Pelvic Floor Exercises During Pregnancy: When to Start and How

Pelvic floor exercises during pregnancy are recommended to everyone and explained to almost nobody. This guide covers when to start, how to do them properly, how they change by trimester, and why they matter as much for recovery afterwards as for the pregnancy itself. Written for UK readers at any stage of pregnancy.

TL;DR

• Start as soon as you know, or before conceiving if you are planning.
• Antenatal pelvic floor training reduces the likelihood of leaking in late pregnancy and afterwards.
• Three sets a day: up to ten slow holds and up to ten quick squeezes.
• Learn to release fully as well as squeeze. Birth needs both.
• Lie on your side rather than flat on your back after the first trimester.
• Leaking in pregnancy is common but it is not something you have to accept.

Why they matter more than they sound

Pregnancy loads the pelvic floor for nine months regardless of how the baby is eventually born. A growing uterus presses down on it continuously, and hormonal changes soften the connective tissue supporting it. That combination is why leaking is so common in the third trimester.

Training the muscle through pregnancy does two things. It reduces the likelihood of leaking during pregnancy and in the months after birth, and it means you go into recovery with a muscle you can already find and control, which makes postnatal rehabilitation considerably easier. NHS guidance on exercise in pregnancy includes pelvic floor work for exactly this reason.

How to do pelvic floor exercises during pregnancy

Sit or lie comfortably with your thighs, buttocks and stomach relaxed.

• Squeeze as though stopping yourself passing wind and stopping the flow of urine at the same time.
• The sensation is a lift inwards and upwards, not a push down.
• Your stomach stays soft, your buttocks stay still, your breathing carries on normally.
• Release completely between repetitions.

Slow holds: hold for as long as you can cleanly, building towards ten seconds, rest for the same length, up to ten repetitions.

Quick squeezes: squeeze and release fast, up to ten repetitions. These handle coughs and sneezes, which is where most leaking happens.

How often: three sets a day. Attach them to things you already do rather than relying on memory. Our kegel technique guide covers the detail if you are unsure whether you have found the right muscle.

By trimester

First trimester

Start now. Any position works, including lying flat. This is the easiest stage to learn the technique properly, because the muscle is not yet under much extra load and you can feel it more clearly. If you are exhausted and nauseous, one set a day is better than none.

Second trimester

Stop lying flat on your back for extended periods, as the weight of the uterus can press on a major blood vessel. Do the exercises sitting, standing, or lying on your side instead. Expect holds to feel harder than they did, which is the increasing load rather than a loss of progress.

Third trimester

Keep going, and expect the numbers to drop. Shorter holds are normal. Sitting and side-lying are the most comfortable positions for most people.

This is also the stage to practise the other half: letting go. Being able to fully release the pelvic floor is useful for birth, and many people have only ever practised the squeeze. Spend a couple of minutes on slow breathing, imagining the pelvic floor softening and widening on each inhale, alongside the strengthening. Our guide to releasing a tight pelvic floor covers that breathing pattern.

What else helps

• Stay generally active. Walking and swimming are well tolerated by most people through pregnancy.
• Avoid constipation. Straining loads the pelvic floor repeatedly, and constipation is common in pregnancy. Fibre, fluid and a footstool.
• Exhale when you lift. Including getting out of a chair or lifting a toddler.
• Use the knack. Squeeze deliberately just before you cough or sneeze. It often reduces leaking straight away.
• Gentle glute and hip work. Ball squeezes and small-range bridges support the pelvis, which matters if you have pelvic girdle pain.

A small soft ball is the most useful piece of kit at this stage, for gentle inner-thigh work and as back support when sitting. Our Pilates ball is £5.99, and if you want a full-size ball to sit on, our guide to using a Pilates ball as a birth ball covers sizing.

Shop the Pilates Ball

For after the birth, the Postnatal Recovery Kit at £14.99 covers the gentle rebuilding kit, though none of it should be used until you have been cleared at your postnatal check.

When to speak to someone

Tell your midwife or GP if you are leaking, if you feel heaviness or a dragging sensation, or if you cannot feel a contraction at all. Referral to a women's health physiotherapist is available during pregnancy and does not need to wait until afterwards. The Pelvic, Obstetric and Gynaecological Physiotherapy network and the Chartered Society of Physiotherapy list specialists.

FAQs

When should I start pelvic floor exercises in pregnancy?

As soon as you know you are pregnant, or before conceiving if you are planning. Starting early means you learn the technique while the muscle is easier to feel, and antenatal training reduces the likelihood of leaking later in pregnancy and after the birth.

How many pelvic floor exercises should I do while pregnant?

Three sets a day, each up to ten slow holds and up to ten quick squeezes. Expect to manage fewer and shorter holds as pregnancy progresses, which is the increasing load rather than lost progress. Consistency matters more than the numbers.

Can pelvic floor exercises help with birth?

Being able to fully relax the pelvic floor is useful during birth, and knowing how to find and control the muscle helps with recovery afterwards. Practise releasing as well as squeezing, particularly in the third trimester, since most people only ever practise the contraction.

Is it safe to do pelvic floor exercises lying down when pregnant?

In the first trimester, yes. After that, avoid lying flat on your back for extended periods, because the weight of the uterus can press on a major blood vessel. Do them sitting, standing or lying on your side instead, which works just as well.

Is leaking during pregnancy normal?

It is very common, particularly in the third trimester, but common is not the same as something you have to put up with. Pelvic floor training helps in most cases, and if it is affecting daily life, ask your midwife or GP for a referral rather than waiting until after the birth.

Do I still need pelvic floor exercises if I am having a caesarean?

Yes. Pregnancy loads the pelvic floor for nine months regardless of how the baby is born, so the muscle needs the same training. People who have had a caesarean can still experience leaking and heaviness afterwards, and antenatal training helps either way.

Conclusion

Start early, do three sets a day, practise releasing as well as squeezing, and change position as pregnancy progresses. The muscle you train now is the one you will be rebuilding afterwards, and going in able to find it makes that considerably easier.

A Pilates ball at £5.99 is the most useful thing to have during pregnancy, and the Postnatal Recovery Kit covers the rebuilding stage once you have been cleared.