Mark Hibbitts. (First published in Now Magazine February 2007)

All women should perform pelvic floor exercises regularly, but it’s particularly important both during pregnancy and post pregnancy. Strong pelvic floor muscles can aid in childbirth, and also prevent or minimize embarrassing leaks when laughing, coughing, sneezing or lifting (stress incontinence is a billion dollar industry!). Pelvic floor exercises are also known as kegels, so if you've heard that name and wondered what it meant, now you know!

Your pelvic floor is made up of a sling of 3 muscles that connect the pubic bone at the front to the 'sitting bones' at the side and the tailbone at the back. This serves as a support structure for the contents of the abdomen and pelvis, including the bowel, uterus, and bladder. The extra weight of your growing baby makes these muscles work even harder and keeping them strong can help prevent incontinence and prolapse, and also aid in the birthing process. For these reasons pelvic floor exercises should be started as early as possible in the pregnancy.   

Learning to isolate and contract your pelvic floor muscles is easy. The next time you go for a wee just stop in mid flow and it will be these muscles doing the work. Aim to do it without clenching your bum if possible as this brings in another set of muscles entirely. It is important though that you don’t actually do your pelvic floor exercises whilst urinating, as this can lead to problems like bladder infections.    

Exercises

The great thing about pelvic floor exercises is that they can be done anywhere at any time, as only you know you are doing them. The difficult thing is sometimes remembering to do them. To help with this try to associate them with different activities such as ironing, cooking, driving, or even having sex. After a while you'll find yourself doing them automatically when performing these activities. They should also be performed every day, several times if possible. At first you may find it difficult and tire easily, but strength and muscle control should increase rapidly. 

Squeeze and hold 

Squeeze/contract your pelvic floor muscles and hold for a count of 5 seconds. (Aim to build this to 10 seconds over a short period of time). Relax and rest for 10 seconds. Do 10 reps, several times a day. 

Speed-ums

The pelvic floor is made up of 2 different types of muscle fibres. Some respond to quick contractions and some to slow. This exercise is for the 'quick' fibres. 

Contract and lift the pelvic floor muscles as quickly and strongly as possible and let go. Gradually increase the speed of the contraction and the number of repetitions until the muscle tires. When the muscles are fatigued wait a few seconds to recover and start again. Aim to do this 10 times and repeat several times a day.

The Lift (Elevator) 

Try and visualise your midsection as a lift, then draw your pelvic floor upwards to the first floor and hold for 3 seconds. Breathing gently but without releasing the contraction, draw upwards to the second floor and hold for a further 3 seconds, then to the third floor for 3 seconds. Release and repeat several times a day. 

Relaxing

Learning to relax your pelvic floor is very important too, so aim to relax the muscles slowly and under control during the exercises (except the speed-ums). This will help you during the birthing process. Performing these exercises whilst sitting on an exercise ball or pillow can result in a stronger contraction.

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Mark Hibbitts is a personal fitness coach specializing in pregnancy & postnatal exercise. He is director of Newborn Fitness the postnatal exercise specialists, and a full member of the guild of pregnancy and postnatal exercise teachers.