Exercise during pregnancy strengthens the pelvic floor and decreases the need for medical intervention during delivery, a significant risk factor for prolapse and incontinence. Women should be encouraged to maintain a healthy lifestyle before, during, and after pregnancy, including avoiding smoking, proper nutrition, and maintaining a healthy weight. According to the American Congress of Obstetricians and Gynecologists (ACOG), expectant mothers should strive for at least 150 minutes of physical activity (20-30 minutes per day) throughout pregnancy (ACOG, 2020), including exercises to maintain a strong core and pelvic floor.
Pelvic floor exercises and body awareness should be incorporated into daily exercise. Kegels, the repeated contracting and relaxing of pelvic muscles, are the easiest and most effective way to prevent pelvic floor dysfunction during and after pregnancy (Neels et al., 2017). Ensuring that the exercise is done consistently and correctly and that the right muscles are involved is important. Combining Kegels with other activities or exercises makes them more likely to become a habit.
Avoiding the Valsalva maneuver and breathing steadily during physical activity can help reduce internal pressure and strain on the pelvic floor and abdominal wall. Water-based exercise is an excellent no-impact option for women experiencing pelvic or lower back pain.
After giving birth, new mothers should start slowly and see how they feel when returning to exercise. The recommendation of waiting 6-8 weeks before returning to exercise is only a general timeframe and can vary greatly depending on the situation. In the weeks postpartum, it is important to avoid exercises that require deep twisting and focus on regaining strength for basic functional movements, proper body alignment, and posture. Pushing too hard too soon can be a setback in recovery. Each person’s body and experience with pregnancy, labor, and delivery is unique, and the return to exercise should be determined by comfort level and a doctor’s clearance.
References:
American College of Obstetricians and Gynecologists. (2020). Physical activity and exercise during pregnancy and the postpartum period: ACOG committee opinion, No. 804. Obstetrics and Gynecology, 135(4), e178–e188. https://doi.org/10.1097/AOG.0000000000003772
Neels, H., De Wachter, S., Wyndaele, J., Wyndaele, M., & Vermandel, A. (2017). Does pelvic floor muscle contraction early after delivery cause perineal pain in postpartum women?. European Journal Of Obstetrics And Gynecology, 1. https://doi.org/10.1016/j.ejogrb.2016.11.009