Pelvic floor exercises

As soon as possible after your baby's birth, start these exercises, even if you have stitches. Gentle rhythmic tightening and relaxing of the muscles will help healing, ease pain and swelling, and strengthen the pelvic floor muscles.

They can be done lying, sitting or standing. If you are sore after delivery, start by trying to do the exercises in the bath where you will feel more relaxed.

Pelvic floor diagram

The pelvic floor muscles are at the bottom of your pelvis, supporting your pelvic organs. They will have been stretched in pregnancy and during vaginal deliveries, so it is important to perform pelvic floor exercises to improve muscle strength.

If you have a catheter, it may be more comfortable to wait until it is removed and you are passing urine normally before starting pelvic floor exercises.

How to do the exercises

Tighten the muscles around the back passage and draw them up, as if trying to stop passing wind. At the same time tighten the muscles around the front passage and draw them up as if trying to stop passing water. As you squeeze and lift the pelvic floor muscles keep the buttocks and tummy muscles relaxed and do not hold your breath.

Exercise 1: Hold the squeeze for a few seconds, then relax for a few seconds. Gradually increase the hold time and the number that you do until you can hold the squeeze for up to 10 seconds and repeat 10 times.

Exercise 2: Tighten the pelvic floor muscles quickly and strongly, then relax quickly (twitching action). Do this up to 10 times each session.

Practice these exercises at least three or four times a day. To maintain improved performance throughout life, continue to exercise regularly.

Try the exercises in different positions and find ways of reminding yourself to do the exercises; for example:

When you sit down to feed your baby
When you are washing up
When you watch television
When you are resting

Remember these exercises will help prevent:

Stress incontinence, which is an embarrassing leakage of urine when laughing, coughing, running or doing star jumps at aerobics!!

Prolapse or ‘dropping down’ of the pelvic organs into the vagina

Pelvic floor exercises will also improve lovemaking by toning up the vaginal muscles.

It can take several months for the pelvic floor muscles to return to their previous strength, so don't be discouraged.

Exercises to help you relax, improve your circulation and tone up your tummy muscles

Day 1

Being mobile is good for you. Get out of bed and sit in a chair or walk around as soon as possible, unless you are advised otherwise.

Exercise 3 - Deep breathing

Lie with your knees bent or sit upright and place your hands on your tummy. Take a deep breath in through your nose and sigh out through your mouth. As you breathe in, tummy rises; as you sigh out, tummy sinks down. Repeat four times.

This exercise will also help you relax.

Exercise 4 - Foot exercises

Lying with your knees straight or sitting out in the chair, move your feet and ankles briskly towards and away from you. Circle your feet around in one direction and then the other. Repeat 10 times every hour.

This exercise improves the circulation in your legs and helps to reduce swelling in the feet and ankles.

If your ankles are swollen, put your feet up with your knees supported.

Avoid crossing your legs or ankles or standing still for long periods.

Exercise 5 - Abdominal muscle exercise

The abdominal (tummy) muscles form a natural corset supporting your back and internal organs. These muscles have been stretched and weakened during your pregnancy. The following exercises will help to strengthen them, regain your body shape and prevent or relieve backache.

Lying with your knees bent and hands below your tummy button, breathe in through your nose and, as you breathe out, pull your lower tummy gently away from your hand towards your back. As you feel the muscles tighten try to hold for the count of three and then relax. Breathe in and out normally.

This exercise can also be done sitting.

Practice these exercises three times a day or as often as you can. You will gradually be able to hold for longer until you reach 10 seconds and can repeat 10 times.

Remember to do the pelvic floor exercises as explained above!

Useful resting position

It is important to get sufficient rest after having a baby. Try to relax and, if possible, sleep when your baby sleeps.

Lie on your side and make yourself comfortable by placing pillows under your head and abdomen, and between your legs.

Days 2 Onwards - additional exercises

If you notice any bulging of your abdominal muscles whilst doing any of the following, stop and seek advice from the ward staff. Wait until you are stronger to progress.

Start all exercises by lying with your head on a pillow, knees bent and a shoulder-width apart, and feet flat on the bed.

Exercise 6 - Pelvic tilting

Place your hands in the hollow of your back. Tighten your tummy muscles (Exercise 5), flatten your lower back onto your hands and tilt your bottom. Breathe normally. Hold for three seconds and release gently. Repeat three times.

This exercise gently strengthens tummy muscles.

Exercise 7 - Combined pelvic tilting and pelvic floor exercise

Tighten your tummy muscles, pull up your pelvic floor and repeat the above exercise.
These exercises can be done lying, sitting or standing.
Progress to repeating up to 10 times, three times a day.

Exercise 8 – Knee rolling

Tighten your tummy muscles (Exercise 5) and gently lower both knees to one side as far as comfortable. Bring them back to the middle and relax. Repeat to the other side.

knee rolling

Do this three times each side if you can. Repeat three times a day.

If you have had a Caesarean operation you will progress more slowly - see separate leaflet.

Exercise 9 - Abdominal exercise and head lift

Do not do this exercise if you have neck pain.

Lie with your head on two pillows. Tighten your tummy muscles (Exercise 5) and pull up your pelvic floor muscles. Slowly raise your head and shoulders a little way off the pillows. Hold for three seconds, then gently lower and relax. Repeat five times if you can.

Progress by removing one pillow and then gradually increase up to 10 repetitions, three times a day.

Look after your back

A good posture is important in lying, sitting, standing or walking. It may improve the way you feel, and help to prevent aches and pains.

Your pelvic joints can take between three and six months to return to normal, and possibly longer if breastfeeding. You can easily strain your back during this time, so take care with posture and exercise. Begin with gentle exercise, build up your fitness and do not start too soon with high-impact activity, such as aerobics classes.

Back pain is often caused by slouching when feeding your baby and stooping when changing your baby's nappy. Remember to maintain an upright posture.

Lifting

Try to avoid or minimize any heavy lifting in the first few weeks.

Try to tighten your pelvic floor and tummy muscles and to breathe out as you lift.

Remember to keep your back straight and your knees bent when lifting.

Never attempt double leg lifts as this exercise puts too much strain on your tummy and pelvic floor muscles and could injure your back.