles contracted for 10 seconds at a time and relaxing them for 10 seconds in between your contractions.

Try to stay focused and breathe normally through each contraction of the muscles. Don’t tighten your bottom, thighs or abdomen but try to isolate the pelvic floor muscles alone. Pilates is a fantastic way of starting a good relationship with your pelvic floor as during many of the exercises you have to tighten your pelvic floor muscles, too.

Repeat these exercises three times a day, with three sets of 10 repetitions.

The good news

Though you will have to work on your pelvic floor strength for the rest of your life – problems can increase with hormonal changes after the menopause – you’ll reap the benefits. When your pelvic floor is stronger, it increases blood flow and sensitivity during sex, giving you more powerful orgasms. It will also help you avoid an extremely uncomfortable vaginal prolapse later, when the bladder, bowel or uterus can sag down outside of the vagina, sometimes requiring surgery. Put simply, it’s worth factoring these simple exercises into your daily routine, starting now.

Want more? Take a look at our guide to fitness post-baby