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Pelvic Floor Exercises

Safe Pelvic Floor Exercises for Every Stage of Pregnancy

Last updated: | Medically reviewed by Dr. Evelyn Reed, DPT, WCS

Key Takeaways

  • In pregnancy, the goal is both support and suppleness—train a gentle lift and a complete let-go with each breath.
  • Use diaphragmatic breathing: inhale to lengthen and soften; exhale to gently lift. This protects your core and pelvic floor as your baby grows.
  • Build confidence for birth with pressure management, perineal preparation, and functional strategies you’ll carry into postpartum recovery.

Your Pregnancy Pelvic Floor: Support + Suppleness

A growing baby changes pressure, posture, and mobility throughout your core canister (diaphragm as the “lid,” deep abdominals as the “walls,” pelvic floor as the “base”). Your training focus during pregnancy is balanced:

  • Support: Enough endurance to manage daily pressures (standing, walking, lifting).
  • Suppleness: The ability to fully let go and lengthen to accommodate growth and prepare for birth.

For the big picture (anatomy, progressions, and how this fits postpartum), start with our pillar: The Ultimate Guide to Pelvic Floor Exercises.


The Core Breath You’ll Use All Pregnancy (and Beyond)

  • Inhale: Ribs expand 360°, belly softens, pelvic floor releases/lengthens (visualize sit-bone-to-sit-bone widening).
  • Exhale: Gentle narrowing of your lower belly; pelvic floor lifts and recoils.
    Keep intensity light (about 20–40% effort). This is about coordination and comfort, not max strength.

Deep dive on the mechanics: Breathing for Pelvic Floor Exercises and technique basics in How to Do Kegels Correctly.


Trimester-by-Trimester Guide

First Trimester (Weeks 1–12): Lay the Foundation

Goals: Learn the pattern; reduce nausea/fatigue strain; prevent breath-holding habits.

Session (8–10 minutes):

  1. Breath prep (2 min): Crook lying or side lying; feel ribs widen on inhale, soften the pelvic floor.
  2. Gentle holds: Exhale + light lift 3–5s; inhale + complete release 8–10s. 10 reps.
  3. Quick reflexes: 1-second lift, 1-second release, 1–2 sets of 10 (only if comfortable).
  4. Relaxation minute: Long, easy inhales; visualize the pelvic floor melting downward.

Daily life anchors: Exhale + light lift when rising from a chair or lifting small items; avoid prolonged breath holds for nausea.

Second Trimester (Weeks 13–27): Endurance + Functional Support

Goals: Build gentle endurance, reinforce pressure management in movement.

Session (10–12 minutes):

  1. Breath prep (1–2 min).
  2. Endurance holds: Exhale + light lift 8–10s; inhale + release 8–10s. 10 reps.
  3. Quick flicks: 2 sets of 10 if symptom-free.
  4. Functional integration:
    • Sit-to-stand, squats to chair, supported lunges: inhale on the way down; exhale + lift to stand/return.
    • Carry strategy: Before lifting a bag or toddler: exhale + light lift, keep ribs soft (no bracing).

Modifications: Use pillows for side-lying comfort, widen stance to reduce pelvic girdle discomfort, keep moves symmetrical if SPD/PGP is present.

Third Trimester (Weeks 28–Birth): Suppleness + Birth Prep

Goals: Maintain light endurance, prioritize lengthening, practice birth pressure strategies, and perineal preparation (if cleared).

Session (10–14 minutes):

  1. Down-training (2–3 min): Child’s pose, supported deep squat (heels elevated), or side-lying rib breathing.
  2. Gentle holds: If comfortable, 3–5s light lifts with 10s full releases, 6–8 reps total—quality over quantity.
  3. Birth breath practice:
    • Open-glottis exhale: Think long sighs, jaw relaxed, pelvic floor soft and lengthened as you bear down when instructed in labor.
    • Practice release on inhale, then maintain softness as if pressure moves through a relaxed pelvic floor, not against a rigid one.
  4. Perineal prep (from ~34–35 weeks, if cleared):
    • Clean hands, comfortable position, gentle warm oil/lube.
    • Apply light pressure downward and outward to practice the sensations of stretch and conscious relaxation.
    • Stop if pain, burning, or bleeding—discuss with your clinician.

Everyday tips: Avoid straining on the toilet; try a footstool to relax the pelvic floor; keep breath flowing during household tasks.


If You Have SPD/PGP (Pelvic Girdle Pain)

  • Favor symmetrical positions (sit-to-stand with feet hip-width, supported squats).
  • Shorter step lengths, avoid heavy single-leg tasks if painful.
  • Breath-led releases to reduce protective gripping.
  • Consider a pelvic health PT for belt/bracing guidance and targeted stability drills.

For additional symptom-aware strategies after birth, see Postpartum Pelvic Floor Exercises.


Safe Exercise Menu (Use What Feels Good)

  • Breath + PF coordination: Always your base layer.
  • Gentle endurance holds: 3–5s in T1; 8–10s in T2; light 3–5s in late T3 as tolerated.
  • Quick flicks: If comfortable (skip with pain, heaviness, contractions).
  • Glute bridge (supported), seated ball squeeze/release (very light), side-lying clams (pain-free ranges).
  • Mobility/down-training: Happy baby (supported), side-lying thoracic opener, child’s pose with pillows, pelvic circles on a birth ball.

When in doubt, make it easier, breathe slower, and aim for comfort over intensity.


Birth Preparation: What Actually Carries Over

  • Pressure strategy: Practice not holding your breath for daily exertions. In late pregnancy, rehearse long, open-glottis exhales to guide pressure down and out with a soft, lengthened pelvic floor.
  • Body positions: Explore sidelying, hands-and-knees, supported deep squat, and forward-leaning positions; note which help you feel relaxed and open.
  • Partner cues: “Relax your jaw,” “long exhale,” “soften your pelvic floor,” “melt around the pressure.”
  • After birth: Return to basics—breath, gentle reconnection—then follow a graded plan: Postpartum Pelvic Floor Exercises.

When to Modify or Pause

  • Contractions that increase with training
  • Vaginal bleeding, fluid leakage, or concerning symptoms—contact your clinician
  • New heaviness, bulging, or urinary retention
  • Pelvic pain that worsens with Kegels—switch to down-training only and seek PT input

Your Pregnancy-Safe Weekly Rhythm (Template)

  • Most days (8–12 minutes):
    • 2–3 minutes rib breathing + pelvic floor release
    • 6–8 minutes gentle holds with full releases (volume adjusts by trimester)
    • 1–2 minutes down-training to finish
  • Sprinkle in functional reps during daily tasks (exhale + light lift to stand, carry, or climb).
  • Late pregnancy (T3): shift to more release and birth breath practice; reduce holds if fatiguing.

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Frequently Asked Questions

Are Kegels safe during pregnancy?

Yes for most people, especially when paired with full relaxation and breath coordination. If you have pelvic pain, overactivity, or feel tightening worsens symptoms, focus on down-training and consult a pelvic health PT.

How often should I do pelvic floor exercises while pregnant?

Most days works well. Short daily sessions (8–12 minutes) focusing on quality, plus breath-led relaxation, are more effective than occasional long sessions.

Should I stop at any point?

Pause if you notice pain, new heaviness/bulging, or urinary retention. After your clinician clears you, continue with gentle breath and reconnection work.

Do I need to push during birth with Kegels?

Pelvic floor training is about control: **contract, relax, and lengthen on command**. During second stage, the ability to release and lengthen is key. Your breathing and pressure strategies matter more than maximal ‘squeezing’ strength.

Is perineal massage helpful?

From around 34–35 weeks (if cleared), perineal massage can help you practice sensation, relaxation, and stretch tolerance. Follow hygiene and comfort guidance.

What if I have SPD/PGP (pelvic girdle pain)?

Use pain-free ranges, symmetrical positions, and breath-led releases. Prioritize stability exercises and modify single-leg tasks. Consider a pelvic health PT.

Keep Reading

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Medical Disclaimer: The information in this article is for educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.